Date of Conferral

2021

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Robin Sneed

Abstract

Since the Health Information Technology for Economic and Clinical Health Act was enacted in 2009, a majority of U.S. hospitals have adopted electronic health records (EHR) to improve quality of care. However, variations exist in the technology's capability and maturity, making it difficult for researchers to analyze the full impact. The purpose of this quantitative study was to explore the relationship between hospitals' EHR maturity and the quality measure of excess readmissions, as well as the relationship between hospital characteristics, specifically, hospital location and the number of licensed beds in Medicare hospitals (N = 1,006). Both the chi-square statistical test and logistic regression models were used to analyze whether EHR maturity has an impact on excess readmissions. Rogers's diffusion of innovation provided the theoretical framework. A retrospective data analysis for FY 2017 was conducted using EHR adoption analytics from the Healthcare Information and Management Systems Society and excess readmission ratio (ERR) data from the Centers for Medicare and Medicaid Services’ Hospital Readmissions Reduction Program. Analyses indicated no significant association between EHR maturity and ERR for either coronary artery bypass grafts or total hip or total knee arthroplasty (THA/TKA). However, there was a significant relationship between hospitals' EHR maturity, location, and number of licensed beds. In addition, EHR maturity and hospitals' location were significant predictors of elective primary THA/TKA ERR. The results of this study may lead to positive social change by informing hospital administrators on the impact of investments in mature EHR technology to reduce excess readmissions and improve quality of care.

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