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The impact of health information technology on inpatient medical errors in US hospitals

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TitleInfo
Title
The impact of health information technology on inpatient medical errors in US hospitals
Name (type = personal)
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Ramey
NamePart (type = given)
Nadia
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Nadia Ramey
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author
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Syed
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Syed Haque
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Advisory Committee
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chair
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Srinivasan
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Shankar
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Shankar Srinivasan
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Advisory Committee
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internal member
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Coffman
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Frederick
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Frederick Coffman
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Advisory Committee
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internal member
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Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
School of Health Professions
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school
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Text
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theses
OriginInfo
DateCreated (encoding = w3cdtf); (qualifier = exact)
2015
DateOther (qualifier = exact); (type = degree)
2015-10
CopyrightDate (encoding = w3cdtf); (qualifier = exact)
2015
Place
PlaceTerm (type = code)
xx
Language
LanguageTerm (authority = ISO639-2b); (type = code)
eng
Abstract (type = abstract)
Background In today’s complex and high risk healthcare environment the race to implement health information technology (health IT) in the care delivery system is becoming more prevalent in United States hospitals but the science to support its safe and effective use is contradictory at best. Since the 1999 Institute of Medicine Report, To Err is Human, Building a Safer Health System; there has been an increasingly intensive focus on the prevention of medical errors and the improvement of hospital safety and quality. In more recent years information technology has been identified as having the potential to reduce and prevent a wide range of issues, including medical errors, thus increasing patient safety, improving the quality of care, and reducing costs. Many hospitals and provides have integrated health IT into the patient care process, usually in the form of decision support systems, electronic health records, provider order entry systems, and the like. However, not all providers, clinicians, and researchers are in agreement on the impact these computerized systems have on safety, quality, and patient outcomes. With contradicting results in the literature and gaps in the evidence of the safe and effective use of health IT there is much to be learned in this area. This research project aims to quantify the impact of health IT on hospitals in the United States by investigating inpatient medical claims data, specifically medical errors and mortality rates and how they are impacted by health IT implementation data. The stage of health IT implementation from year to year will be evaluated for its impact on the number of medical errors and mortality rates. Methods To address the study objectives data from two datasets, the HIMSS Analytics datasets, provided by the Healthcare Information Management and Systems Society (HIMSS) and the Healthcare Cost and Utilization Project’s (HCUP) National Inpatient Sample (NIS) datasets provided by the Agency for Healthcare Research and Quality (AHRQ), were aggregated to form the analysis dataset. To accurately match the hospitals in each dataset the hospital’s Medicare ID code was used. Once the datasets were matched, the study outcomes, number of medical errors and mortality rates, were drawn from the HCUP data and the health IT stages was derived from the HIMSS data. The International Classification of Disease version 9 (ICD-9) codes were used to identify medical errors from the HCUP data. To address the primary and secondary objectives, both SAS and SPSS were utilized for data manipulation, data cleaning, and analysis. As part of the analysis descriptive statistics on hospital characteristics were assessed to determine the characteristics of hospitals at different stages of health IT implementation. Additionally, analysis of variance (ANOVA) was performed to determine the effects of health IT on medical errors and mortality rates. Finally multiple regression analysis was performed to determine if health IT stage is a predictor of medical errors and mortality rates. Results More than 530 hospitals were assessed for each of the four study years (2008, 2009, 2010, and 2011). Overall, US hospitals in three of the four years assessed support a significant difference in the mean number of medical errors between health IT stages within each year and for mortality rates all four years demonstrated the a significant amount of the variation in the model could be explained by health IT stage. Additionally, it was demonstrated that Stage 7 and Stage 0 were significantly different indicating that health IT stage can be a predictor for medical errors and mortality rates in three of the four years assessed. Conclusion This study demonstrates that there is an affect on quality of care, measured by medical errors and mortality rates, as it relates to the implementation of health IT. While the results are able to demonstrate this relationship between stages of health IT, further research is needed to assess health IT’s affects on hospital outcomes in greater detail. Additionally, the hospital characteristics associated with hospitals at various levels of health IT provides insight into the available resources for implementation of technology in the clinical setting.
Subject (authority = RUETD)
Topic
Biomedical Informatics
Subject (authority = ETD-LCSH)
Topic
Medical informatics
Subject (authority = ETD-LCSH)
Topic
Medical errors
Subject (authority = ETD-LCSH)
Topic
Patients--Safety measures
RelatedItem (type = host)
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Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
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TitleInfo
Title
School of Health Related Professions ETD Collection
Identifier (type = local)
rucore10007400001
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ETD_6720
Identifier (type = doi)
doi:10.7282/T3VT1V2R
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electronic resource
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application/pdf
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text/xml
Extent
1 online resource (xii, 193 p. : ill.)
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = statement of responsibility)
by Nadia Ramey
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
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Rights

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The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Ramey
GivenName
Nadia
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Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2015-09-10 00:32:03
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Name
Nadia Ramey
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Copyright holder
Affiliation
Rutgers University. School of Health Related Professions
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
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Copyright protected
Availability
Status
Open
Reason
Permission or license
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windows xp
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