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Hospital characteristics associated with highly automated and usable clinical information systems in Texas, United States.

Amarasingham R, Diener-West M, Plantinga L, Cunningham AC, Gaskin DJ, Powe NR - BMC Med Inform Decis Mak (2008)

Bottom Line: Teaching hospitals, hospitals with higher IT operating expenses (>$1 million annually), IT capital expenses (>$75,000 annually) and hospitals with larger IT staff (> or = 10 full-time staff) had higher automation scores than hospitals that did not meet these criteria (p < 0.05 in all cases).There were few significant associations between the hospital characteristics tested in this study and usability scores.Academic affiliation and larger IT operating, capital, and staff budgets are associated with more highly automated clinical information systems.

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Affiliation: Department of Medicine, UT Southwestern Medical Center and Parkland Health & Hospital System, Dallas, USA. ramara@parknet.pmh.org

ABSTRACT

Background: A hospital's clinical information system may require a specific environment in which to flourish. This environment is not yet well defined. We examined whether specific hospital characteristics are associated with highly automated and usable clinical information systems.

Methods: This was a cross-sectional survey of 125 urban hospitals in Texas, United States using the Clinical Information Technology Assessment Tool (CITAT), which measures a hospital's level of automation based on physician interactions with the information system. Physician responses were used to calculate a series of CITAT scores: automation and usability scores, four automation sub-domain scores, and an overall clinical information technology (CIT) score. A multivariable regression analysis was used to examine the relation between hospital characteristics and CITAT scores.

Results: We received a sufficient number of physician responses at 69 hospitals (55% response rate). Teaching hospitals, hospitals with higher IT operating expenses (>$1 million annually), IT capital expenses (>$75,000 annually) and hospitals with larger IT staff (> or = 10 full-time staff) had higher automation scores than hospitals that did not meet these criteria (p < 0.05 in all cases). These findings held after adjustment for bed size, total margin, and ownership (p < 0.05 in all cases). There were few significant associations between the hospital characteristics tested in this study and usability scores.

Conclusion: Academic affiliation and larger IT operating, capital, and staff budgets are associated with more highly automated clinical information systems.

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Distribution of CITAT scores: a) CIT; b) automation; c) usability; d) order entry; e) notes & records; f) test results; and g) decision support for all hospitals, hospitals whose total margin exceeds the median for all hospitals (≥ 0.03), and safety net hospitals.
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Figure 1: Distribution of CITAT scores: a) CIT; b) automation; c) usability; d) order entry; e) notes & records; f) test results; and g) decision support for all hospitals, hospitals whose total margin exceeds the median for all hospitals (≥ 0.03), and safety net hospitals.

Mentions: Overall CITAT scores were low in this sample of hospitals (Figure 1). The median automation score was 18.3 (out of a total of 100 points), with a floor at 8.2 points. The usability score was higher than both CIT and automation, with a median score of 40.6. The CIT score, an average of the automation and usability scores, was normally distributed and also exhibited low values (median, 29.1). Most hospitals scored poorly on order entry and decision support, both of which had floors at 0 points and median values of 11.7 and 5.3, respectively. Notes and records and test results had the broadest distribution with higher median values of 28.7 and 53.4, respectively. The median total margin for hospitals in this study was 0.03; both safety net hospitals and hospitals that exceeded a total margin of 0.03 follow the distributions of other hospitals (Figure 1).


Hospital characteristics associated with highly automated and usable clinical information systems in Texas, United States.

Amarasingham R, Diener-West M, Plantinga L, Cunningham AC, Gaskin DJ, Powe NR - BMC Med Inform Decis Mak (2008)

Distribution of CITAT scores: a) CIT; b) automation; c) usability; d) order entry; e) notes & records; f) test results; and g) decision support for all hospitals, hospitals whose total margin exceeds the median for all hospitals (≥ 0.03), and safety net hospitals.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2553406&req=5

Figure 1: Distribution of CITAT scores: a) CIT; b) automation; c) usability; d) order entry; e) notes & records; f) test results; and g) decision support for all hospitals, hospitals whose total margin exceeds the median for all hospitals (≥ 0.03), and safety net hospitals.
Mentions: Overall CITAT scores were low in this sample of hospitals (Figure 1). The median automation score was 18.3 (out of a total of 100 points), with a floor at 8.2 points. The usability score was higher than both CIT and automation, with a median score of 40.6. The CIT score, an average of the automation and usability scores, was normally distributed and also exhibited low values (median, 29.1). Most hospitals scored poorly on order entry and decision support, both of which had floors at 0 points and median values of 11.7 and 5.3, respectively. Notes and records and test results had the broadest distribution with higher median values of 28.7 and 53.4, respectively. The median total margin for hospitals in this study was 0.03; both safety net hospitals and hospitals that exceeded a total margin of 0.03 follow the distributions of other hospitals (Figure 1).

Bottom Line: Teaching hospitals, hospitals with higher IT operating expenses (>$1 million annually), IT capital expenses (>$75,000 annually) and hospitals with larger IT staff (> or = 10 full-time staff) had higher automation scores than hospitals that did not meet these criteria (p < 0.05 in all cases).There were few significant associations between the hospital characteristics tested in this study and usability scores.Academic affiliation and larger IT operating, capital, and staff budgets are associated with more highly automated clinical information systems.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, UT Southwestern Medical Center and Parkland Health & Hospital System, Dallas, USA. ramara@parknet.pmh.org

ABSTRACT

Background: A hospital's clinical information system may require a specific environment in which to flourish. This environment is not yet well defined. We examined whether specific hospital characteristics are associated with highly automated and usable clinical information systems.

Methods: This was a cross-sectional survey of 125 urban hospitals in Texas, United States using the Clinical Information Technology Assessment Tool (CITAT), which measures a hospital's level of automation based on physician interactions with the information system. Physician responses were used to calculate a series of CITAT scores: automation and usability scores, four automation sub-domain scores, and an overall clinical information technology (CIT) score. A multivariable regression analysis was used to examine the relation between hospital characteristics and CITAT scores.

Results: We received a sufficient number of physician responses at 69 hospitals (55% response rate). Teaching hospitals, hospitals with higher IT operating expenses (>$1 million annually), IT capital expenses (>$75,000 annually) and hospitals with larger IT staff (> or = 10 full-time staff) had higher automation scores than hospitals that did not meet these criteria (p < 0.05 in all cases). These findings held after adjustment for bed size, total margin, and ownership (p < 0.05 in all cases). There were few significant associations between the hospital characteristics tested in this study and usability scores.

Conclusion: Academic affiliation and larger IT operating, capital, and staff budgets are associated with more highly automated clinical information systems.

Show MeSH
Related in: MedlinePlus