Date of Award

2016

Document Type

Dissertation

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Abby Kazley

Second Advisor

Karen A. Wager

Third Advisor

Scott Stickles

Fourth Advisor

Lisa K. Saladin

Abstract

A review of the literature revealed the need for further analysis of the impact of advanced electronic health record (EHR) use on medication error rates within US hospitals. A retrospective cross-sectional patient level analysis using the combined 2009 data from the National Inpatient Sample (NIS), Health Information Management Systems Society (HIMSS) Analytics, and American Hospital Association (AHA) annual survey datasets was conducted to study the relationship between advanced electronic health record use and medication error rates. A random sample of 1,032,905 patient cases was selected. A total of 301,289 (29.2%) patient cases originated from hospitals with advanced EHR. A total of 550 hospitals were included in the analysis, with 104 (18.9%) reporting use of advanced EHR. Compared to patient cases from hospitals without advanced EHR, those with advanced EHR had a lower proportion of medication errors (6.7% vs. 6.3%, p < 0.0001). There was only a small difference in the assumed direction to begin with, but it remained when using the propensity score stratification although the association was no longer statistically significant when using the matched sample. This indicates that the small statistically significant difference revealed in the initial analyses may have been due to selection bias. While use of advanced EHRs has great potential for improving a variety of health and safety matters in the hospital, it is possible that its current implementation has not evolved enough to have an effect. Technology alone will not solve the problem, but it can be a part of the solution. We must establish a total systems approach to problem of patient safety where technology is part of the solution.

Rights

All rights reserved. Copyright is held by the author.

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