Abstract
Clinical information systems (CIS) capture clinical data to support more efficient and effective decision making and clinical care delivery. Only a few estimates of CIS availability and use in hospitals are available nationally. The purpose of the current research is to examine differences in CIS availability and use between urban and rural hospitals. A survey addressing this purpose was completed by 74 (63.7%) of Iowa hospitals. Rural hospitals lag behind urban hospitals in terms of many CIS applications. More than 80% of the urban hospitals, but only between 30 and 40% of the rural hospitals, reported using computers to collect basic clinical information for potential use in an electronic medical record (EMR) and computerized provider order entry (CPOE) system. Comparison of CIS within one state’s urban and rural hospitals sheds light on variation in clinical support applications, decision support, and electronic medical record “readiness” in these settings.
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Austin, C., and Boxerman, S., Information Systems for Healthcare Management, 6th ed, Health Administration Press, Chicago, 2003.
Hillstad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., and Taylor, R., Can electronic health record systems transform health care? Potential health benefits, savings and costs. Health Aff. 24(5):1103–1117, 2005.
Toole, J. The need for transformation, health care technology: Innovating clinical care through technology. A thought leadership project from Montgomery Research, Inc. Retrieved from www.HCTProject.com. 2003.
Miller, R. H. Physician’s use of electronic medical records: Barriers and solutions. Health Aff. 23(2):116–126, 2004.
Vogel, L. Finding value from IT investments: Exploring the elusive ROI in healthcare. J. Healthc. Inf. Manage. 17(4): 20–28, 2003.
DHHS, United States Department of Health & Human Services; Office of the National Coordinator for Health Information Technology (ONC). Retrieved August, 2005 from http://www.OS.dhhs.gov/healthit/.
Friedman, B. A. Informating, not automating, the medical record. J. Med. Syst. 13(4):221–225, 1989.
Kerr, E. A., McGlynn, E. A., and Damberg, C. Developing and using a clinical information system. In McGlyn, E. A., Damberg, C. L., Kerr, E. A., and Brook, R. H. (eds.), Health Information Systems: Designs Issues and Analytical Application, RAND Health Publications, Santa Monica, California, 141–187, 1998.
Burke, D. E., and Menachemi, N. Opening the black box: Measuring hospital information technology capability. Health Care Manage. Rev. 29(3):207–217, 2004.
Kelly, B. Clinical Information Systems: Perspective 2001. Retrieved December 26, 2002 from http://www3.gartner.com/DisplayDocument?id=308838andref=g_search.
Brooks, R. G., Manachemi, N., Burke, D., and Clawson, A. Patient safety-related information technology utilization in urban and rural hospitals. J. Med. Syst. 29(2):103–109, 2005.
Burke, D. E., Wang, B. B. L., Wan, T. T. H., and Diana, M. L. Exploring hospitals’ adoption of information technology. J. Med. Syst. 26(4):349–355, 2002.
Menachemi, N., Burke, D., Clawson, A., and Brooks, R. G. Information technologies in Florida’s rural hospitals: Does system affiliation matter? J. Rural Health 21(3): 263–268, 2005.
Ohsfeldt, R., Ward, M. M., Schneider, J., Jaana, M., Miller, T., Lei, Y., and Wakefield, D. S. Implementation of computerized physician order entry systems in Iowa hospitals: Feasibility and financial impact. J. Am. Med. Inform. Assoc. 12(1): 20–27, 2005.
Walston, S. L., Kimberly, J. R., and Burns, L. R. Institutional and economic influences on the adoption and extensiveness of managerial innovation in hospitals: The case of reengineering. Med. Care Res. Rev. 58:194–228, 2001.
Paré, G., and Sicotte, C. Information technology capability in health care: An instrument validation study among Canadian hospitals. Int. Med. Inform. 63: 205–223, 2001.
Jaana, M., Ward, M. M., Pare, G., and Wakefield, D. S. Clinical information technology in hospitals: A comparison between the state of Iowa and two provinces in Canada. Int. J. Med. Inform. 74: 719–731, 2005.
American Hospital Association (AHA), Annual Survey Database, 2002.
Iowa Hospital Association (IHA), Profiles, 2002.
Health Care Financing Administration. Urban / Rural Reclassification (2001). Retrieved November 05, 2003 from http://www.cms.hhs.gov/medicaid/survey-cert/06142001.pdf.
Reynolds, J., and Rabin, J. Maximizing IT in smaller hospitals. Retrieved September 4, 2005 from http://www.healthcare-informatics.com/issues/2004/05_04/reynolds.htm.
Cushman, R. Series technology assessment for health care information technology. J. Am. Med. Inform. Assoc. 4:259–265, 1997.
Raghupathi, W., and Tan, J. Strategic uses of information technology in HC: A state of the art survey. Topics Health Inform. Manage. 20(1):1–15, 1999.
Chu, S. Part I-Clinical information systems: A fourth generation. Nurs. Manage. 24(10):59–60, 1993.
Truchaud, A., Le Neel, T., Brochard, H., Malvaux, S., Moyon, M., and Cazaubiel, M. New tools for laboratory design and management. Clin. Chem. 43(9):1709–1715, 1997.
PriceWaterhouseCoopers. Cost of caring: Key drivers of growth in spending on hospital care. Retrieved August, 2005 from http://www.mdhospitals.org/Payor_Issues/PwC%20Report%20Final.021803.pdf.
Levin, B. Enterprise PACS: Practical, Proven, and In Demand, HCT Project. A thought leadership project from Montgomery Research, Inc., 2003.
Serb, C. J., Haugh, R., Sarudi-Scalise, D., Carpenter, D., and Gearon, C. J. Special report: Information technology point and click. Hospital and Health Networks. Retrieved January 14, 2002, from http://www.hhnmag.com/asp/ArticleDisplay.asp?PubID=1&ArticleID=16298.
Healthcare Information and Management Systems Society. 14th annual HIMSS leadership survey: Healthcare CIO survey final report. Retrieved December 21, 2003 from http://www.himss.org/content/files/surveyresults.
Turisco, F., and Metzger, J. Rural healthcare delivery: Connecting communities through technology. Manuscript prepared for California Healthcare Foundation by First Consulting Group. pp. 1–39, 2002.
Feied, C. F., Smith, M. S., Handler, J. A., and Kanhouwa, M. Emergency medicine can play a leadership role in enterprise-wide clinical information systems. Ann. Emerg. Med. 5(2):162–167, 2000.
Blendon, R. J., DesRoches, C. M., Brodie, M., Benson, J. M., Rosen, A. B., Schneider, E., Altman, D. E., Zapper, K., Herrmann, M. J., and Steffenson, A. E. Views of practicing physicians and the public on medical errors. New Engl. J. Med. 347(24): 1933–1940, 2002.
Metzger, J., and Fortin, J. Computerized physician order entry in community hospitals: Lessons from the field. Manuscript prepared for California Healthcare Foundation by First Consulting Group, pp. 1–52, 2003.
James, B. E-Health: Steps on the road to interoperability. Health Aff. W5: 26–30, 2005.
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Support for this work was provided by a grant from the Iowa Department Public Health and by grant HS015009 from the Agency for Healthcare Research and Quality.
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Ward, M.M., Jaana, M., Bahensky, J.A. et al. Clinical Information System Availability and Use in Urban and Rural Hospitals. J Med Syst 30, 429–438 (2006). https://doi.org/10.1007/s10916-006-9014-3
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DOI: https://doi.org/10.1007/s10916-006-9014-3