Skip to main content

Advertisement

Log in

Clinical Information System Availability and Use in Urban and Rural Hospitals

  • Original Paper
  • Published:
Journal of Medical Systems Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Austin, C., and Boxerman, S., Information Systems for Healthcare Management, 6th ed, Health Administration Press, Chicago, 2003.

    Google Scholar 

  2. 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.

    Article  Google Scholar 

  3. 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.

  4. Miller, R. H. Physician’s use of electronic medical records: Barriers and solutions. Health Aff. 23(2):116–126, 2004.

    Article  Google Scholar 

  5. Vogel, L. Finding value from IT investments: Exploring the elusive ROI in healthcare. J. Healthc. Inf. Manage. 17(4): 20–28, 2003.

    Google Scholar 

  6. 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/.

  7. Friedman, B. A. Informating, not automating, the medical record. J. Med. Syst. 13(4):221–225, 1989.

    Article  Google Scholar 

  8. 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.

    Google Scholar 

  9. Burke, D. E., and Menachemi, N. Opening the black box: Measuring hospital information technology capability. Health Care Manage. Rev. 29(3):207–217, 2004.

    Google Scholar 

  10. Kelly, B. Clinical Information Systems: Perspective 2001. Retrieved December 26, 2002 from http://www3.gartner.com/DisplayDocument?id=308838andref=g_search.

  11. 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.

    Article  Google Scholar 

  12. 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.

    Article  Google Scholar 

  13. 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.

    Article  Google Scholar 

  14. 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.

    Article  Google Scholar 

  15. 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.

    Google Scholar 

  16. 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.

    Article  Google Scholar 

  17. 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.

    Article  Google Scholar 

  18. American Hospital Association (AHA), Annual Survey Database, 2002.

  19. Iowa Hospital Association (IHA), Profiles, 2002.

  20. Health Care Financing Administration. Urban / Rural Reclassification (2001). Retrieved November 05, 2003 from http://www.cms.hhs.gov/medicaid/survey-cert/06142001.pdf.

  21. 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.

  22. Cushman, R. Series technology assessment for health care information technology. J. Am. Med. Inform. Assoc. 4:259–265, 1997.

    Google Scholar 

  23. 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.

    Google Scholar 

  24. Chu, S. Part I-Clinical information systems: A fourth generation. Nurs. Manage. 24(10):59–60, 1993.

    Google Scholar 

  25. 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.

    Google Scholar 

  26. 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.

  27. Levin, B. Enterprise PACS: Practical, Proven, and In Demand, HCT Project. A thought leadership project from Montgomery Research, Inc., 2003.

  28. 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.

  29. 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.

  30. 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.

  31. 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.

    Article  Google Scholar 

  32. 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.

    Article  Google Scholar 

  33. 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.

  34. James, B. E-Health: Steps on the road to interoperability. Health Aff. W5: 26–30, 2005.

    Google Scholar 

Download references

Acknowledgments

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.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marcia M. Ward.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10916-006-9014-3

Keywords

Navigation