Information technology and hospital patient safety: a cross-sectional study of US acute care hospitals.

Abstract

OBJECTIVES: To determine whether health information technology (IT) systems are associated with better patient safety in acute care settings. STUDY DESIGN: In a cross-sectional retrospective study, data on hospital patient safety performance for October 2008 to June 2010 were combined with 2007 information technology systems data. The sample included 3002 US non-federal acute care hospitals. Electronic health record (EHR) system was coded as a composite dichotomous variable based on the presence of 10 major clinical and administrative applications that (if in use) could potentially meet stage 1 "meaningful use" objectives. The surgical IT system was measured as a dichotomous variable if a hospital used at least 1 of the perioperative, preoperative, or postoperative information systems. Hospital patient safety performance was measured by risk-standardized estimated rates per 1000 admissions. Statistical analyses were conducted using an estimated dependent variable methodology with gamma-log link-based weighted generalized linear models, adjusting for hospital characteristics, historical composite process quality, and propensity for EHR adoption. RESULTS: We found that the use of surgical IT systems was associated with 7% to 26% lower rates for 7 of 8 patient safety indicators (incidence rate ratio [IRR] range from 0.74 to 0.93; all P values < .01). Further, stage 1 meaningful use-capable EHR systems were associated with 7% to 11% lower rates on 3 of 8 measures (IRR range from 0.89 to 0.93; all P values < .01). CONCLUSIONS: Our results suggest that the use of IT is associated with modestly lower rates of adverse events in hospitals. However, the cross-sectional design limits our ability to make causal conclusions.

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