While healthcare entities have integrated various forms of health information technology (HIT) into their systems due to claims of increased quality and decreased costs, as well as various incentives, there is little available information about which applications of HIT are actually the most beneficial and efficient. In this study, we aim to assist administrators in understanding the characteristics of top performing hospitals. We utilized data from the Health Information and Management Systems Society and the Center for Medicare and Medicaid to assess 1039 hospitals. Inputs considered were full time equivalents, hospital size, and technology inputs. Technology inputs included personal health records (PHR), electronic medical records (EMRs), computerized physician order entry systems (CPOEs), and electronic access to diagnostic results. Output variables were measures of quality, hospital readmission and mortality rate. The analysis was conducted in a two-stage methodology: Data Envelopment Analysis (DEA) and Automatic Interaction Detector Analysis (AID), decision tree regression (DTreg). Overall, we found that electronic access to diagnostic results systems was the most influential technological characteristics; however organizational characteristics were more important than technological inputs. Hospitals that had the highest levels of quality indicated no excess in the use of technology input, averaging one use of a technology component. This study indicates that prudent consideration of organizational characteristics and technology is needed before investing in innovative programs.
Background
Little is known about how accountable care organizations (ACOs) participate with rural health providers. This pilot study examines ACO participation with rural health clinics (RHCs).
Methods
Telephone interviews with 8 ACO administrators were conducted to determine the early implementation experiences of these organizations and their participation with rural health providers, such as RHCs, using qualitative content analysis, ACO characteristics and emerging themes from the ACO executive responses were identified.
Results
Three predominant themes emerged: (1) ACOs are growing in size and number, and have various organizational structures; (2) there is an expanding emphasis on preventive primary care and chronic disease management for patients; and (3) there is a need for improved information technology (IT) integration with clinical services and financial systems.
Conclusion
Seven of 8 participants reported that their ACO was planning to expand into rural areas and partner with rural providers.
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