Diffusion dynamics of electronic health records: A longitudinal observational study comparing data from hospitals in Germany and the United States

Esdar, Moritz; Hüsers, Jens; Weiß, Jan-Patrick; Rauch, Jens; Hübner, Ursula

doi:10.1016/j.ijmedinf.2019.103952

Cited by 18 publications

(17 citation statements)

References 69 publications

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“…While Esdar et al used an existing diffusion model to calculate the diffusion dynamics of EHRs in German and U.S. hospital care between 2007 and 2017, 18 access to different types of health information by different types of care providers was not addressed by them.…”

Section: Comparisons To Other Ehealth Benchmarksmentioning

confidence: 99%

International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study

et al. 2020

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Background Many countries adopt eHealth applications to support patient-centered care. Through information exchange, these eHealth applications may overcome institutional data silos and support holistic and ubiquitous (regional or national) information logistics. Available eHealth indicators mostly describe usage and acceptance of eHealth in a country. The eHealth indicators focusing on the cross-institutional availability of patient-related information for health care professionals, patients, and care givers are rare. Objectives This study aims to present eHealth indicators on cross-institutional availability of relevant patient data for health care professionals, as well as for patients and their caregivers across 14 countries (Argentina, Australia, Austria, Finland, Germany, Hong Kong as a special administrative region of China, Israel, Japan, Jordan, Kenya, South Korea, Sweden, Turkey, and the United States) to compare our indicators and the resulting data for the examined countries with other eHealth benchmarks and to extend and explore changes to a comparable survey in 2017. We defined “availability of patient data” as the ability to access data in and to add data to the patient record in the respective country. Methods The invited experts from each of the 14 countries provided the indicator data for their country to reflect the situation on August 1, 2019, as date of reference. Overall, 60 items were aggregated to six eHealth indicators. Results Availability of patient-related information varies strongly by country. Health care professionals can access patients' most relevant cross-institutional health record data fully in only four countries. Patients and their caregivers can access their health record data fully in only two countries. Patients are able to fully add relevant data only in one country. Finland showed the best outcome of all eHealth indicators, followed by South Korea, Japan, and Sweden. Conclusion Advancement in eHealth depends on contextual factors such as health care organization, national health politics, privacy laws, and health care financing. Improvements in eHealth indicators are thus often slow. However, our survey shows that some countries were able to improve on at least some indicators between 2017 and 2019. We anticipate further improvements in the future.

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Section: Comparisons To Other Ehealth Benchmarksmentioning

confidence: 99%

International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study

et al. 2020

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“…Furthermore, these domains can be assumed to be influenced by an organization's ICs. In addition, internal structural characteristics such as the organization's size, teaching status, and ownership as well as external influences in terms of national health policies and legal regulations need to be accounted for as possible covariates in the model, as both have been shown to be significantly associated with HIT use [58][59][60][61].…”

Section: Conceptual Model and Study Objectivesmentioning

confidence: 99%

The Effect of Innovation Capabilities of Health Care Organizations on the Quality of Health Information Technology: Model Development With Cross-sectional Data

Esdar¹,

Hübner²,

Thye³

et al. 2021

JMIR Med Inform

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Background Large health organizations often struggle to build complex health information technology (HIT) solutions and are faced with ever-growing pressure to continuously innovate their information systems. Limited research has been conducted that explores the relationship between organizations’ innovative capabilities and HIT quality in the sense of achieving high-quality support for patient care processes. Objective The aim of this study is to explain how core constructs of organizational innovation capabilities are linked to HIT quality based on a conceptual sociotechnical model on innovation and quality of HIT, called the IQHIT model, to help determine how better information provision in health organizations can be achieved. Methods We designed a survey to assess various domains of HIT quality, innovation capabilities of health organizations, and context variables and administered it to hospital chief information officers across Austria, Germany, and Switzerland. Data from 232 hospitals were used to empirically fit the model using partial least squares structural equation modeling to reveal associations and mediating and moderating effects. Results The resulting empirical IQHIT model reveals several associations between the analyzed constructs, which can be summarized in 2 main insights. First, it illustrates the linkage between the constructs measuring HIT quality by showing that the professionalism of information management explains the degree of HIT workflow support (R²=0.56), which in turn explains the perceived HIT quality (R²=0.53). Second, the model shows that HIT quality was positively influenced by innovation capabilities related to the top management team, the information technology department, and the organization at large. The assessment of the model’s statistical quality criteria indicated valid model specifications, including sufficient convergent and discriminant validity for measuring the latent constructs that underlie the measures of HIT quality and innovation capabilities. Conclusions The proposed sociotechnical IQHIT model points to the key role of professional information management for HIT workflow support in patient care and perceived HIT quality from the viewpoint of hospital chief information officers. Furthermore, it highlights that organizational innovation capabilities, particularly with respect to the top management team, facilitate HIT quality and suggests that health organizations establish this link by applying professional information management practices. The model may serve to stimulate further scientific work in the field of HIT adoption and diffusion and to provide practical guidance to managers, policy makers, and educators on how to achieve better patient care using HIT.

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“…CIS has been applied to a considerable extent, and the popularization rate of EMR exceeded the average level of its US counterparts in 2015 [22] (85.26% vs 83.8%) and the average level of its German counterparts in 2017 [23] 10. The construction and implementation of CIS including CPOE, EMR, LIS, and PACS in level III hospitals in China has developed vigorously and is maturing daily.…”

Section: Implementation and Application Of Clinical Information Systementioning

confidence: 99%

Evaluating the Applications of Health Information Technologies in China During the Past 11 Years: Consecutive Survey Data Analysis

Liang¹,

Liu²,

Zhang³

et al. 2020

JMIR Med Inform

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Background To achieve universal access to medical resources, China introduced its second health care reform in 2010, with health information technologies (HIT) as an important technical support point. Objective This study is the first attempt to explore the unique contributions and characteristics of HIT development in Chinese hospitals from the three major aspects of hospital HIT—human resources, funding, and materials—in an all-around, multi-angled, and time-longitudinal manner, so as to serve as a reference for decision makers in China and the rest of the world when formulating HIT development strategies. Methods A longitudinal research method is used to analyze the results of the CHIMA Annual Survey of Hospital Information System in China carried out by a Chinese national industrial association, CHIMA, from 2007 to 2018. The development characteristics of human resources, funding, and materials of HIT in China for the past 12 years are summarized. The Bass model is used to fit and predict the popularization trend of EMR in Chinese hospitals from 2007 to 2020. Results From 2007 to 2018, the CHIMA Annual Survey interviewed 10,954 hospital CIOs across 32 administrative regions in Mainland China. Compared with 2007, as of 2018, in terms of human resources, the average full time equivalent (FTE) count in each hospital’s IT center is still lower than the average level of US counterparts in 2014 (9.66 FTEs vs. 34 FTEs). The proportion of CIOs with a master’s degree or above was 25.61%, showing an increase of 18.51%, among which those with computer-related backgrounds accounted for 64.75%, however, those with a medical informatics background only accounted for 3.67%. In terms of funding, the sampled hospitals’ annual HIT investment increased from ¥957,700 (US $136,874) to ¥6.376 million (US $911,261), and the average investment per bed increased from ¥4,600 (US $658) to ¥8,100 (US $1158). In terms of information system construction, as of 2018, the average EMR implementation rate of the sampled hospitals exceeded the average level of their US counterparts in 2015 and their German counterparts in 2017 (85.26% vs. 83.8% vs. 68.4%, respectively). The results of the Bass prediction model show that Chinese hospitals will likely reach an adoption rate of 91.4% by 2020 (R2=0.95). Conclusions In more than 10 years, based on this top-down approach, China’s medical care industry has accepted government instructions and implemented the unified model planned by administrative intervention. With only about one-fifth of the required funding, and about one-fourth of the required human resources per hospital as compared to the US HITECH project, China’s EMR coverage in 2018 exceeded the average level of its US counterparts in 2015 and German counterparts in 2017. This experience deserves further study and analysis by other countries.

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Diffusion dynamics of electronic health records: A longitudinal observational study comparing data from hospitals in Germany and the United States

Cited by 18 publications

References 69 publications

International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study

International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study

The Effect of Innovation Capabilities of Health Care Organizations on the Quality of Health Information Technology: Model Development With Cross-sectional Data

Evaluating the Applications of Health Information Technologies in China During the Past 11 Years: Consecutive Survey Data Analysis

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