Doctors’ orders––If they’re electronic, do they improve patient satisfaction? A complements/substitutes perspective

Queenan, Carrie; Angst, Corey M.; Devaraj, Sarv

doi:10.1016/j.jom.2011.03.001

Cited by 66 publications

(79 citation statements)

References 89 publications

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“…HIT tools such as computerized decision support systems (CDSS) can reduce uncertainty and ambiguity in treatments by providing supportive information for specific patient conditions. Queenan et al (2011) found that both CPOE and aggregate HIT infrastructure are associated with higher overall Patient Satisfaction .…”

Section: Hypothesis Development Via Information Processing Theorymentioning

confidence: 95%

Operational and strategic information processing: Complementing healthcare IT infrastructure

Gardner

Boyer

Gray

2014

J of Ops Management

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Healthcare information technologies (HIT) have been promoted as key enablers of improved patient safety, reduced medical errors, and increased patient satisfaction but have yielded mixed results. Drawing upon information processing theory and quality management concepts, we examine HIT infrastructure simultaneously with two distinct means of processing information: (1) operational use of error data for detecting and reducing hospital errors, and (2) strategic use of objective data for organizational planning. We use time‐sequenced data to examine HIT infrastructure (secondary data in 2008), information processing mechanisms (primary survey data from 258 hospitals in 2009), and two measures of hospital performance: (1) care quality, and (2) patient satisfaction (secondary data in 2010). Using hierarchical regression analysis we find that whether and how investments in HIT infrastructure are complemented by information processing mechanisms depends upon the performance measure under consideration and the form of information processing employed. Specifically, operational error processing complements HIT infrastructure in its association with higher care quality but not with patient satisfaction. In comparison, higher levels of strategic information processing complement HIT infrastructure in its association with higher patient satisfaction.

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Section: Hypothesis Development Via Information Processing Theorymentioning

confidence: 95%

Operational and strategic information processing: Complementing healthcare IT infrastructure

Gardner

Boyer

Gray

2014

J of Ops Management

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“…Aggressiveness, or the willingness to perform more procedures (Currie et al, 2016), in choosing a treatment is more of a physician-specific preference (Currie et al, 2016), and there is no reason to believe that justification would change an individual physician's preference for a test. The collaborative nature of justification may also improve physicians' judgment about whether a patient is high probability or not, since greater collaboration among clinicians leads to improved outcomes (Dobrzykowski, McFadden, & Vonderembse, 2016;Queenan, Angst, & Devaraj, 2011;Senot, Chandrasekaran, & Ward, 2016). Research has shown that nurses consider the personal cost to themselves when deciding to contribute improvement ideas regarding operational failures (Tucker, 2016).…”

Section: Mechanisms: the Moderating Effect Of Patient Conditionmentioning

confidence: 99%

The value of process friction: The role of justification in reducing medical costs

Jaeker

Tucker

2019

J of Ops Management

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We study the role of process friction in increasing efficiency of service provisions. We examine one potential lever for reducing the provision of discretionary services: “justification”—an otherwise non‐value‐added process step that introduces process friction by forcing workers to explain the rationale for requesting an optional service. We exploit the presence—and absence—of a justification step in the ultrasound (US) ordering process at two emergency departments (EDs). We find that patients with abdominal pain are less than half as likely to receive an US when there is a justification step compared to when there is not. Additionally, we find a spillover effect: other diagnostic tests are also ordered less frequently. The decrease in testing reduces the average length of stay of the patients, and reduces testing costs by more than $200,000, with no decrease in quality. We show that two mechanisms underlie these results: (a) justification reduces clinicians' available time, and (b) justification forces clinicians to reflect on a patient's need for service. Our paper contributes to recent theory on friction and reflection as drivers of efficiency in services. We show that justification can serve as an effective lever for reducing medical tests—and costs—without negatively impacting quality.

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“…The size of improvements in performance varied considerably due to implementation of clinical guidelines (Grimshaw and Russell, 1993). In addition to supporting the clinicians, it can be also be used as a tool of verification by administrators, who can study the computerized physician order entry (CPOE) reports and ascertain if the patient was informed by the clinician that s/he was eligible to receive the selected preventable care, thus appraising how well clinicians follow hospital guidelines (Dexter et al, 2001;Overhage et al, 1997Overhage et al, , 1996Queenan et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Research and Education, 2011). Therefore, the CPOEs recommend suitable drug formulation and ensure administration of appropriate drug dose (Teich et al, 2000;Chertow et al, 2001;Queenan et al, 2011). Content process is defined as the process that "nurses use to gather information based on the patient case history, evaluate the information, and make a judgment that results in patient care" (White et al, 1992).…”

Section: Introductionmentioning

confidence: 99%

Utility of clinical technology-processes for developing countries

Agarwal

Sebastian

2014

Clinical Governance: An International Journal

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If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -The purpose of this paper is to evaluate the utility of clinical processes in healthcare institutions of different sizes. The implications of adoption rate of computerized physicians order entry (CPOE) and electronic medical/health records (EMRs/EHRs) in different sized healthcare institutions in the USA were studied in terms of understanding its impact on enhancement of quality of patient care. Design/methodology/approach -This study has used secondary data to obtain insights on the processes and technologies used in hospitals of different sizes in the USA and enlighten those in the developing countries to adopt a strategy that would be most appropriate for them. The Dorenfest Institute for H.I.T. Research and Education Analytics database (The Dorenfest Institute, 2011) provided the data for 5,038 US hospitals. Logistic regression was performed to study the impact of the different types of processes and technologies on institutions of different sizes, classified based on the number of beds, physicians, and nurses. Findings -The findings show that small sized hospitals had a positive relationship with drug dosing interactions process and nursing and clinician content process. On the contrary, medium sized hospitals had a negative relationship with the usage of CPOE for entering medical records, i.e. o25 percent ( po0.05). In order to be effective, these institutions should increase the usage of EMRs by more than 25 percent to get positive outcomes. Large hospitals showed a positive relationship with the usage of 475 percent of CPOE to enter medical records and usage of medical records 475 percent. Practical implications -The authors demonstrate the need for an evaluation of utility of acute care hospitals based on hospital size in terms of number of physicians, and nurses, which have not been dealt earlier by the past studies. Moreover, there is also a need for an evaluation of utility of acute care hospitals for implementation of CPOEs and EMRs that are integrated with clinical decision support systems. Originality/value -Although the data are US-centric, the insights provided by the results are very much relevant to the Indian scenario to support the improvement of t...

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Doctors’ orders––If they’re electronic, do they improve patient satisfaction? A complements/substitutes perspective

Cited by 66 publications

References 89 publications

Operational and strategic information processing: Complementing healthcare IT infrastructure

Operational and strategic information processing: Complementing healthcare IT infrastructure

The value of process friction: The role of justification in reducing medical costs

Utility of clinical technology-processes for developing countries

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