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首页> 外文期刊>Decision Sciences >IT Governance Characteristics, Electronic Medical Records Sophistication, and Financial Performance in U.S. Hospitals: An Empirical Investigation
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IT Governance Characteristics, Electronic Medical Records Sophistication, and Financial Performance in U.S. Hospitals: An Empirical Investigation

机译：美国医院的IT治理特征，电子病历的复杂程度和财务绩效：一项实证研究

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As a result of a recent federal government mandate, an increasing number of hospitals have decided to adopt electronic medical record (EMR) systems. This initiative is expected to lead toward more efficient and higher quality health care; however, little is known about governance characteristics and organizational performance for EMR adopters. Our goal is to inform theory and practice by examining hospitals with a sophisticated EMR and comparing those hospitals to similar hospitals (with a less sophisticated EMR) to understand the association between information technology (IT) governance characteristics and the implications on financial performance. Leveraging elements of the upper echelon theory, we posit that hospitals in which the chief information officer (CIO) reports to the chief executive officer, CIO turnover is low, and an IT steering committee is present are more likely to have a sophisticated EMR. We argue that EMR sophistication leads to improved financial performance. Our results underscore the importance of continuity in the CIO position on successful EMR implementations. Results also show that hospital size and financial performance are strongly associated with EMR sophistication. In addition, we find that a sophisticated EMR appears to be a fundamental element in improving hospitals' revenue cycle management. Moreover, we find that hospitals with a sophisticated EMR appear to be more profitable. Finally, we observe that total payroll expense adjusted by total discharges drops among the sophisticated hospitals, potentially due to an increase in employee productivity. These insights can serve as a basis for tempering expectations relative to the financial impact of EMR adoption.
机译：由于联邦政府最近的一项命令，越来越多的医院决定采用电子病历（EMR）系统。预计该倡议将导致更有效和更高质量的保健；但是，对于EMR采用者的治理特征和组织绩效知之甚少。我们的目标是通过检查具有复杂EMR的医院，并将这些医院与具有较低EMR的类似医院进行比较，从而为理论和实践提供信息，以了解信息技术（IT）治理特征与财务绩效之间的关系。利用上层梯级理论的要素，我们假设首席信息官（CIO）向首席执行官报告的医院中，CIO流动率较低，并且设有IT指导委员会的医院更有可能拥有复杂的EMR。我们认为，复杂的EMR可以改善财务绩效。我们的结果强调了成功实施EMR时CIO职位连续性的重要性。结果还表明，医院规模和财务状况与EMR的复杂程度密切相关。此外，我们发现完善的EMR似乎是改善医院收入周期管理的基本要素。此外，我们发现拥有先进的EMR的医院似乎更有利可图。最后，我们观察到，在复杂的医院中，由总出院额调整的总工资支出有所下降，这可能是由于员工生产率的提高。这些见解可作为调节有关采用EMR的财务影响的期望的基础。

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