Information Technology and Patient Safety

Evidence from National Data
Faculty Scholarship
Thursday, January 23, 2014
Department of Sociology, Dartmouth College

Am J Manag Care, 20(17):SP39-SP47 

Author(s): Ajit Appari, Eric Johnson, and Denise Anthony 

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.

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 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 values <.01).

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.

Rockefeller Center Faculty Grant Proposal: "Exploring the Relationship Between Health Information Technology and Hospital Quality"