The Impact of Accelerating Electronic Prescribing on Hospitals' Productivity Levels: Can Health Information Technology Bend the Curve?

By Ford, Eric W.; Huerta, Timothy R. et al. | Inquiry, Winter 2011 | Go to article overview
Save to active project

The Impact of Accelerating Electronic Prescribing on Hospitals' Productivity Levels: Can Health Information Technology Bend the Curve?


Ford, Eric W., Huerta, Timothy R., Thompson, Mark A., Patry, Roland, Inquiry


This paper examines how different strategies for implementing computerized prescriber order entry (CPOE) impact hospitals' productivity. We used the American Hospital Association's Annual Survey to construct hospital-level measures for 1,812 facilities and analyzed the productivity indices against CPOE use rates. The relationship between CPOE use rates and indices for "technical efficiency change" and "total factor productivity" was significant. Hospitals introducing CPOE facility wide in a one-year period (where usage went from zero to more than 50%) experienced declines in both productivity indices. One implication is that hospitals achieving the goals of the "meaningful use" program promoted by the Centers for Medicare and Medicaid Services may do so at the expense of productivity.

**********

Significant parts of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act and the 2010 Patient Protection and Affordable Care Act (ACA) are dedicated to increasing the use of health information technology (HIT) as a way of coordinating patient care, improving hospital operating efficiencies, and helping to control costs (Blumenthal 2010). In particular, order entry systems have been promoted as potential innovations for savings because they serve as the starting point for nearly 80% of all hospital activities (McCormack 2011). Collectively, the transforming of clinical processes on a national scale is intended to "bend the curve" of health care inflation downward (Cutler, Davis, and Stremikis 2009).

The timelines and levels for implementing HIT are being measured against a "meaningful use" standard promulgated by the Centers for Medicare and Medicaid Services (CMS). Meaningful use measures revolve around providers' utilization levels of specific applications, the generation of key information during care delivery, and the demonstration of improved clinical outcomes. The meaningful use program, which provides financial incentives to organizations that use HITs at ever increasing levels, is being implemented in multiple stages to allow providers to adapt to the magnitude of changes required. Nevertheless, the deadline for the initial meaningful use program stage occurred in 2011, and hospitals used aggressive implementation strategies to meet the deadline (Ford et al. 2010; Furukawa, Raghu, and Shao 2010).

Despite the reported benefits of computerized prescriber order entry (CPOE), U.S. hospitals have been slow to adopt the systems due to their high installation and operating costs, disruptions to operating procedures, organizational and clinical work practice issues, and uncertainty about governmental requirements related to HIT (Ash and Bates 2005; Callen, Westbrook, and Braithwaite 2006; Ford et al. 2008; Wachter 2006). As of 2010, only 14% of U.S. hospitals had achieved the 10% use rate of CPOE required to receive Stage 1 meaningful use rewards in 2011 (Chaffee 2010; Hess 2010). However, the impact of CPOE systems on hospitals' efficiency and productivity levels is not well understood.

The purpose of this paper is to quantify the impact on hospitals' productivity associated with implementing CPOE technology (in particular, the prescription order entry component). We also measure how accelerating CPOE implementation rates--as is being promoted by the Office of the National Coordinator for Health Information Technology (ONC)--affects productivity. Using data from the American Hospital Association's (AHA's) Annual Survey and CMS, we have calculated "total factor productivity" (TFP) indices for the hospital sector. Productivity is the ratio of outputs created compared to the inputs required to complete a process. In addition to measuring the number of outputs, it is common practice to assess the quality of those outputs as part of the productivity calculation. In the hospital setting, productivity is derived by assessing hospitals' patient care output levels, which are measured as discharges and average length of stay.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

The Impact of Accelerating Electronic Prescribing on Hospitals' Productivity Levels: Can Health Information Technology Bend the Curve?
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?