Hospital computerized provider order entry adoption and quality: An examination of the United States

Background: There is increasing national interest in advancing health information technology use in hospitals, but there is little research about the impact on quality in a nationally representative sample. Purposes: The purpose of this study was to investigate the relationship between hospital health information technology adoption and quality. Specifically, we examined the relationship between hospital computerized provider order entry (CPOE) and quality. Methodology: We used a retrospective cross-sectional approach with multiple regression to examine the relationship between hospital CPOE adoption and 10 quality measures from the Hospital Quality Alliance. We used control variables and a propensity score approach to control for confounding factors. Findings: Hospital CPOE adoption is positively and significantly associated with five of the quality measures. A significant negative relationship exists between hospital CPOE adoption and another quality measure. When we controlled for confounding factors using the propensity score approach, the significant relationships remain. Practice Implications: Strategic adoption of health information technology applications in hospitals along with careful and inclusive implementation of such systems is needed for optimal performance. Universal gains in quality are not guaranteed with CPOE adoption.