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Description

Introduction
Hospitals are increasingly adopting health information technology (HIT) to facilitate patient engagement to meet governmental pressures,1, 2 as well as consumer demand for using technology in their health.4, 5 Several studies have highlighted the functionalities and benefits of HIT for patient engagement, and others have examined the association of HIT and care quality. However, few have determined if any one HIT functionality may be salient for improved quality of care. This study therefore aims to examine the relationship between the specific patient engagement functionalities offered through health information technology (HIT) and quality of care.

Methods
Data on hospital adoption of patient engagement functionalities obtained from the American Hospital Association (AHA) IT supplement were combined with quality data obtained from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare. Hospital fixed effects regression models with time dummies were used to analyze a panel data consisting of 1,463 hospitals from 2012 to 2014. Quality of care was measured as patient satisfaction and 30-day readmission rate for acute myocardial infarction, heart failure, and pneumonia.

Results
This study revealed that certain patient engagement functions were significantly associated with improved quality of care measures in hospitals. For instance, it was determined that hospitals offering patients’ electronic access to patient–specific education materials (β= 0.806, p < 0.05), the ability to download their health information (β= 0.640, p < 0.05), the ability to request changes in their medical records (β= 0.778, p < 0.05), and the ability to generate their own health data (β= 0.832, p < 0.05) were associated with improved patient satisfaction. Additionally, hospitals allowing patients to view their health records and to download their health information were also significantly associated with improved readmission rates for acute myocardial infarction, heart failure, and pneumonia respectively. Permitting patients to access their discharge instructions electronically (β= -0.658, p < 0.05) was significantly associated with improved acute myocardial infarction readmission rates and allowing patients to generate their health data (β= -0.280, p < 0.05) was significantly associated with improved readmission rates for heart failure.

Conclusions
Hospitals can improve their overall quality by offering health information technology with certain engagement functionalities to their patients. While it is important to adopt a broad range of functionalities to meet internal and external demands, the findings of this particular study suggest that hospitals that offer patient engagement HIT functionalities related to patient education, viewing and downloading health information, requesting changes in medical record, and patient generated data entry are likely to have higher patient satisfaction and lower readmission rates for acute myocardial infarction, heart failure, and pneumonia. It may be because these functionalities enable patients to become more engaged and activated in their care. This study will potentially assist hospital administrators in justifying their strategic deployment of HIT resources to improve both perceived and actual care quality.

References
1. D. Ahern, S. Woods, M. Lightowler, S. Finley, T. Houston, Promise of and Potential for Patient-Facing Technologies to Enable Meaningful Use, Am J Prev Med. 40 (2011) S162-S172. doi:10.1016/j.amepre.2011.01.005.
2. O. Asagbra, D. Burke, H. Liang, Why hospitals adopt patient engagement functionalities at different speeds? A moderated trend analysis, Int J Med Inform. 111 (2018) 123-130. doi:10.1016/j.ijmedinf.2017.12.023.
3. S. Jones, S. Fox, Generations Online in 2009 | Pew Research Center, Pew Research Center: Internet, Science & Tech. (2018). http://www.pewinternet.org/2009/01/28/generations-online-in-2009/ (accessed 20 September 2018).
4. S. Fox, M. Duggan, Health Online 2013 | Pew Research Center, Pew Research Center: Internet, Science & Tech. (2018). http://www.pewinternet.org/2013/01/15/health-online-2013/ (accessed 20 September 2018).

Learning Objective: To describe patient engagement functionalities of health information technology (HIT) that may be important for improved quality of care

To discuss hospital administrators’ strategic deployment and allocation priorities of HIT resources to enhance patient engagement, and subsequently improve both perceived and actual care quality

Authors:

Oghale Asagbra (Presenter)
East Carolina University

Presentation Materials:

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