ingest cdrApp 2017-06-30T21:03:11.439Z aac86417-22f1-4cf6-b34c-2c21f31ce694 modifyDatastreamByValue RELS-EXT fedoraAdmin 2017-06-30T23:56:29.740Z Setting exclusive relation modifyDatastreamByValue RELS-EXT fedoraAdmin 2017-06-30T23:56:40.129Z Setting exclusive relation addDatastream MD_TECHNICAL fedoraAdmin 2017-06-30T23:56:50.115Z Adding technical metadata derived by FITS modifyDatastreamByValue RELS-EXT fedoraAdmin 2017-06-30T23:57:07.997Z Setting exclusive relation addDatastream MD_FULL_TEXT fedoraAdmin 2017-06-30T23:57:19.567Z Adding full text metadata extracted by Apache Tika modifyDatastreamByValue RELS-EXT fedoraAdmin 2017-06-30T23:57:41.854Z Setting exclusive relation modifyDatastreamByValue RELS-EXT cdrApp 2017-07-05T15:55:07.561Z Setting exclusive relation modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-01-04T20:23:42.479Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-01-25T01:24:02.542Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-01-27T02:07:44.857Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-03-13T21:45:17.447Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-05-16T19:32:28.919Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-07-10T20:19:46.519Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-07-17T16:35:36.998Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-08-02T16:35:39.507Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-08-08T16:01:39.566Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-08-14T20:24:04.150Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-08-16T16:11:05.241Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-09-21T13:46:17.497Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-09-26T16:43:46.987Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-10-10T17:00:09.604Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-10-11T17:32:24.053Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2019-02-28T00:40:52.259Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2019-03-19T19:58:15.808Z Jason Mose Author Department of Health Policy and Management Gillings School of Global Public Health ESTIMATING THE EFFECTS OF ELECTRONIC HEALTH RECORDS (EHRS) SOPHISTICATION AND EHRS YEARS OF EXPERIENCE ON HEALTH CARE QUALITY, PATIENT EXPERIENCE, 30-DAY READMISSIONS, AND PROFITABILITY IN U.S ACUTE CARE HOSPITALS The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. Spring 2017 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text Jason Mose Author Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. Spring 2017 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. Spring 2017 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. Spring 2017 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017-05 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Daniel Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Daniel Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation Health Policy and Management Shoou-Yih Daniel Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 University of North Carolina at Chapel Hill Degree granting institution Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions; Acute care hospitals; Effects of electronic health records; Electronic Health Records; Health care financial management; Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation Health Policy and Management Shoou-Yih Daniel Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 University of North Carolina at Chapel Hill Degree granting institution Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health Estimating the Effects of Electronic Health Records (EHRs) Sophistication and EHRs Years of Experience on Health Care Quality, Patient Experience, 30-Day Readmissions, and Profitability in U.S Acute Care Hospitals The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions, Acute care hospitals, Effects of electronic health records, Electronic Health Records, Health care financial management, Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Daniel Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions; Acute care hospitals; Effects of electronic health records; Electronic Health Records; Health care financial management; Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Health Policy and Management Shoou-Yih Daniel Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Jason Mose Creator Department of Health Policy and Management Gillings School of Global Public Health The objective of this dissertation was to estimate the effects of EHRs sophistication on health care quality, patient experience, 30-day readmissions, and hospital profitability. EHRs data was sourced from Healthcare Information and Management Systems Society and Meaningful Use program. Healthcare quality, financial and hospital-specific data came from several Centers for Medicare & Medicaid Services files and programs. Demographic data came from the Area Health Resources Files. The analysis employed ordinary least squares (OLS) with propensity weighting and feasible generalized least squares to investigate the association between EHRs sophistication and healthcare quality, patient experience, and 30-day readmissions. Also, OLS with hospital level fixed effects to evaluate the effects of EHRs sophistication on profitability. Controlling for several factors, a hospital with more sophisticated EHRs was associated with negative performance on clinical process of care and patient outcomes as compared to a hospital with less sophisticated EHRs. The study found a statistically significant association between EHRs enabled patient engagement activities with patient experience, but not between patient engagement, care coordination activities, and 30-day readmission. Nevertheless, there was a positive association between improved patient experience and a reduction in 30-day readmission. Lastly, the study found a statistically significant negative effect on hospital operating margin when moving from a less to a more sophisticated EHRs system. Also, generally speaking, the longer a hospital remains in any given higher EHRs sophisticated stage, the better a hospital’s operating margin. Moreover, the study found EHRs sophistication has a positive effect on profitability through revenue gain and not through a reduction of operating expenses. Overall, evidence shows there is a substantial operational disruption upon implementing a more sophisticated EHRs. In addition, there is a positive association between EHRs sophistication and clinical process of care and not patient outcomes, between EHRs enabled patient engagement, care coordination activities and 30-day readmission through improved patient experience and not directly, between EHRs sophistication and profitability through operating revenue gain and not through a reduction of operating expenses. 2017 Information technology Health care management Finance 30-day readmissions; Acute care hospitals; Effects of electronic health records; Electronic Health Records; Health care financial management; Health care quality eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Shoou-Yih Daniel Lee Thesis advisor Bryan Weiner Thesis advisor Morris Weinberger Thesis advisor Kristin Reiter Thesis advisor Christopher Shea Thesis advisor Carlton Moore Thesis advisor text 2017-05 Mose_unc_0153D_16735.pdf uuid:a0d15f25-474f-45e8-856b-13e21a900524 2019-06-30T00:00:00 2017-03-23T14:16:10Z proquest application/pdf 2118755 yes