Appl Clin Inform 2016; 07(04): 1182-1201
DOI: 10.4338/ACI-2016-08-RA-0145
Research Article
Schattauer GmbH

A Novel Survey to Examine the Relationship between Health IT Adoption and Nurse-Physician Communication

A Jay Holmgren
1  School of Information, University of Michigan, Ann Arbor, MI
2  School of Public Health, University of Michigan, Ann Arbor, MI
,
Eric Pfeifer
1  School of Information, University of Michigan, Ann Arbor, MI
2  School of Public Health, University of Michigan, Ann Arbor, MI
,
Milisa Manojlovich
3  School of Nursing, University of Michigan, Ann Arbor, MI
,
Julia Adler-Milstein
1  School of Information, University of Michigan, Ann Arbor, MI
2  School of Public Health, University of Michigan, Ann Arbor, MI
› Author Affiliations
Funding This project was supported by grant number R01HS022305 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Further Information

Publication History

received: 23 August 2016

accepted: 04 November 2016

Publication Date:
18 December 2017 (online)

Summary

Background As EHR adoption in US hospitals becomes ubiquitous, a wide range of IT options are theoretically available to facilitate physician-nurse communication, but we know little about the adoption rate of specific technologies or the impact of their use.

Objectives To measure adoption of hardware, software, and telephony relevant to nurse-physician communication in US hospitals. To assess the relationship between non-IT communication practices and hardware, software, and telephony adoption. To identify hospital characteristics associated with greater adoption of hardware, software, telephony, and non-IT communication practices.

Methods We conducted a survey of 105 hospitals in the National Nursing Practice Network. The survey captured adoption of hardware, software, and telephony to support nurse-physician communication, along with non-IT communication practices. We calculated descriptive statistics and then created four indices, one for each category, by scoring degree of adoption of technologies or practices within each category. Next, we examined correlations between the three technology indices and the non-IT communication practices index. We used multivariate OLS regression to assess whether certain types of hospitals had higher index scores.

Results The majority of hospitals surveyed have a range of hardware, software, and telephony tools available to support nurse-physician communication; we found substantial heterogeneity across hospitals in non-IT communication practices. More intensive non-IT communication was associated with greater adoption of software (r=0.31, p=0.01), but was not correlated with hardware or telephony. Medium-sized hospitals had lower adoption of software (r =−1.14,p=0.04) in comparison to small hospitals, while federally-owned hospitals had lower software (r=−2.57, p=0.02) and hardware adoption (r=−1.63, p=0.01).

Conclusions The positive relationship between non-IT communication and level of software adoption suggests that there is a complementary, rather than substitutive, relationship. Our results suggest that some technologies with the potential to further enhance communication, such as CPOE and secure messaging, are not being utilized to their full potential in many hospitals.

Citation: Holmgren AJ, Pfeifer E, Manojlovich M, Adler-Milstein J. A novel survey to examine the relationship between health IT adoption and nurse-physician communication.