Graduation Date

Fall 12-16-2016

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Health Services Research, Administration, and Policy

First Advisor

Dr. Preethy Nayar

Abstract

Medication errors and adverse drug events (ADEs) are a significant public health concern in the United States as they pose a threat to patient safety. The medication management process is a complicated process in U.S. acute care hospitals, consisting of a series of steps such as ordering, transcribing, dispensing and administration and each step is prone to medication errors.The use of technology is considered to be an important intervention in improving the medication management process and thereby reducing medication errors and ADEs and further improve patient safety. The Health Information Technology for Economic and Clinical Health (HITECH) Act, implemented in the year 2011, is the most important regulation in recent years focused on enhancing the use of IT in the health care system.This study examined the organizational and environmental correlates of the adoption of Medication Management Technologies (MMTs) by U.S. acute care hospitals after the HITECH Act.

The rational adaptation perspective of the resource dependence theory is utilized in this study, using panel data from 2009 to 2013 with a one-year lag for independent variables and mixed-effects regression models for analyses. The study operationalized adoption of MMTs through seven measures: global adoption of MMTs, adoption of closed loop medication management, adoption of meaningful use MMTs and adoption-levels for the four steps of the medication management process: ordering, transcribing, dispensing and administration.

Hospitals were more likely to adopt MMTs in the time after the implementation of the HITECH Act (2012, 2013) and were less likely to adopt MMTs before the implementation of the HITECH Act (2009, 2010) as compared to the HITECH Act implementation period (2011). The study further found that the resource dependence construct of munificence, operationalized through organizational size, and the construct of interdependence, operationalized through private payer mix was significantly associated with the adoption of MMTs.

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