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State Consent Policies and the Meaningful Use of Electronic Health Records Among Nonfederal Acute Care Hospitals in the United States

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State Consent Policies and the Meaningful Use of Electronic Health Records Among Nonfederal Acute Care Hospitals in the United States Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2021 State Consent Policies and the Meaningful Use of Electronic Health Records Among Nonfederal Acute Care Hospitals in the United States Adetoro Kafilat Longe Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Health and Medical Administration Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Professions This is to certify that the doctoral study by Adetoro K. Longe has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Rabeh Hijazi, Committee Chairperson, Health Sciences Faculty Dr. Kevin Broom, Committee Member, Health Sciences Faculty Dr. Suzanne Richins, University Reviewer, Health Sciences Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2021 Abstract State Consent Policies and the Meaningful Use of Electronic Health Records Among Nonfederal Acute Care Hospitals in the United States by Adetoro Kafilat Longe MJ, Loyola University, Chicago, 2010 BS, UT Southwestern Medical Center, Dallas, 1995 Proposal Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Healthcare Administration Walden University August 2021 Abstract The less-than-nationwide use of electronic health record (EHR) systems to send, receive, and integrate (SRI) patient summary of care (PSC) records limits the ability of hospital administrators to maximize efficiency and improve quality in the continuum of care. Despite obvious differences in state health information exchange (HIE) consent policies, there is no known research that has determined if and what aspects of state-level HIE legislation affect the use of EHR systems to SRI PSC records. Guided by the unified theory of acceptance and use of technology (UTAUT), the purpose of this quantitative cross-sectional research study was to examine the relationship between one independent variable (type of HIE consent policy) and three dependent variables: percent of nonfederal acute care hospitals that electronically (a)send (b) receive (c) integrate PSC records from and into their EHR from outside providers respectively. Data analysis using multivariate analysis of variance (MANOVA) statistical test found that Opt-in policy states had the lowest percentage of hospitals engaging in the three domains. The study also found that the use of EHR systems was most rampant in states with relatively less stringent HIE policies., there was a non-statistically significant relationship between HIE policy type and the dependent variable. However, the relationship between year (secular trend) and the dependent variable was statistically significant as there was incremental changes in the independent variable between 2015 and 2017. The study contributes to positive social change by providing increased research within the (HIE) field aiming to promote government and private sector investment to understand and address technological, practice, and policy barriers regarding EHR-to-EHR system integrations. State Consent Policies and the Meaningful Use of Electronic Health Records Among Nonfederal Acute Care Hospitals in the United States by Adetoro Kafilat Longe MJ, Loyola University, Chicago, 2010 BS, UT Southwestern Medical Center, Dallas, 1995 Proposal Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Healthcare Administration Walden University August 2021 Dedication First and foremost, I praise and thank the Almighty, the Supreme Allah, who gave me life, strength, knowledge, and good health throughout my course work. It is also dedicated to my grandmother, “Iya alakara,” for instilling in me very early in life the value of education when she enrolled me in elementary and secondary schools many years ago. I also thank my husband, who inspired and supported me through this journey. Acknowledgments My deepest gratitude goes to the people who helped make this research possible: Dr. Hijazi, my proposal committee chairperson, providing invaluable guidance throughout this research, Dr. Broom, committee member, for his insightful comments and hard questions, Dr. Richins, committee URR, and one of my course facilitators who enlightened me the first glance of writing research question. Also, I express my thanks to Dr. Ester Nnorom, my coach and mentor, Dr. Sheryl Richard, one of my course facilitators, who encouraged me to stay the course until I cross the finish line, Dr. Raymond Thron, who challenged and helped me learn how to interpret the statistics computation to the layperson and encouraged me to stay focused and committed. Thanks to my student success advisors James Williams and Jennifer Rothamel for their support and periodic progress phone chats. I also want to thank my husband, Rahman, and my children: Olanrewaju and Oluwatobi, for their love, cooperation, and understanding throughout the writing of this research. My special thanks go to my parents, sisters, brother, and friends for their support and valuable prayers. Finally, my thanks go to all the people who have supported me to complete the research work directly or indirectly. Table of Contents Abstract .............................................................................................................................. iii Dedication ............................................................................................................................v Acknowledgments.............................................................................................................. vi List of Tables .......................................................................................................................v List of Figures .................................................................................................................... vi Section 1: Foundation of the Study ......................................................................................1 Introduction ....................................................................................................................1 Problem Statement .........................................................................................................3 Purpose of the Study ......................................................................................................4 Research Questions and Hypothesis ..............................................................................5 Theoretical Foundation for the Study ............................................................................7 The Main Theoretical Proposition of the UTAUT ................................................. 8 Rationale for Choice of Theory ............................................................................ 12 Logical Connection Between Key Elements of the UTAUT ................................ 14 Relationship with Study Approach ....................................................................... 15 Application of the UTAUT to Similar Studies ..................................................... 16 Nature of the Study ......................................................................................................19 Literature Research Strategy ........................................................................................19 Literature Review Related to Key Concepts ................................................................20 Historical Background of EHR Meaningful Use .................................................. 20 Studies Related to the Constructs of Interest ........................................................ 23 i Methodologies in Studies that are Consistent with the Scope of Research .......... 26 Ways Researchers Have Approached the Problem ............................................... 28 The Impact of EHR Technology ........................................................................... 39 Factors that Influence EHR Adoption and MU .................................................... 48 EHR Data Privacy and Security ............................................................................ 53 Studies Related to HIE Consent Policies .............................................................. 58 Studies Related to Research Questions ................................................................. 60 Definitions....................................................................................................................62 Basic EHR System ................................................................................................ 62 Certified EHR System........................................................................................... 62 EHR 62 EHR MU ............................................................................................................... 63 Interoperability ...................................................................................................... 63 Nonfederal Acute Care Hospital ........................................................................... 63 PSC Records ........................................................................................................
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