Accelerating adoption of clinical IT among the healthcare providers in United States: Strategies and policies

As complex and fragmented as it is, US healthcare system cannot deliver high-quality care in an efficient manner without having timely and appropriate clinical information and decision support at the point of care. Moreover, there are substantial difficulties with proper monitoring of quality, safety and efficiency of delivered health care in the absence of appropriate infrastructure for capture and analysis of clinical information. Healthcare and IT experts argue that nationwide adoption of advanced clinical health information technology (HIT) is essential tool to transform US healthcare into the system that delivers consistently high quality of care with greater efficiency for more patients. The goal of this dissertation is to analyze the adoption process and derive policy strategies that can promote the nationwide adoption of Healthcare Information Technology (HIT) in the US.; To this end, the current status and dynamics of HIT adoption in US is assessed, as well as its implications for the menu of policy options. The dissertation provides an economic analysis of adoption decision in hospitals and healthcare systems, as well as analysis of market failures that stymie the diffusion and require policy interventions. Finally, the hypotheses on the factors of clinical HIT adoption are evaluated in the empirical analysis of adoption in the US hospitals, helping to identify the facilities that are disadvantaged or least likely to adopt. The conclusions call for greater CMS involvement and reimbursement models that would reward higher quality and efficiency achieved through HIT.