The purpose of this study is to further understanding about the state of electronic medical record (EMR) systems in U.S. hospitals.Specifically, the study addresses the following questions: (1) How can sophistication be measured in the context of EMR systems in U.S. hospitals?(2) Is the sophistication level of EMR systems associated with specific information system leadership structures, planning practices, or strategies?A stage model of EMR sophistication was tested using Guttman scaling techniques and was found not to be a valid characterization of EMR systems.Therefore, using latent class analysis, a three-class model was identified, categorizing EMR system sophistication into basic, intermediate, and advanced systems.Logistic regression procedures were used to identify whether specific organizational variables correlate to EMR class membership.These variables measured delivery system capacity, hospital capacity, information system leadership structure, and information system planning practices and strategies.Multinomial logistic regression results suggest that the best predictors of EMR sophistication are the size of the delivery system, having a disaster recovery backup facility for information systems, and pursuing a best-of-suite vendor selection strategy.
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Understanding Sophistication in the Context of Electronic Medical Record Systems