Operational and strategic information processing: Complementing healthcare IT infrastructure

Healthcare information technologies (HIT) have been promoted as key enablers of improved patient safety, reduced medical errors, and increased patient satisfaction but have yielded mixed results. Drawing upon information processing theory and quality management concepts, we examine HIT infrastructure simultaneously with two distinct means of processing information: (1) operational use of error data for detecting and reducing hospital errors, and (2) strategic use of objective data for organizational planning. We use time-sequenced data to examine HIT infrastructure (secondary data in 2008), information processing mechanisms (primary survey data from 258 hospitals in 2009), and two measures of hospital performance: (1) care quality, and (2) patient satisfaction (secondary data in 2010). Using hierarchical regression analysis we find that whether and how investments in HIT infrastructure are complemented by information processing mechanisms depends upon the performance measure under consideration and the form of information processing employed. Specifically, operational error processing complements HIT infrastructure in its association with higher care quality but not with patient satisfaction. In comparison, higher levels of strategic information processing complement HIT infrastructure in its association with higher patient satisfaction.