Appl Clin Inform - Measurement error in performance studies of health information technology: lessons from the management literature.

Tópicos

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Resumo

Just as researchers and clinicians struggle to pin down the benefits attendant to health information technology (IT), management scholars have long labored to identify the performance effects arising from new technologies and from other organizational innovations, namely the reorganization of work and the devolution of decision-making authority. This paper applies lessons from that literature to theorize the likely sources of measurement error that yield the weak statistical relationship between measures of health IT and various performance outcomes. In so doing, it complements the evaluation literature's more conceptual examination of health IT's limited performance impact. The paper focuses on seven issues, in particular, that likely bias downward the estimated performance effects of health IT. They are 1.) negative self-selection, 2.) omitted or unobserved variables, 3.) mis-measured contextual variables, 4.) mismeasured health IT variables, 5.) lack of attention to the specific stage of the adoption-to-use continuum being examined, 6.) too short of a time horizon, and 7.) inappropriate units-of-analysis. The authors offer ways to counter these challenges. Looking forward more broadly, they suggest that researchers take an organizationally-grounded approach that privileges internal validity over generalizability. This focus on statistical and empirical issues in health IT-performance studies should be complemented by a focus on theoretical issues, in particular, the ways that health IT creates value and apportions it to various stakeholders.

Resumo Limpo

just research clinician struggl pin benefit attend health inform technolog manag scholar long labor identifi perform effect aris new technolog organiz innov name reorgan work devolut decisionmak author paper appli lesson literatur theoriz like sourc measur error yield weak statist relationship measur health various perform outcom complement evalu literatur conceptu examin health limit perform impact paper focus seven issu particular like bias downward estim perform effect health negat selfselect omit unobserv variabl mismeasur contextu variabl mismeasur health variabl lack attent specif stage adoptiontous continuum examin short time horizon inappropri unitsofanalysi author offer way counter challeng look forward broad suggest research take organizationallyground approach privileg intern valid generaliz focus statist empir issu health itperform studi complement focus theoret issu particular way health creat valu apport various stakehold

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