Summary
Background As EHR adoption in US hospitals becomes ubiquitous, a wide range of IT options are
theoretically available to facilitate physician-nurse communication, but we know little
about the adoption rate of specific technologies or the impact of their use.
Objectives To measure adoption of hardware, software, and telephony relevant to nurse-physician
communication in US hospitals. To assess the relationship between non-IT communication
practices and hardware, software, and telephony adoption. To identify hospital characteristics
associated with greater adoption of hardware, software, telephony, and non-IT communication
practices.
Methods We conducted a survey of 105 hospitals in the National Nursing Practice Network.
The survey captured adoption of hardware, software, and telephony to support nurse-physician
communication, along with non-IT communication practices. We calculated descriptive
statistics and then created four indices, one for each category, by scoring degree
of adoption of technologies or practices within each category. Next, we examined correlations
between the three technology indices and the non-IT communication practices index.
We used multivariate OLS regression to assess whether certain types of hospitals had
higher index scores.
Results The majority of hospitals surveyed have a range of hardware, software, and telephony
tools available to support nurse-physician communication; we found substantial heterogeneity
across hospitals in non-IT communication practices. More intensive non-IT communication
was associated with greater adoption of software (r=0.31, p=0.01), but was not correlated
with hardware or telephony. Medium-sized hospitals had lower adoption of software
(r =−1.14,p=0.04) in comparison to small hospitals, while federally-owned hospitals
had lower software (r=−2.57, p=0.02) and hardware adoption (r=−1.63, p=0.01).
Conclusions The positive relationship between non-IT communication and level of software adoption
suggests that there is a complementary, rather than substitutive, relationship. Our
results suggest that some technologies with the potential to further enhance communication,
such as CPOE and secure messaging, are not being utilized to their full potential
in many hospitals.
Citation: Holmgren AJ, Pfeifer E, Manojlovich M, Adler-Milstein J. A novel survey to examine
the relationship between health IT adoption and nurse-physician communication.
Keywords
Electronic health records and systems - inpatient CPOE - provider-provider - hospital
information systems - communication
