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Evaluating the impact of organisational digital maturity on clinical outcomes in secondary care in England

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Title: Evaluating the impact of organisational digital maturity on clinical outcomes in secondary care in England
Authors: Martin, G
Clarke, J
Liew, F
Arora, S
King, D
Paul, A
Darzi, A
Item Type: Journal Article
Abstract: All healthcare systems are increasingly reliant on health information technology to support the delivery of high-quality, efficient and safe care. Data on its effectiveness are however limited. We therefore sought to examine the impact of organisational digital maturity on clinical outcomes in secondary care within the English National Health Service. We conducted a retrospective analysis of routinely collected administrative data for 13,105,996 admissions across 136 hospitals in England from 2015 to 2016. Data from the 2016 NHS Clinical Digital Maturity Index were used to characterise organisational digital maturity. A multivariable regression model including 12 institutional covariates was utilised to examine the relationship between one measure of organisational digital maturity and five key clinical outcome measures. There was no significant relationship between organisational digital maturity and risk-adjusted 30-day mortality, 28-day readmission rates or complications of care. In multivariable analysis risk-adjusted long length of stay and harm-free care were significantly related to aspects of organisational digital maturity; digitally mature hospitals may not only deliver more harm-free care episodes but also may have a significantly increased risk of patients experiencing a long length of stay. Organisational digital maturity is to some extent related to selected clinical outcomes in secondary care in England. Digital maturity is, however, also strongly linked to other institutional factors that likely play a greater role in influencing clinical outcomes. There is a need to better understand how health IT impacts care delivery and supports other drivers of hospital quality.
Issue Date: 16-May-2019
Date of Acceptance: 18-Apr-2019
URI: http://hdl.handle.net/10044/1/70259
DOI: https://dx.doi.org/10.1038/s41746-019-0118-9
ISSN: 2398-6352
Publisher: Nature Research (part of Springer Nature)
Journal / Book Title: npj Digital Medicine
Volume: 2
Copyright Statement: © The Author(s) 2019. This article is licensed under a Creative CommonsAttribution 4.0 International License, which permits use, sharing,adaptation, distribution and reproduction in any medium or format, as long as you giveappropriate credit to the original author(s) and the source, provide a link to the CreativeCommons license, and indicate if changes were made. The images or other third partymaterial in this article are included in the article’s Creative Commons license, unlessindicated otherwise in a credit line to the material. If material is not included in thearticle’s Creative Commons license and your intended use is not permitted by statutoryregulation or exceeds the permitted use, you will need to obtain permission directlyfrom the copyright holder. To view a copy of this license, visithttp://creativecommons.org/licenses/by/4.0/.
Sponsor/Funder: National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
National Institute of Health Research
Funder's Grant Number: n/a
RDB04
Publication Status: Published
Article Number: ARTN 41
Appears in Collections:Division of Surgery



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