JMIR Publications

ABSTRACT

Background:

The healthcare system in the United States (US) is burdened with high costs in part caused by hospital readmission. The use of smart tracking technology (STT) has demonstrated the potential to improve clinical outcomes through streamlining clinical use, health information exchange (HIE), mobile information technology (IT), and supply chain workflow processes with improved accuracy, mobility, and efficiency, thus lowering the risk of patient readmission. Despite these benefits, the joint effects of STT and associated complementary health information technologies (HITs) on readmission risk have yet to be examined in depth.

Objective:

Through a complementarity theory lens, this study aims to examine the joint effects of STT for clinical use and three other HITs: STT for supply chain management, mobile IT, and HIE on 30-day all-cause readmission risk.

Methods:

This study employs a substantial in-patient dataset from 2014 to 2015 from multiple sources in the US, comprising 879,122 in-patient admissions from 347,949 patients in 61 hospitals located in Florida and New York states. Logistic regression was applied to assess the effect of HITs on readmission risks, and robust standard errors were utilized to identify potential heteroskedasticity. Additionally, the errors were clustered at the patient level to consider possible correlations within patient groups.

Results:

The interaction between STT for clinical use and STT for supply chain management, mobile IT, and HIE, respectively, was associated with a decreased likelihood of 30-day readmission, with odds ratios (OR) of 0.9654 (95% CI 0.943 - 0.988), 0.9494 (95% CI 0.929 - 0.970), and 0.9786 (95% CI 0.959 - 0.999). The joint effects of these HITs varied depending on the hospital affiliation and disease type.

Conclusions:

This study utilizes the complementarity theory lens to explore the complementary use of various HITs, STT for clinical use, STT for supply chain management, mobile IT, and HIE in a real-world setting. We demonstrate different complementary HITs can be integrated together and used to achieve optimal results in a hospital setting. This study provides evidence-based research on the potential for hospitals to tailor their HITs to their specific affiliations and different care settings. Furthermore, it also offers practical implications for hospitals to maximize the benefits of their complementary HITs in reducing their patient readmission rates and their respective care scenarios.