Associations Between Hospital Health Information Technology Adoption and Star Ratings, Readmissions, and Mortality

BACKGROUND: Quality of care is essential to an efficient and cost-effective healthcare system. Health information technology (HIT) adoption has emerged as a promising structural solution for improving the quality of clinical processes and patient outcomes at hospitals. The objective of this work was to estimate the association between hospital HIT adoption and performance on quality indicators (QIs). METHODS: Cross-sectional study linking data from the 2023 American Hospital Association Annual Survey and Information Technology Supplement, the 2021-2024 Centers for Medicare and Medicaid Services Hospital Care Compare databases, and the 2023 Area Health Resources Files. Descriptive and regression analyses were run with hospital-level clustering, examining the association between adoption of telehealth (treatment-stage and postdischarge), health information exchange (HIE), and patient engagement (PE) technologies and performance on star ratings (scale of 1-5), 30-day readmissions, and 30-day mortality. RESULTS: Among a sample ranging from 1,636 to 2,771 acute care hospitals in the United States (depending on QI outcome and HIT exposure), telehealth, HIE, and PE adoption were found to be associated with higher star ratings (treatment-stage: 0.36 stars; postdischarge: 0.15 stars; HIE: 0.17 stars; PE: 0.12 stars) and lower mortality (treatment-stage: -0.31 pp.; postdischarge: -0.19 pp.; HIE: -0.19 pp.; PE: -0.16 pp.). HIE adoption was also associated with lower readmissions (-0.07 pp.), whereas the association between PE adoption and readmissions was not statistically significant. CONCLUSIONS: Hospital HIT adoption is associated with better performance on QIs, suggesting that digital infrastructure may support hospital quality improvement. Policy efforts should focus on alleviating barriers to adoption and promoting access to technology resources.