Although electronic medical records (EMR) have attracted significant academic and practitioner interest, findings regarding the impacts of EMR on hospital performance remain inconclusive. Drawing on organizational information processing theory, we examine whether EMR will improve the process of care to a greater extent when the complexity of hospital operations is higher. In addition, we investigate whether clinical focus complements or substitutes EMR in mitigating hospital complexity. We cluster hospitals into three stages based on their cumulative capabilities as identified by the EMR Adoption Model (EMRAM) and assemble a longitudinal database tracking hospitals’ EMR capabilities and their performance between 2005 and 2014. Our study reveals that advanced stages of EMR mitigate hospital complexity and thus improve the process of care to greater extents than lower stages of EMR. In addition, we find that clinical focus substitutes for lower stages of EMR whereas complements higher stages of EMR in mitigating the potential negative impacts of complexity on the process of care. These findings offer significant managerial implications in aligning EMR capabilities and the clinical focus strategy to mitigate complexity.

中文翻译：

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电子病历对护理过程的影响：与复杂性和临床重点保持一致

尽管电子病历 (EMR) 引起了学术界和从业人员的极大兴趣，但关于 EMR 对医院绩效影响的研究结果仍然没有定论。借鉴组织信息处理理论，我们研究了当医院运营的复杂性更高时，EMR 是否会更大程度地改善护理过程。此外，我们调查了临床重点是补充还是替代 EMR 以减轻医院的复杂性。我们根据 EMR 采用模型 (EMRAM) 确定的累积能力将医院分为三个阶段，并组装一个纵向数据库，跟踪医院在 2005 年至 2014 年期间的 EMR 能力及其绩效。我们的研究表明，EMR 的晚期阶段减轻了医院的复杂性，从而比 EMR 的较低阶段在更大程度上改善了护理过程。此外，我们发现临床重点替代了 EMR 的较低阶段，而补充了 EMR 的较高阶段，以减轻复杂性对护理过程的潜在负面影响。这些发现在调整 EMR 能力和临床重点战略以减轻复杂性方面提供了重要的管理意义。