IT Governance Characteristics,Electronic Medical Records Sophistication,and Financial Performance in U.S. Hospitals: An Empirical Investigation

As a result of a recent federal government mandate, an increasing number of hospitals have decided to adopt electronic medical record (EMR) systems. This initiative is expected to lead toward more efficient and higher quality health care; however, little is known about governance characteristics and organizational performance for EMR adopters. Our goal is to inform theory and practice by examining hospitals with a sophisticated EMR and comparing those hospitals to similar hospitals (with a less sophisticated EMR) to understand the association between information technology (IT) governance characteristics and the implications on financial performance. Leveraging elements of the upper echelon theory, we posit that hospitals in which the chief information officer (CIO) reports to the chief executive officer, CIO turnover is low, and an IT steering committee is present are more likely to have a sophisticated EMR. We argue that EMR sophistication leads to improved financial performance. Our results underscore the importance of continuity in the CIO position on successful EMR implementations. Results also show that hospital size and financial performance are strongly associated with EMR sophistication. In addition, we find that a sophisticated EMR appears to be a fundamental element in improving hospitals’ revenue cycle management. Moreover, we find that hospitals with a sophisticated EMR appear to be more profitable. Finally, we observe that total payroll expense adjusted by total discharges drops among the sophisticated hospitals, potentially due to an increase in employee productivity. These insights can serve as a basis for tempering expectations relative to the financial impact of EMR adoption.     

The Effect of Implicit and Explicit Rules on Customer Greeting and Productivity in a Retail Organization

The purpose of this study was to determine the effects of presenting organizational information through implicit and explicit rules on sales-related target behaviors in a retail setting. Results indicated that when organizational information was presented in a specific form, productivity was increased and maintained longer than when presented in other forms. The data provided by secret shoppers generally resembled the findings of the data collected in the experiment.     

Trauma,coping resources,and family functioning in emergency services personnel: A comparative study

In this study a sample of male, shift-working, operational ambulance officers were compared with a group of male shift-workers from a range of occupations in which exposure to traumatic events was not inherent in the role ( N = 71). Three dimensions of family functioning were examined: intimacy, conflict, and parenting styles, with respect to occupational type (i.e. work-related exposure to trauma) and accounting for personal resources (coping). Personal resources were found to have a significant impact on the dimensions of family functioning. Furthermore, differences emerged in the pattern of coping between the two groups. Ambulance officers demonstrated a more varied repertoire of personal resources than the control group. Social support was found to be the sole predictor of intimacy and conflict levels in the control sample. However, in the ambulance group social support was predictive of intimacy levels, rational-cognitive strategies were predictive of conflict levels, and self-care, social support, and rational-cognitive strategies were all significantly correlated with the three dimensions of family functioning.     

Costly and discrete communication: an experimental investigation

Language is an imperfect and coarse means of communicating information about a complex and nuanced world. We report on an experiment designed to capture this feature of communication. The messages available to the sender imperfectly describe the state of the world; however, the sender can improve communication, at a cost, by increasing the complexity or elaborateness of the message. Here the sender learns the state of the world, then sends a message to the receiver. The receiver observes the message and provides a best guess about the state. The incentives of the players are aligned in the sense that both sender and receiver are paid an amount which is increasing in the accuracy of the receiver’s guess. We find that the size of the language endogenously emerges as a function of the costs of communication. Specifically, we find that higher communication costs are associated with a smaller language. Although the equilibrium predictions do not perform well, this divergence occurs in a manner which is consistent with the experimental communication literature: overcommunication. We find that the sender’s payoffs, relative to equilibrium payoffs, are decreasing in the cost of communication. We also find that the receiver’s payoffs, relative to equilibrium payoffs, are increasing in the cost of communication. Finally, we find imperfections in coordination on the basis of the experimental labels.     

Accurate Confidence Interval Estimation of Small Area Parameters Under the Fay–Herriot Model

Small area estimation has long been a popular and important research topic due to its growing demand in public and private sectors. We consider here the basic area level model, popularly known as the Fay–Herriot model. Although much of current research is predominantly focused on second order unbiased estimation of mean squared prediction errors, we concentrate on developing confidence intervals (CIs) for the small area means that are second order correct. The corrected CI can be readily implemented, because it only requires quantities that are already estimated as part of the mean squared error estimation. We extend the approach to a CI for the difference of two small area means. The findings are illustrated with a simulation study.     

Predictors of children's understandings of death: age, cognitive ability, death experience and maternal communicative competence

A child's age, cognitive ability, and exposure to death in the environment have been documented as major factors affecting the formation of a mature death concept. The present study investigated the relationships between these three factors (age, cognitive ability, and death experience) and children's understandings of death, as well as the relationship between mothers' communicative competence and children's understandings of death. Thirty-seven children (ages 48-96 months) completed three cognitive tasks and answered four dichotomous questions about death. Their mothers (N = 37) responded in writing to 16 questions about death that children are likely to ask. Results showed significant relationships between age and understanding, between seriation ability and understanding, and between death experience and understanding. There was no statistically significant relationship between maternal response competence and children's understandings of death. Implications are discussed.     

A note on homogeneity tests of covariance matrices

In this note we propose two procedures for testing homogeneity of co-variance matrices that are both extensions of Hartley's (1940) test for equality of variances. The first is a two-stage procedure where the first step is a simple test for equality of the largest eigenvalues, and corresponding eigenvectors, of the covariance matrices. The second is based on projection pursuit and seems harder to apply in practice.     

A continuous repeated measurements model:the experimental design problem with fixed time constraints

A repeated measurements model where the within-subject response is modeled as a continuous time regression is analyzed using reproducing kernel Hilbert space methods, Parzen (1961). The basic goal is to study the statistical design problem when experimental units and measurements are "free", but the total measurement time is fixed. This kind of situation arises when the experiment uses scarce resources such as space or oceanographic platforms or a magnetic resonance imaging (MRI) device. In this situation the only constraint is the total time allocated to the experiment.