The Impact of Electronic Medical Records on the Process of Care: Alignment with Complexity and Clinical Focus

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.