Doctors' orders--If they're electronic, do they improve patient satisfaction? A complements/substitutes perspective

Doctors' orders entered with Computerized Physician Order Entry (CPOE) systems are designed to enhance patient care by standardizing routines that are intended to improve quality of healthcare. As with other health information technology (IT) performance studies, literature shows conflicting results regarding the CPOE-performance relationship. By adopting a more nuanced perspective and employing not just adoption but extent of use of CPOE, we first examine whether or not CPOE use improves patient satisfaction. Next, given that CPOEs are implemented in the backdrop of other hospital IT infrastructure, we examine how IT infrastructure impacts the relationship between CPOE use and satisfaction, testing both a complementary and substitution perspective. Finally, we examine the differential impact of CPOE use between academic and non-academic hospitals. Using data from 806 hospitals nationwide, we find a positive relationship between extent of CPOE use and patient satisfaction. Contrary to extant research, our results suggest this relationship is stronger in non-academic hospitals. We also find evidence that a hospital's IT infrastructure substitutes for CPOE use in its effect on patient satisfaction. (C) 2011 Elsevier B.V. All rights reserved.