All ETDs from UAB

Advisory Committee Chair

Darrell Burke

Advisory Committee Members

Nancy Borkowski

Grant T Savage

Bisakha Sen

Ferhat D Zengul

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


The Centers for Medicare and Medicaid (CMS) meaningful use requirement, as well as documented evidence suggest that health information technology (HIT) has the potential to promote patient engagement and consequently improve quality and reduce cost. This prompts a better understanding of hospital adoption of HIT for patient engagement. The purpose of the three papers presented in this dissertation is to examine hospital adoption of health information technology (HIT) to facilitate patient engagement. Emphasis is placed on the functionalities (i.e., functions or capabilities) offered by these technologies that have been determined to allow patients be more involved in their care because an initial systematic review revealed inconsistencies in the functionalities offered by different HIT. How hospital characteristics and environmental characteristics moderate the rate of adoption of these functionalities is examined. The characteristics of early adopters of these functionalities are also presented. These early adopters were then compared to the later adopter groups based on their financial performance. The findings of this dissertation suggest that hospital leadership must be deliberate and proactive in their HIT strategy for patient engagement. It suggests that while there is a positive trend in the adoption of HIT functionalities for patient engagement, hospital and environmental characteristics play an important role in how quickly hospitals will adopt. Additionally, a hospital’s innovativeness as it pertains to its adoption of patient engagement functionalities is associated with better operating margins, but not total margins or return on assets. Altogether, these studies will be helpful to hospital leaders as they attempt to develop a strategy to adopt HIT for patient engagement in their hospitals.