All ETDs from UAB

Advisory Committee Chair

Sue S Feldman

Advisory Committee Members

Eta Berner

Allen Johnston

William Opoku-Agyeman

Benjamin Schooley

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


The Electronic Health Record (EHR) is defined as “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting” (HIMSS, 2011). EHRs have become an important part of the current health system as a result of government regulations, technology advancements, health care challenges, and market conditions. EHRs are considered an expensive investment; however, the complexity of adopting and implementing EHRs also demands attention. Given the complexity of health information technology (HIT) systems and the hefty investment that is required in the adoption of EHRs, a return on investment is expected, and it is essential to analyze return on investment (ROI) from more than just the financial perspective. This study analyzes the ROI of EHR adoption investment in terms of value. For the purpose of this study, value is broken down in two measures: financial and clinical. The objective of this study was to determine how EHR adoption (levels of EHR adoption) contributes to financial (operating margins, total margins) and clinical outcomes (readmission rate, length of stay) for acute care hospitals. To do this, a fixed effects and fixed effects moderation analysis was conducted. The findings from this study provided statistically-significant evidence indicating that there is a relationship between EHR adoption and operating margins when this relationship is moderated by readmission rates.



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