The cost of healthcare in the United States is on an upward trajectory towards an unsustainable level. In order to address this, Congress and the Obama Administration passed the American Recovery and Reinvestment Act (ARRA) of 2009 to begin the process of controlling these costs. Within the ARRA is the Health Information Technology for Economic and Clinical Health (HITECH) section which creates financial incentives to invest in Health Information Technology (HIT) and to develop a means to measure the Meaningful Use of specific functions of Electronic Health Records (EHRs). This research examines the widely used Joint Commission datasets to determine their suitability as a basis of meeting the government mandated measuring of Meaningful Use. The datasets used for this study consists of hospital level performance measures with a sample size of 370 hospital samples of HIT Use Intensity and Cardiovascular Performance attained from the Veterans Health Administration (VHA). An Organizational Network Theoretical approach was applied to the data in a non-experimental, sample-resample design to data collected in 2007. A Structural Equation Model (SEM) was built to test for the strength of the correlation between HIT Use Intensity and Cardiovascular Performance and a Latent Growth Curve Model (LGM) was built to examine the effect of the trajectory of HIT Use Intensity on the trajectory of Cardiovascular Performance. The SEM found a weak (.18) correlation between HIT Use Intensity and Cardiovascular Performance and the model only captured 12 percent of the variance. The LGM found no convergence between the trajectories of HIT Use Intensity and Cardiovascular Performance. This may have been the result of the data being non-normally distributed and heavily skewed to the high end of the scale. The policy implications of this study indicate that while Joint vi Commission data capture only a small amount of the variance attributed to HIT Use it does show a weak but positive correlation between increases in HIT Use Intensity and Increases in Cardiovascular Performance at the hospital level. Future research into adjustments to Joint Commission data measures (or others) may prove to be valuable in measuring the Meaningful Use of HIT systems in order to help hospitals make educated decisions on which HIT systems to purchase and the potential benefits associated with them.


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Graduation Date





Wan, Thomas T. H.


Doctor of Philosophy (Ph.D.)


College of Health and Public Affairs

Degree Program

Public Affairs









Release Date

June 2013

Length of Campus-only Access

1 year

Access Status

Doctoral Dissertation (Open Access)


Dissertations, Academic -- Health and Public Affairs, Health and Public Affairs -- Dissertations, Academic