Background: This study demonstrates that digital maturity contributes to strengthened quality and safety performance outcomes in US hospitals. Advanced digital maturity is associated with more digitally enabled work environments with automated flow of data across information systems to enable clinicians and leaders to track quality and safety outcomes. This research illustrates that an advanced digitally enabled workforce is associated with strong safety leadership and culture and better patient health and safety outcomes. Objective: This study aimed to examine the relationship between digital maturity and quality and safety outcomes in US hospitals. Methods: The data sources were hospital safety letter grades as well as quality and safety scores on a continuous scale published by The Leapfrog Group. We used the digital maturity level (measured using the Electronic Medical Record Assessment Model [EMRAM]) of 1026 US hospitals. This was a cross-sectional, observational study. Logistic, linear, and Tweedie regression analyses were used to explore the relationships among The Leapfrog Group's Hospital Safety Grades, individual Leapfrog safety scores, and digital maturity levels classified as advanced or fully developed digital maturity (EMRAM levels 6 and 7) or underdeveloped maturity (EMRAM level 0). Digital maturity was a predictor while controlling for hospital characteristics including teaching status, urban or rural location, hospital size measured by number of beds, whether the hospital was a referral center, and type of hospital ownership as confounding variables. Hospitals were divided into the following 2 groups to compare safety and quality outcomes: hospitals that were digitally advanced and hospitals with underdeveloped digital maturity. Data from The Leapfrog Group's Hospital Safety Grades report published in spring 2019 were matched to the hospitals with completed EMRAM assessments in 2019. Hospital characteristics such as number of hospital beds were obtained from the CMS database. Results: The results revealed that the odds of achieving a higher Leapfrog Group Hospital Safety Grade was statistically significantly higher, by 3.25 times, for hospitals with advanced digital maturity (EMRAM maturity of 6 or 7; odds ratio 3.25, 95% CI 2.33-4.55). Conclusions: Hospitals with advanced digital maturity had statistically significantly reduced infection rates, reduced adverse events, and improved surgical safety outcomes. The study findings suggest a significant difference in quality and safety outcomes among hospitals with advanced digital maturity compared with hospitals with underdeveloped digital maturity.
This research outlines a digital imaging method under development to systemize a rapid in-field corrosion evaluation measure, to evaluate and monitor the degree of corrosion on target corrosion-prone parts on light-duty vehicles. This procedure uses digital imaging to study and compare corrosion levels of 228 vehicles that were treated with aftermarket applications of corrosion prevention products versus 141 vehicles that were untreated. It introduces a Corrosion Index (CI) as a common measure. Single-factor and two-factor analysis of variance (ANOVA) of the digitally-based corrosion measurements show statistically significant correlations between CI and treatment (treated versus untreated), as well as CI, vehicle age, and treatment. The ANOVA results show that the aftermarket-treated vehicles have statistically significantly less corrosion than the untreated vehicles, demonstrating that digital image analysis is a viable method of measuring corrosion on corrosion-prone vehicle parts, offering the potential to monitor and track the performance/efficacy of aftermarket corrosion treatment in real-time.