31 Profile of the digitization of patient medical records in Dutch hospitals H2: As environmental competition increases, the likelihood of having advanced EMR capabilities increases. The ‘Randstad’ area of NL (defined by the area around Amsterdam, The Hague, Rotterdam and Utrecht with 40% of total population of the Netherlands) has the highest concentration of hospitals in all of NL. With the density of hospitals per 10km in the Randstad area equaling 4.5, compared to a hospital density of 1.3 in the non-Randstad area, 17 the findings of this study provide no support for the hypothesis that EMR adoption increases based on environmental competition (Table 4). On the contrary, the nonRandstad area generally presents as having a more advanced EMR profile as the largest grouping of hospitals in the non-Randstad area (58.1%) are in Stage 3-5, while in the Randstad area 52.2% are in Stages 1 and 2. TABLE 4: Competition Density by EMRAM Stage competion density Average numbers of hospitals within a 10km area Stage 0-2 Stage 3-5 Stage 6 and 7 Count Row N% Count Row N% Count Row N% non-Randstad 1.3 13 30.2% 25 58.1% 5 11.6% Randstad 4.5 12 52.2% 8 34.8% 3 8.3% Non-Randstad region has more digital potential H3: Larger hospitals are more likely to have advanced EMR capabilities. Although not statistically significant, the general pattern emerging from this study (Table 5) supports the hypothesis that larger hospitals tended to have more advanced EMR capabilities than smaller hospitals. This pattern is reflected in the number of staffed beds. 2
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