72 Chapter 5 Our thesis behind this study is that when basic clinical functionalities (EMRAM>=3) are available in a hospital, the patients will have a more efficient hospitalization. Efficient communication could prevent medical or organizational mistakes andmake it possible to transfer patients from an intensive care unit (ICU) to a general ward and transfer patients from the ward to home without undue delay. We used the post-operative length of stay (LOS) in this study because that is where the presumed effect is expected. Preoperative patients are usually admitted to the hospital the same day or the day before the surgery. University and top teaching hospitals provide a great deal of specialized care andmedical research, as well as the training and education of many of the nation’s health care providers. Former studies 12,13 indicate that academic affiliated hospitals may more easily adapt to changes than general hospitals. According to Retchin and Wenzel13, university health centers, as well as top teaching hospitals, can easily adapt to the use of EMRs because they, “have the expertise to resolve remaining software issues, the components necessary for the integrated delivery, a culture for innovation in clinical practice, and a generation of future providers that can be acclimated to the requisites for computerized records”(p.493 of Retchin and Wenzel13). Another reason for this increased likelihood is that medical training occurs in these hospitals, and younger medical trainees tend to be more comfortable with computers as they have recently used them in school14. Because of this, the staff resistance to EMR usemay not be as great as in other hospitals13. Based upon these properties we expect that in academic affiliated hospitals the abovementioned effect is even stronger. From this model (Figure 1) we deducted the following hypotheses. Figure 1 - the theoretical model
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