In 2009, the American Recovery and Reinvestment Act was signed into law. This legislation provided for monetary rewards for those acute-care hospitals that meet \"meaningful use\" computerization and reporting criteria.
The study used a descriptive, nonexperimental design to answer three research questions (1) What is the level of readiness to meet \"meaningful use\" criteria in the Tennessee Hospital Association (THA) member hospitals; (2) What is the level of readiness to meet \"meaningful use\" criteria in the rural THA member hospitals; and (3) Is there a difference in the readiness to meet \"meaningful use\" criteria between rural and urban THA member hospitals?.
A survey was sent to 115 THA member hospital, with a return rate of 83% (N=95). The inclusion criteria focused on acute-care hospitals, with rehabilitation, psychiatric and long-term care hospitals falling into the exclusion criteria.
The Readiness Score was determined for the total survey respondents (N=95), as well as for the rural (N=41) hospitals and urban (N=54) hospitals in the Tennessee Hospital Association member hospitals meeting the inclusion criteria. Z-scores of the readiness score were examined and indicated that there was one outlier with z>3.0. Therefore, that case was removed from the comparison in the t-test (N=94). The t-test comparison of rural and urban hospital found a significant difference at (p=.002), two tailed.
To ensure that the slightly nonnormal distribution of the readiness scores did not explain the difference found with the t-test, an additional nonparametric test was also conducted. The Mann Whitney U-test showed that even with the assumption of a normal distribution is not made, the difference in readiness between urban and rural hospitals is still statistically significant at p=0.026.
","abstract_html":"<p>In 2009, the American Recovery and Reinvestment Act was signed into law. This legislation provided for monetary rewards for those acute-care hospitals that meet "meaningful use" computerization and reporting criteria.</p><p>The study used a descriptive, nonexperimental design to answer three research questions (1) What is the level of readiness to meet "meaningful use" criteria in the Tennessee Hospital Association (THA) member hospitals; (2) What is the level of readiness to meet "meaningful use" criteria in the rural THA member hospitals; and (3) Is there a difference in the readiness to meet "meaningful use" criteria between rural and urban THA member hospitals?.</p><p>A survey was sent to 115 THA member hospital, with a return rate of 83% (N=95). The inclusion criteria focused on acute-care hospitals, with rehabilitation, psychiatric and long-term care hospitals falling into the exclusion criteria.</p><p>The Readiness Score was determined for the total survey respondents (N=95), as well as for the rural (N=41) hospitals and urban (N=54) hospitals in the Tennessee Hospital Association member hospitals meeting the inclusion criteria. Z-scores of the readiness score were examined and indicated that there was one outlier with z>3.0. Therefore, that case was removed from the comparison in the t-test (N=94). The t-test comparison of rural and urban hospital found a significant difference at (p=.002), two tailed.</p><p>To ensure that the slightly nonnormal distribution of the readiness scores did not explain the difference found with the t-test, an additional nonparametric test was also conducted. The Mann Whitney U-test showed that even with the assumption of a normal distribution is not made, the difference in readiness between urban and rural hospitals is still statistically significant at p=0.026.</p>","abstract_has_math":false,"creators":["Wilhoit, Kathryn Wallin"],"institution":null,"degree_name":"PhD (Doctor of Philosophy)","degree_level":"Dissertation - unrestricted","degree_discipline":"Nursing","degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2012,"date_issued":"2012-05-05T07:00:00Z","date_published":"2012-05-05T07:00:00Z","updated_at":"2026-07-24T02:20:31Z","subjects":["rule","rural","meaningful use","ARRA","HITECH","CPOE","meaningful use criteria","non-rural","urban","Health Services Research","Medicine and Health Sciences","Public Health"],"languages":[],"rights":["Copyright by the authors."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://dc.etsu.edu/etd/1449","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Wilhoit, Kathryn Wallin"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.issued","label":"Date","values":["2012-05-05T07:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Nursing"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Dissertation - unrestricted"]},{"key":"thesis:degree_name","label":"Degree Name","values":["PhD (Doctor of Philosophy)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["rule","rural","meaningful use","ARRA","HITECH","CPOE","meaningful use criteria","non-rural","urban","Health Services Research","Medicine and Health Sciences","Public Health"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["Copyright by the authors."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://dc.etsu.edu/context/etd/article/2642/viewcontent/WilhoitK050112f.pdf","https://dc.etsu.edu/etd/1449"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["In 2009, the American Recovery and Reinvestment Act was signed into law. This legislation provided for monetary rewards for those acute-care hospitals that meet \"meaningful use\" computerization and reporting criteria.
The study used a descriptive, nonexperimental design to answer three research questions (1) What is the level of readiness to meet \"meaningful use\" criteria in the Tennessee Hospital Association (THA) member hospitals; (2) What is the level of readiness to meet \"meaningful use\" criteria in the rural THA member hospitals; and (3) Is there a difference in the readiness to meet \"meaningful use\" criteria between rural and urban THA member hospitals?.
A survey was sent to 115 THA member hospital, with a return rate of 83% (N=95). The inclusion criteria focused on acute-care hospitals, with rehabilitation, psychiatric and long-term care hospitals falling into the exclusion criteria.
The Readiness Score was determined for the total survey respondents (N=95), as well as for the rural (N=41) hospitals and urban (N=54) hospitals in the Tennessee Hospital Association member hospitals meeting the inclusion criteria. Z-scores of the readiness score were examined and indicated that there was one outlier with z>3.0. Therefore, that case was removed from the comparison in the t-test (N=94). The t-test comparison of rural and urban hospital found a significant difference at (p=.002), two tailed.
To ensure that the slightly nonnormal distribution of the readiness scores did not explain the difference found with the t-test, an additional nonparametric test was also conducted. The Mann Whitney U-test showed that even with the assumption of a normal distribution is not made, the difference in readiness between urban and rural hospitals is still statistically significant at p=0.026.
"]},{"key":"dc:title","label":"Title","values":["A Measurement of Readiness for Tennessee Hospitals to Implement “Meaningful Use” Criteria Resulting from the American Recovery and Reinvestment Act, 2009"]}]}],"canonical_facts":{"dc:creator":["Wilhoit, Kathryn Wallin"],"dc:date.issued":["2012-05-05T07:00:00Z"],"dc:description.abstract":["In 2009, the American Recovery and Reinvestment Act was signed into law. This legislation provided for monetary rewards for those acute-care hospitals that meet \"meaningful use\" computerization and reporting criteria.
The study used a descriptive, nonexperimental design to answer three research questions (1) What is the level of readiness to meet \"meaningful use\" criteria in the Tennessee Hospital Association (THA) member hospitals; (2) What is the level of readiness to meet \"meaningful use\" criteria in the rural THA member hospitals; and (3) Is there a difference in the readiness to meet \"meaningful use\" criteria between rural and urban THA member hospitals?.
A survey was sent to 115 THA member hospital, with a return rate of 83% (N=95). The inclusion criteria focused on acute-care hospitals, with rehabilitation, psychiatric and long-term care hospitals falling into the exclusion criteria.
The Readiness Score was determined for the total survey respondents (N=95), as well as for the rural (N=41) hospitals and urban (N=54) hospitals in the Tennessee Hospital Association member hospitals meeting the inclusion criteria. Z-scores of the readiness score were examined and indicated that there was one outlier with z>3.0. Therefore, that case was removed from the comparison in the t-test (N=94). The t-test comparison of rural and urban hospital found a significant difference at (p=.002), two tailed.
To ensure that the slightly nonnormal distribution of the readiness scores did not explain the difference found with the t-test, an additional nonparametric test was also conducted. The Mann Whitney U-test showed that even with the assumption of a normal distribution is not made, the difference in readiness between urban and rural hospitals is still statistically significant at p=0.026.
"],"dc:identifier":["https://dc.etsu.edu/context/etd/article/2642/viewcontent/WilhoitK050112f.pdf","https://dc.etsu.edu/etd/1449"],"dc:rights":["Copyright by the authors."],"dc:subject":["rule","rural","meaningful use","ARRA","HITECH","CPOE","meaningful use criteria","non-rural","urban","Health Services Research","Medicine and Health Sciences","Public Health"],"dc:title":["A Measurement of Readiness for Tennessee Hospitals to Implement “Meaningful Use” Criteria Resulting from the American Recovery and Reinvestment Act, 2009"],"thesis:degree_discipline":["Nursing"],"thesis:degree_level":["Dissertation - unrestricted"],"thesis:degree_name":["PhD (Doctor of Philosophy)"]},"updated_at":"2026-07-24T02:20:31Z"}