OBJECTIVE:: The aim of this study was to compare health information technology (HIT) adoption strategies' relative performance on hospital-level productivity measures. DATA SOURCES:: The American Hospital Association's Annual Survey and Healthcare Information and Management Systems Society Analytics for fiscal years 2002 through 2007 were used for this study. STUDY DESIGN:: A two-stage approach is employed. First, a Malmquist model is specified to calculate hospital-level productivity measures. A logistic regression model is then estimated to compare the three HIT adoption strategies' relative performance on the newly constructed productivity measures. PRINCIPAL FINDINGS:: The HIT vendor selection strategy impacts the amount of technological change required of an organization but does not appear to have either a positive or adverse impact on technical efficiency or total factor productivity. CONCLUSIONS:: The higher levels in technological change experienced by hospitals using the best of breed and best of suite HIT vendor selection strategies may have a more direct impact on the organization early on in the process. However, these gains did not appear to translate into either increased technical efficiency or total factor productivity during the period studied. Over a longer period, one HIT vendor selection strategy may yet prove to be more effective at improving efficiency and productivity. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.