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Adoption and Diffusion of Health Information Technology - The Case of Primary Care Clinics

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  • Brant Callaway
  • Vivek Ghosal

Abstract

We empirically examine the determinants of adoption of information technology by primary healthcare clinics using a large sample of physician clinics from several States in the U.S. Ours is one of the first studies to intensively investigate primary care clinics. These clinics are important as they represent the frontlines in the delivery of services in this large and complex market. Our study generates several interesting results related to the adoption and diffusion of Health Information Technology (HIT), including: (1) the adoption probabilities vary considerably by the specific type of clinic; (2) in contrast to numerous studies in the broader technology adoption literature, we find little evidence to suggest a relationship between firm (clinic) size and the likelihood of adoption; (3) there appears to be no definitive relationship between the age of a clinic and the likelihood of adoption; (4) there is a strong effect of geographic location, as measured by specific types of urban and rural counties, on the likelihood of adoption; (5) market competitive forces appear to have a mixed influence on adoption; (6) there is a distinct State-specific effect suggesting that information privacy, medical malpractice laws and State initiatives may play an important role in adoption; and (7) HIT is diffusing at a faster rate over time. Our findings have the potential to provide a better understanding of the longer-run effectiveness and efficiency in the provision of healthcare, and crafting appropriate policy responses. We note some future extensions of our work.

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Bibliographic Info

Paper provided by CESifo Group Munich in its series CESifo Working Paper Series with number 3925.

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Date of creation: 2012
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Handle: RePEc:ces:ceswps:_3925

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Related research

Keywords: healthcare; primary care; health information technology; electronic medical records; technology; adoption; diffusion; urban and rural locations; competition; healthcare policy;

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References

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  1. Nancy L. Rose & Paul L. Joskow, 1988. "The Diffusion of New Technologies: Evidence from the Electric Utility Industry," Working papers 501, Massachusetts Institute of Technology (MIT), Department of Economics.
  2. David Dranove & Christopher Forman & Avi Goldfarb & Shane Greenstein, 2012. "The Trillion Dollar Conundrum: Complementarities and Health Information Technology," NBER Working Papers 18281, National Bureau of Economic Research, Inc.
  3. Thomas, Louis A., 1999. "Adoption order of new technologies in evolving markets," Journal of Economic Behavior & Organization, Elsevier, vol. 38(4), pages 453-482, April.
  4. Georg Götz, 1999. "Monopolistic Competition and the Diffusion of New Technology," RAND Journal of Economics, The RAND Corporation, vol. 30(4), pages 679-693, Winter.
  5. Maddala,G. S., 1986. "Limited-Dependent and Qualitative Variables in Econometrics," Cambridge Books, Cambridge University Press, number 9780521338257, Fall.
  6. Timothy H. Hannan & John M. McDowell, 1984. "The Determinants of Technology Adoption: The Case of the Banking Firm," RAND Journal of Economics, The RAND Corporation, vol. 15(3), pages 328-335, Autumn.
  7. Davies, Stephen W., 1979. "Inter-firm diffusion of process innovations," European Economic Review, Elsevier, vol. 12(4), pages 299-317, October.
  8. Vivek Ghosal & Prakash Loungani, 2000. "The Differential Impact of Uncertainty on Investment in Small and Large Businesses," The Review of Economics and Statistics, MIT Press, vol. 82(2), pages 338-343, May.
  9. Silvia Fabiani & Fabiano Schivardi & Sandro Trento, 2005. "ICT adoption in Italian manufacturing: firm-level evidence," Industrial and Corporate Change, Oxford University Press, vol. 14(2), pages 225-249, April.
  10. Amalia R. Miller & Catherine Tucker, 2009. "Privacy Protection and Technology Diffusion: The Case of Electronic Medical Records," Management Science, INFORMS, vol. 55(7), pages 1077-1093, July.
  11. Stoneman, Paul & Kwon, Myung-Joong, 1994. "The Diffusion of Multiple Process Technologies," Economic Journal, Royal Economic Society, vol. 104(423), pages 420-31, March.
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