IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/13493.html
   My bibliography  Save this paper

Information Technology and Medical Missteps: Evidence from a Randomized Trial

Author

Listed:
  • Jonathan C. Javitt
  • James B. Rebitzer
  • Lonny Reisman

Abstract

We analyze the effect of a decision support tool designed to help physicians detect and correct medical "missteps". The data comes from a randomized trial of the technology on a population of commercial HMO patients. The key findings are that the new information technology lowers average charges by 6% relative to the control group. This reduction in resource utilization was the result of reduced in-patient charges (and associated professional charges) for the most costly patients. The rate at which identified issues were resolved was generally higher in the study group than in the control group, suggesting the possibility of improvements in care quality along measured dimensions and enhanced diffusion of new protocols based on new clinical evidence.

Suggested Citation

  • Jonathan C. Javitt & James B. Rebitzer & Lonny Reisman, 2007. "Information Technology and Medical Missteps: Evidence from a Randomized Trial," NBER Working Papers 13493, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:13493
    Note: EH LS
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w13493.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Nancy Beaulieu & David M. Cutler & Katherine Ho, 2006. "The Business Case for Diabetes Disease Management for Managed Care Organizations," NBER Chapters, in: Frontiers in Health Policy Research, Volume 9, National Bureau of Economic Research, Inc.
    2. Susan Athey & Scott Stern, 2002. "The Impact of Information Technology on Emergency Health Care Outcomes," RAND Journal of Economics, The RAND Corporation, vol. 33(3), pages 399-432, Autumn.
    3. Duggan, Mark, 2005. "Do new prescription drugs pay for themselves?: The case of second-generation antipsychotics," Journal of Health Economics, Elsevier, vol. 24(1), pages 1-31, January.
    4. Martin Gaynor & James Rebitzer & Lowell Taylor, "undated". "Incentives in HMOs," GSIA Working Papers 2003-E21, Carnegie Mellon University, Tepper School of Business.
    5. David H. Autor & Frank Levy & Richard J. Murnane, 2003. "The skill content of recent technological change: an empirical exploration," Proceedings, Federal Reserve Bank of San Francisco, issue Nov.
    6. Timothy F. Bresnahan & Erik Brynjolfsson & Lorin M. Hitt, 2002. "Information Technology, Workplace Organization, and the Demand for Skilled Labor: Firm-Level Evidence," The Quarterly Journal of Economics, Oxford University Press, vol. 117(1), pages 339-376.
    7. Phelps, Charles E., 2000. "Information diffusion and best practice adoption," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 5, pages 223-264, Elsevier.
    8. Ann P. Bartel & Casey Ichniowski & Kathryn L. Shaw, 2005. "How Does Information Technology Really Affect Productivity? Plant-Level Comparisons of Product Innovation, Process Improvement and Worker Skills," NBER Working Papers 11773, National Bureau of Economic Research, Inc.
    9. Casey Ichniowski & Kathryn Shaw, 2003. "Beyond Incentive Pay: Insiders' Estimates of the Value of Complementary Human Resource Management Practices," Journal of Economic Perspectives, American Economic Association, vol. 17(1), pages 155-180, Winter.
    10. Erik Brynjolfsson & Lorin M. Hitt, 2000. "Beyond Computation: Information Technology, Organizational Transformation and Business Performance," Journal of Economic Perspectives, American Economic Association, vol. 14(4), pages 23-48, Fall.
    11. Jonathan Skinner & Douglas Staiger, 2007. "Technology Adoption from Hybrid Corn to Beta-Blockers," NBER Chapters, in: Hard-to-Measure Goods and Services: Essays in Honor of Zvi Griliches, pages 545-570, National Bureau of Economic Research, Inc.
    12. Jonathan S. Skinner & Elliott S. Fisher & John Wennberg, 2005. "The Efficiency of Medicare," NBER Chapters, in: Analyses in the Economics of Aging, pages 129-160, National Bureau of Economic Research, Inc.
    13. Richard G. Frank, 2004. "Behavioral Economics and Health Economics," NBER Working Papers 10881, National Bureau of Economic Research, Inc.
    14. Thomas N. Hubbard, 2003. "Information, Decisions, and Productivity: On-Board Computers and Capacity Utilization in Trucking," American Economic Review, American Economic Association, vol. 93(4), pages 1328-1353, September.
    15. David H. Autor & Frank Levy & Richard J. Murnane, 2002. "Upstairs, Downstairs: Computers and Skills on Two Floors of a Large Bank," ILR Review, Cornell University, ILR School, vol. 55(3), pages 432-447, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Andrew I. Friedson, 2018. "Medical Scribes as an Input in Health-Care Production: Evidence from a Randomized Experiment," American Journal of Health Economics, University of Chicago Press, vol. 4(4), pages 479-503, Fall.
    2. McCullough, Jeffrey S. & Snir, Eli M., 2010. "Monitoring technology and firm boundaries: Physician-hospital integration and technology utilization," Journal of Health Economics, Elsevier, vol. 29(3), pages 457-467, May.
    3. Randall D. Cebul & James B. Rebitzer & Lowell J. Taylor & Mark E. Votruba, 2008. "Organizational Fragmentation and Care Quality in the U.S. Healthcare System," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 93-113, Fall.
    4. Agha, Leila, 2014. "The effects of health information technology on the costs and quality of medical care," Journal of Health Economics, Elsevier, vol. 34(C), pages 19-30.
    5. Seth Freedman & Haizhen Lin & Jeffrey T. Prince, 2014. "Information Technology and Patient Health: An Expanded Analysis of Outcomes, Populations, and Mechanisms," Working Papers 2014-02, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    6. James B. Rebitzer & Mari Rege & Christopher Shepard, 2008. "Influence, information overload, and information technology in health care," Advances in Health Economics and Health Services Research, in: Beyond Health Insurance: Public Policy to Improve Health, pages 43-69, Emerald Group Publishing Limited.
    7. Seth Freedman & Haizhen Lin & Jeffrey Prince, 2018. "Information Technology and Patient Health: Analyzing Outcomes, Populations, and Mechanisms," American Journal of Health Economics, MIT Press, vol. 4(1), pages 51-79, Winter.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. David H. Autor & Frank Levy & Richard J. Murnane, 2003. "The skill content of recent technological change: an empirical exploration," Proceedings, Federal Reserve Bank of San Francisco, issue Nov.
    2. James B. Rebitzer & Mari Rege & Christopher Shepard, 2008. "Influence, information overload, and information technology in health care," Advances in Health Economics and Health Services Research, in: Beyond Health Insurance: Public Policy to Improve Health, pages 43-69, Emerald Group Publishing Limited.
    3. Viete, Steffen & Erdsiek, Daniel, 2018. "Trust-based work time and the productivity effects of mobile information technologies in the workplace," ZEW Discussion Papers 18-013, ZEW - Leibniz Centre for European Economic Research.
    4. Brent Boning & Casey Ichniowski & Kathryn Shaw, 2007. "Opportunity Counts: Teams and the Effectiveness of Production Incentives," Journal of Labor Economics, University of Chicago Press, vol. 25(4), pages 613-650.
    5. Luis Garicano & Paul Heaton, 2010. "Information Technology, Organization, and Productivity in the Public Sector: Evidence from Police Departments," Journal of Labor Economics, University of Chicago Press, vol. 28(1), pages 167-201, January.
    6. Viete, Steffen & Erdsiek, Daniel, 2015. "Mobile information and communication technologies, flexible work organization and labor productivity: Firm-level evidence," ZEW Discussion Papers 15-087, ZEW - Leibniz Centre for European Economic Research.
    7. Ann Bartel & Casey Ichniowski & Kathryn Shaw & Ricardo Correa, 2007. "International Differences in the Adoption and Impact of New Information Technologies and New HR Practices: The Valve-Making Industry in the U.S. and U.K," NBER Working Papers 13651, National Bureau of Economic Research, Inc.
    8. Viete, Steffen & Erdsiek, Daniel, 2020. "Mobile Information Technologies and Firm Performance: The Role of Employee Autonomy," Information Economics and Policy, Elsevier, vol. 51(C).
    9. Kathryn Shaw, 2004. "The Human Resources Revolution: Is It a Productivity Driver?," NBER Chapters, in: Innovation Policy and the Economy, Volume 4, pages 69-114, National Bureau of Economic Research, Inc.
    10. Greenstein, Shane, 2010. "Innovative Conduct in Computing and Internet Markets," Handbook of the Economics of Innovation, in: Bronwyn H. Hall & Nathan Rosenberg (ed.), Handbook of the Economics of Innovation, edition 1, volume 1, chapter 0, pages 477-537, Elsevier.
    11. Adam Seth Litwin & Sherry M. Tanious, 2021. "Information Technology, Business Strategy and the Reassignment of Work from In‐House Employees to Agency Temps," British Journal of Industrial Relations, London School of Economics, vol. 59(3), pages 816-847, September.
    12. Ann Bartel & Casey Ichniowski & Kathryn L. Shaw & Ricardo Correa, 2009. "International Differences in the Adoption and Impact of New Information Technologies and New HR Practices: The Valve-Making Industry in the United States and United Kingdom," NBER Chapters, in: International Differences in the Business Practices and Productivity of Firms, pages 55-78, National Bureau of Economic Research, Inc.
    13. Francis Green, 2012. "Employee Involvement, Technology and Evolution in Job Skills: A Task-Based Analysis," ILR Review, Cornell University, ILR School, vol. 65(1), pages 36-67, January.
    14. David Dranove & Chris Forman & Avi Goldfarb & Shane Greenstein, 2014. "The Trillion Dollar Conundrum: Complementarities and Health Information Technology," American Economic Journal: Economic Policy, American Economic Association, vol. 6(4), pages 239-270, November.
    15. Casey Ichniowski & Kathryn Shaw, 2003. "Beyond Incentive Pay: Insiders' Estimates of the Value of Complementary Human Resource Management Practices," Journal of Economic Perspectives, American Economic Association, vol. 17(1), pages 155-180, Winter.
    16. Ann P. Bartel & Casey Ichniowski & Kathryn L. Shaw, 2005. "How Does Information Technology Really Affect Productivity? Plant-Level Comparisons of Product Innovation, Process Improvement and Worker Skills," NBER Working Papers 11773, National Bureau of Economic Research, Inc.
    17. Seth Freedman & Haizhen Lin & Jeffrey Prince, 2018. "Information Technology and Patient Health: Analyzing Outcomes, Populations, and Mechanisms," American Journal of Health Economics, University of Chicago Press, vol. 4(1), pages 51-79, Winter.
    18. Chris Forman & Avi Goldfarb & Shane Greenstein, 2009. "The Internet and Local Wages: Convergence or Divergence?," NBER Working Papers 14750, National Bureau of Economic Research, Inc.
    19. David H. Autor & Frank Levy & Richard J. Murnane, 2002. "Upstairs, Downstairs: Computers and Skills on Two Floors of a Large Bank," ILR Review, Cornell University, ILR School, vol. 55(3), pages 432-447, April.
    20. Dale W. Jorgenson & Mun S. Ho & Kevin J. Stiroh, 2008. "A Retrospective Look at the U.S. Productivity Growth Resurgence," Journal of Economic Perspectives, American Economic Association, vol. 22(1), pages 3-24, Winter.

    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • M15 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Business Administration - - - IT Management

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:13493. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.