IDEAS home Printed from https://ideas.repec.org/a/eee/techno/v152y2026ics0166497226000167.html

Revisiting technology races: Evidence from Indian healthcare EMR data

Author

Listed:
  • Rathi, Sawan
  • Chakrabarti, Anindya S.
  • Chatterjee, Chirantan
  • Das, Anthony Vipin
  • Narayanan, Raja

Abstract

Technology replacement is a frequent feature of firms’ innovation journey. However, the internal working of replacement of an old technology by a new one is typically blurred – with three simultaneously interacting mechanisms – demand-pull, technology-push, and a combination of market and non-market institutions. In this paper, we disentangle them using novel electronic medical records (EMR) data from one of the largest eye-care hospital chains in Asia. Specifically, we study a race between a newer high-end medical scanning technology replacing an older and less costly technology. We exploit the COVID-19 lockdown shock in a natural experiment setup, which led to concurrent shifts in the demand and supply of a medical scanning technology. Demand-pull generated via patients propelled new technology adoption as the supply of new technology increased in tandem. This was a cohort-specific phenomenon on the supply side, with an age-identified cohort of physicians driving the adoption, and the replacement was measurably welfare-enhancing. Fixed price for treatment ensures that the replacement was not driven by market-led incentives. We conclude by discussing management of innovation through demand- and supply-side as a strategy for the firms.

Suggested Citation

  • Rathi, Sawan & Chakrabarti, Anindya S. & Chatterjee, Chirantan & Das, Anthony Vipin & Narayanan, Raja, 2026. "Revisiting technology races: Evidence from Indian healthcare EMR data," Technovation, Elsevier, vol. 152(C).
  • Handle: RePEc:eee:techno:v:152:y:2026:i:c:s0166497226000167
    DOI: 10.1016/j.technovation.2026.103481
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0166497226000167
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.technovation.2026.103481?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Christensen, Clayton M. & Rosenbloom, Richard S., 1995. "Explaining the attacker's advantage: Technological paradigms, organizational dynamics, and the value network," Research Policy, Elsevier, vol. 24(2), pages 233-257, March.
    2. Janet M. Currie & W. Bentley MacLeod, 2020. "Understanding Doctor Decision Making: The Case of Depression Treatment," Econometrica, Econometric Society, vol. 88(3), pages 847-878, May.
    3. Jeffrey T. Macher & Nathan H. Miller & Matthew Osborne, 2021. "Finding Mr. Schumpeter: technology adoption in the cement industry," RAND Journal of Economics, RAND Corporation, vol. 52(1), pages 78-99, March.
    4. David Atkin & Azam Chaudhry & Shamyla Chaudry & Amit K. Khandelwal & Eric Verhoogen, 2017. "Organizational Barriers to Technology Adoption: Evidence from Soccer-Ball Producers in Pakistan," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 132(3), pages 1101-1164.
    5. Smith, Adrian & Stirling, Andy & Berkhout, Frans, 2005. "The governance of sustainable socio-technical transitions," Research Policy, Elsevier, vol. 34(10), pages 1491-1510, December.
    6. Ben Halima, Mohamed Ali & Greenan, Nathalie & Lanfranchi, Joseph, 2023. "Getting sick for profit? The impact of cumulative ICT and management changes on long term sickness absence," Journal of Economic Behavior & Organization, Elsevier, vol. 212(C), pages 659-688.
    7. Tavneet Suri, 2011. "Selection and Comparative Advantage in Technology Adoption," Econometrica, Econometric Society, vol. 79(1), pages 159-209, January.
    8. Baudier, Patricia & Kondrateva, Galina & Ammi, Chantal & Chang, Victor & Schiavone, Francesco, 2023. "Digital transformation of healthcare during the COVID-19 pandemic: Patients’ teleconsultation acceptance and trusting beliefs," Technovation, Elsevier, vol. 120(C).
    9. Ritu Agarwal & Michelle Dugas & Guodong (Gordon) Gao & P. K. Kannan, 2020. "Emerging technologies and analytics for a new era of value-centered marketing in healthcare," Journal of the Academy of Marketing Science, Springer, vol. 48(1), pages 9-23, January.
    10. Tinglong Dai & Shubhranshu Singh, 2020. "Conspicuous by Its Absence: Diagnostic Expert Testing Under Uncertainty," Marketing Science, INFORMS, vol. 39(3), pages 540-563, May.
    11. Ceballos, Francisco & Kannan, Samyuktha & Kramer, Berber, 2020. "Impacts of a national lockdown on smallholder farmers’ income and food security: Empirical evidence from two states in India," World Development, Elsevier, vol. 136(C).
    12. von Hippel, Eric, 1976. "The dominant role of users in the scientific instrument innovation process," Research Policy, Elsevier, vol. 5(3), pages 212-239, July.
    13. Muhammad Zia Hydari & Rahul Telang & William M. Marella, 2019. "Saving Patient Ryan—Can Advanced Electronic Medical Records Make Patient Care Safer?," Management Science, INFORMS, vol. 67(5), pages 2041-2059, May.
    14. Munshi, Kaivan & Myaux, Jacques, 2006. "Social norms and the fertility transition," Journal of Development Economics, Elsevier, vol. 80(1), pages 1-38, June.
    15. Iacus, Stefano & King, Gary & Porro, Giuseppe, 2009. "cem: Software for Coarsened Exact Matching," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 30(i09).
    16. Hemant K. Bhargava & Abhay Nath Mishra, 2014. "Electronic Medical Records and Physician Productivity: Evidence from Panel Data Analysis," Management Science, INFORMS, vol. 60(10), pages 2543-2562, October.
    17. Ahmed Mushfiq Mobarak & Edward Miguel, 2022. "The Economics of the COVID-19 Pandemic in Poor Countries," Annual Review of Economics, Annual Reviews, vol. 14(1), pages 253-285, August.
    18. Di Novi, Cinzia & Kovacic, Matija & Orso, Cristina Elisa, 2024. "Online health information seeking behavior, healthcare access, and health status during exceptional times," Journal of Economic Behavior & Organization, Elsevier, vol. 220(C), pages 675-690.
    19. Tor Iversen & Ching‐to Albert Ma, 2022. "Technology adoption by primary care physicians," Health Economics, John Wiley & Sons, Ltd., vol. 31(3), pages 443-465, March.
    20. Ron Adner & Rahul Kapoor, 2016. "Innovation ecosystems and the pace of substitution: Re-examining technology S-curves," Strategic Management Journal, Wiley Blackwell, vol. 37(4), pages 625-648, April.
    21. Andrew D. Foster & Mark R. Rosenzweig, 2010. "Microeconomics of Technology Adoption," Annual Review of Economics, Annual Reviews, vol. 2(1), pages 395-424, September.
    22. Eric von Hippel & Ralph Katz, 2002. "Shifting Innovation to Users via Toolkits," Management Science, INFORMS, vol. 48(7), pages 821-833, July.
    23. Emily Oster & Rebecca Thornton, 2012. "Determinants Of Technology Adoption: Peer Effects In Menstrual Cup Take-Up," Journal of the European Economic Association, European Economic Association, vol. 10(6), pages 1263-1293, December.
    24. Pascaline Dupas, 2014. "Short‐Run Subsidies and Long‐Run Adoption of New Health Products: Evidence From a Field Experiment," Econometrica, Econometric Society, vol. 82(1), pages 197-228, January.
    25. Devi, Yashoda & Koshta, Nitin & Pendyala, Sastry Sarath, 2025. "Digital transformation and rural healthcare disparities: A mixed-methods approach in India," Technovation, Elsevier, vol. 140(C).
    26. Cardol, Hanna & Mignon, Ingrid & Lantz, Björn, 2025. "Rethinking the forecasting of innovation diffusion: A combined actor- and system approach," Technological Forecasting and Social Change, Elsevier, vol. 214(C).
    27. Juhász, Réka & Squicciarini, Mara & Voigtländer, Nico, 2020. "Technology Adoption and Productivity Growth: Evidence from Industrialization in France," CEPR Discussion Papers 14970, Centre for Economic Policy Research.
    28. Andrew A. King & Christopher L. Tucci, 2002. "Incumbent Entry into New Market Niches: The Role of Experience and Managerial Choice in the Creation of Dynamic Capabilities," Management Science, INFORMS, vol. 48(2), pages 171-186, February.
    29. Crentsil, Christian & Gschwandtner, Adelina & Wahhaj, Zaki, 2020. "The effects of risk and ambiguity aversion on technology adoption: Evidence from aquaculture in Ghana," Journal of Economic Behavior & Organization, Elsevier, vol. 179(C), pages 46-68.
    30. Von Hippel, Eric A. & Katz, Ralph, 2002. "Shifting Innovation to Users Via Toolkits," Working papers 4232-02, Massachusetts Institute of Technology (MIT), Sloan School of Management.
    31. Giada Di Stefano & Alfonso Gambardella & Gianmario Verona, 2012. "Technology Push and Demand Pull Perspectives in Innovation Studies: Current Findings and Future Research Directions," Post-Print hal-00696607, HAL.
    32. Gaynor, Martin & Vogt, William B, 2003. "Competition among Hospitals," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 764-785, Winter.
    33. Zhang, Xun & Shen, Kathy Ning & Xu, Biao, 2024. "Double-edged sword of knowledge inertia: Overcoming healthcare professionals’ resistance in innovation adoption," Technovation, Elsevier, vol. 133(C).
    34. Sawan Rathi & Anindya S. Chakrabarti & Chirantan Chatterjee & Aparna Hegde, 2022. "Pandemics and technology engagement: New evidence from m‐Health intervention during COVID‐19 in India," Review of Development Economics, Wiley Blackwell, vol. 26(4), pages 2184-2217, November.
    35. Di Stefano, Giada & Gambardella, Alfonso & Verona, Gianmario, 2012. "Technology push and demand pull perspectives in innovation studies: Current findings and future research directions," Research Policy, Elsevier, vol. 41(8), pages 1283-1295.
    36. Janet M. Currie & W. Bentley MacLeod, 2018. "Understanding Doctor Decision Making: The Case of Depression," NBER Working Papers 24955, National Bureau of Economic Research, Inc.
    37. Ron Adner & Daniel Snow, 2010. "Old technology responses to new technology threats: demand heterogeneity and technology retreats," Industrial and Corporate Change, Oxford University Press and the Associazione ICC, vol. 19(5), pages 1655-1675, October.
    38. Abi Saad, Elie & Tremblay, Nathalie & Agogué, Marine, 2024. "A multi-level perspective on innovation intermediaries: The case of the diffusion of digital technologies in healthcare," Technovation, Elsevier, vol. 129(C).
    39. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
    40. Jonathan Skinner & Douglas Staiger, 2015. "Technology Diffusion and Productivity Growth in Health Care," The Review of Economics and Statistics, MIT Press, vol. 97(5), pages 951-964, December.
    41. Daron Acemoglu & Joshua Linn, 2004. "Market Size in Innovation: Theory and Evidence from the Pharmaceutical Industry," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(3), pages 1049-1090.
    42. Chowdhury, Shyamal & Satish, Varun & Sulaiman, Munshi & Sun, Yi, 2022. "Sooner rather than later: Social networks and technology adoption," Journal of Economic Behavior & Organization, Elsevier, vol. 203(C), pages 466-482.
    43. Sam Ransbotham & Eric M. Overby & Michael C. Jernigan, 2021. "Electronic Trace Data and Legal Outcomes: The Effect of Electronic Medical Records on Malpractice Claim Resolution Time," Management Science, INFORMS, vol. 67(7), pages 4341-4361, July.
    44. Matthew Blackwell & Stefano Iacus & Gary King & Giuseppe Porro, 2009. "cem: Coarsened exact matching in Stata," Stata Journal, StataCorp LLC, vol. 9(4), pages 524-546, December.
    45. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    46. Munshi, Kaivan, 2004. "Social learning in a heterogeneous population: technology diffusion in the Indian Green Revolution," Journal of Development Economics, Elsevier, vol. 73(1), pages 185-213, February.
    47. Trajtenberg, Manuel, 1989. "The Welfare Analysis of Product Innovations, with an Application to Computed Tomography Scanners," Journal of Political Economy, University of Chicago Press, vol. 97(2), pages 444-479, April.
    48. Wirtz, Veronika & Cribb, Alan & Barber, Nick, 2006. "Patient-doctor decision-making about treatment within the consultation--A critical analysis of models," Social Science & Medicine, Elsevier, vol. 62(1), pages 116-124, January.
    49. Timothy G. Conley & Christopher R. Udry, 2010. "Learning about a New Technology: Pineapple in Ghana," American Economic Review, American Economic Association, vol. 100(1), pages 35-69, March.
    50. Arthur, W. Brian, 2007. "The structure of invention," Research Policy, Elsevier, vol. 36(2), pages 274-287, March.
    51. Iacus, Stefano M. & King, Gary & Porro, Giuseppe, 2012. "Causal Inference without Balance Checking: Coarsened Exact Matching," Political Analysis, Cambridge University Press, vol. 20(1), pages 1-24, January.
    52. Cannavacciuolo, Lorella & Capaldo, Guido & Ponsiglione, Cristina, 2023. "Digital innovation and organizational changes in the healthcare sector: Multiple case studies of telemedicine project implementation," Technovation, Elsevier, vol. 120(C).
    53. April M. Franco & MB Sarkar & Rajshree Agarwal & Raj Echambadi, 2009. "Swift and Smart: The Moderating Effects of Technological Capabilities on the Market Pioneering-Firm Survival Relationship," Management Science, INFORMS, vol. 55(11), pages 1842-1860, November.
    54. Lin, Xiaojun & Lu, Liyong & Pan, Jay, 2021. "Hospital market competition and health technology diffusion: An empirical study of laparoscopic appendectomy in China," Social Science & Medicine, Elsevier, vol. 286(C).
    55. Corey M. Angst & Ritu Agarwal & V. Sambamurthy & Ken Kelley, 2010. "Social Contagion and Information Technology Diffusion: The Adoption of Electronic Medical Records in U.S. Hospitals," Management Science, INFORMS, vol. 56(8), pages 1219-1241, August.
    Full references (including those not matched with items on IDEAS)

    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. Raphaël Soubeyran, 2019. "Technology adoption and pro-social preferences," CEE-M Working Papers halshs-02291905, CEE-M, Universtiy of Montpellier, CNRS, INRA, Montpellier SupAgro.
    2. Sebastian Calónico & Rafael Di Tella & Juan Cruz Lopez del Valle, 2023. "The Political Economy of a “Miracle Cure”: The Case of Nebulized Ibuprofen and its Diffusion in Argentina," NBER Working Papers 31781, National Bureau of Economic Research, Inc.
    3. Arias-Granada, Yurani & Bauchet, Jonathan & Ricker-Gilbert, Jacob & Gulati, Kajal, 2025. "Social networks and the demand for credence agricultural technologies," Food Policy, Elsevier, vol. 135(C).
    4. B Kelsey Jack, "undated". "Market Inefficiencies and the Adoption of Agricultural Technologies in Developing Countries," CID Working Papers 50, Center for International Development at Harvard University.
    5. Magnan, Nicholas & Spielman, David J. & Lybbert, Travis J. & Gulati, Kajal, 2015. "Leveling with friends: Social networks and Indian farmers' demand for a technology with heterogeneous benefits," Journal of Development Economics, Elsevier, vol. 116(C), pages 223-251.
    6. Bonan, Jacopo & Battiston, Pietro & Bleck, Jaimie & LeMay-Boucher, Philippe & Pareglio, Stefano & Sarr, Bassirou & Tavoni, Massimo, 2021. "Social interaction and technology adoption: Experimental evidence from improved cookstoves in Mali," World Development, Elsevier, vol. 144(C).
    7. Dominik Naeher, 2022. "Technology Adoption Under Costly Information Processing," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 63(2), pages 699-753, May.
    8. Matsumoto, Tomoya, 2014. "Disseminating new farming practices among small scale farmers: An experimental intervention in Uganda," Journal of the Japanese and International Economies, Elsevier, vol. 33(C), pages 43-74.
    9. Meredith, Jennifer & Robinson, Jonathan & Walker, Sarah & Wydick, Bruce, 2013. "Keeping the doctor away: Experimental evidence on investment in preventative health products," Journal of Development Economics, Elsevier, vol. 105(C), pages 196-210.
    10. Chowdhury, Shyamal & Satish, Varun & Sulaiman, Munshi & Sun, Yi, 2022. "Sooner rather than later: Social networks and technology adoption," Journal of Economic Behavior & Organization, Elsevier, vol. 203(C), pages 466-482.
    11. Peter Bergman, 2020. "Nudging Technology Use: Descriptive and Experimental Evidence from School Information Systems," Education Finance and Policy, MIT Press, vol. 15(4), pages 623-647, Fall.
    12. Terrance Hurley & Jawoo Koo & Kindie Tesfaye, 2018. "Weather risk: how does it change the yield benefits of nitrogen fertilizer and improved maize varieties in sub‐Saharan Africa?," Agricultural Economics, International Association of Agricultural Economists, vol. 49(6), pages 711-723, November.
    13. Khushbu Mishra & Abdoul G. Sam & Gracious M. Diiro & Mario J. Miranda, 2020. "Gender and the dynamics of technology adoption: Empirical evidence from a household‐level panel data," Agricultural Economics, International Association of Agricultural Economists, vol. 51(6), pages 857-870, November.
    14. Francesco D'Acunto & Nagpurnanand Prabhala & Alberto G. Rossi, 2018. "The Promises and Pitfalls of Robo-advising," CESifo Working Paper Series 6907, CESifo.
    15. Magnan, Nicholas & Spielman, David J. & Lybbert, Travis J. & Gulati, Kajal, "undated". "Leveling with Friends: Social Networks and Indian Farmers' Demand for Agricultural Custom Hire Services," 2013 Annual Meeting, August 4-6, 2013, Washington, D.C. 150711, Agricultural and Applied Economics Association.
    16. Clayton M. Christensen & Rory McDonald & Elizabeth J. Altman & Jonathan E. Palmer, 2018. "Disruptive Innovation: An Intellectual History and Directions for Future Research," Journal of Management Studies, Wiley Blackwell, vol. 55(7), pages 1043-1078, November.
    17. Rathi, Sawan & Majumdar, Adrija & Chatterjee, Chirantan, 2024. "Did the COVID-19 pandemic propel usage of AI in pharmaceutical innovation? New evidence from patenting data," Technological Forecasting and Social Change, Elsevier, vol. 198(C).
    18. Pantano, Eleonora & Viassone, Milena, 2014. "Demand pull and technology push perspective in technology-based innovations for the points of sale: The retailers evaluation," Journal of Retailing and Consumer Services, Elsevier, vol. 21(1), pages 43-47.
    19. Juhász, Réka & Squicciarini, Mara & Voigtländer, Nico, 2020. "Technology Adoption and Productivity Growth: Evidence from Industrialization in France," CEPR Discussion Papers 14970, Centre for Economic Policy Research.
    20. Apoorv Gupta & Jacopo Ponticelli & Andrea Tesei, 2020. "Language Barriers, Technology Adoption and Productivity: Evidence from Agriculture in India," NBER Working Papers 27192, National Bureau of Economic Research, Inc.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    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:eee:techno:v:152:y:2026:i:c:s0166497226000167. 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: Catherine Liu (email available below). General contact details of provider: http://www.sciencedirect.com/science/journal/01664972 .

    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.