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Information Technology and Patient Health: Analyzing Outcomes, Populations, and Mechanisms

Author

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  • Seth Freedman

    (School of Public and Environmental Affairs, Indiana University Author email: freedmas@indiana.edu)

  • Haizhen Lin

    (Kelley School of Business, Indiana University)

  • Jeffrey Prince

    (Kelley School of Business, Indiana University)

Abstract

We study the effect of hospital adoption of electronic medical records (EMRs) on health outcomes, focusing on patient safety indicators. We link data on hospital-level EMR adoption from the Healthcare Information and Management Systems Society (HIMSS) Analytics Database to patient-level data from the Nationwide Inpatient Sample, and we exploit within-hospital variation in EMR adoption over time. We find evidence that EMRs reduce the likelihood of adverse patient safety events, particularly for less complex patients. Our results point to decision support as the most likely mechanism driving our findings. We find the most consistent effects for the following: a technology with decision support features, outcomes likely to respond to decision support, and patient populations likely to benefit from decision support. In addition, these findings suggest the negligible impacts found by previous studies of the Medicare population and/or mortality do not apply in all settings.

Suggested Citation

  • 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.
  • Handle: RePEc:ucp:amjhec:v:4:y:2018:i:1:p:51-79
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    1. Nicholas Bloom & Luis Garicano & Raffaella Sadun & John Van Reenen, 2014. "The Distinct Effects of Information Technology and Communication Technology on Firm Organization," Management Science, INFORMS, vol. 60(12), pages 2859-2885, December.
    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. 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.
    4. Kolstad, Jonathan T. & Kowalski, Amanda E., 2012. "The impact of health care reform on hospital and preventive care: Evidence from Massachusetts," Journal of Public Economics, Elsevier, vol. 96(11), pages 909-929.
    5. Dranove, David & Garthwaite, Craig & Li, Bingyang & Ody, Christopher, 2015. "Investment subsidies and the adoption of electronic medical records in hospitals," Journal of Health Economics, Elsevier, vol. 44(C), pages 309-319.
    6. 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.
    7. Toshiaki Iizuka, 2013. "Does Higher Malpractice Pressure Deter Medical Errors?," Journal of Law and Economics, University of Chicago Press, vol. 56(1), pages 161-188.
    8. Javitt, Jonathan C. & Rebitzer, James B. & Reisman, Lonny, 2008. "Information technology and medical missteps: Evidence from a randomized trial," Journal of Health Economics, Elsevier, vol. 27(3), pages 585-602, May.
    9. 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.
    10. Amalia R. Miller & Catherine E. Tucker, 2011. "Can Health Care Information Technology Save Babies?," Journal of Political Economy, University of Chicago Press, vol. 119(2), pages 289-324.
    11. Jeffrey S. McCullough & Stephen T. Parente & Robert Town, 2013. "Health Information Technology and Patient Outcomes: The Role of Organizational and Informational Complementarities," NBER Working Papers 18684, National Bureau of Economic Research, Inc.
    12. 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.
    13. George P. Baker & Thomas N. Hubbard, 2003. "Make Versus Buy in Trucking: Asset Ownership, Job Design, and Information," American Economic Review, American Economic Association, vol. 93(3), pages 551-572, June.
    14. 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.
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    Cited by:

    1. Seth Freedman & Noah Hammarlund, 2019. "Electronic medical records and medical procedure choice: Evidence from cesarean sections," Health Economics, John Wiley & Sons, Ltd., vol. 28(10), pages 1179-1193, October.
    2. Seth Freedman & Haizhen Lin & Jeffrey Prince, 2018. "Does Competition Lead to Agglomeration or Dispersion in EMR Vendor Decisions?," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 53(1), pages 57-79, August.
    3. Gautam Gowrisankaran & Keith A. Joiner & Jianjing Lin, 2016. "How do Hospitals Respond to Payment Incentives?," NBER Working Papers 22873, National Bureau of Economic Research, Inc.

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    More about this item

    Keywords

    health information technology; technology diffusion; patient safety; decision support;
    All these keywords.

    JEL classification:

    • I19 - Health, Education, and Welfare - - Health - - - Other
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes

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