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The Trillion Dollar Conundrum: Complementarities and Health Information Technology

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  • David Dranove
  • Christopher Forman
  • Avi Goldfarb
  • Shane Greenstein

Abstract

We examine the relationship between the adoption of EMR and hospital operating costs. We first identify a puzzle that has been seen in prior studies: Adoption of EMR is associated with a slight cost increase. We draw on the literature on IT and productivity to demonstrate that the average effect masks important differences across time, locations, and hospitals. We find: (1) EMR adoption is initially associated with higher costs; (2) At hospitals with access to complementary inputs, EMR adoption leads to a cost decrease after three years; (3) Hospitals in unfavorable conditions experience increased costs even after six years.

Suggested Citation

  • 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.
  • Handle: RePEc:nbr:nberwo:18281
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    References listed on IDEAS

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    1. Greenstein, Shane & McDevitt, Ryan C., 2011. "The broadband bonus: Estimating broadband Internet's economic value," Telecommunications Policy, Elsevier, vol. 35(7), pages 617-632, August.
    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. Chris Forman & Avi Goldfarb & Shane Greenstein, 2008. "Understanding the Inputs into Innovation: Do Cities Substitute for Internal Firm Resources?," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 17(2), pages 295-316, June.
    4. 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.
    5. Jack E. Triplett, 1999. "The Solow productivity paradox: what do computers do to productivity?," Canadian Journal of Economics, Canadian Economics Association, vol. 32(2), pages 309-334, April.
    6. Jeffrey S. McCullough, 2008. "The adoption of hospital information systems," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 649-664.
    7. Chris Forman & Avi Goldfarb & Shane Greenstein, 2012. "The Internet and Local Wages: A Puzzle," American Economic Review, American Economic Association, vol. 102(1), pages 556-575, February.
    8. Erik Brynjolfsson & Lorin M. Hitt, 2003. "Computing Productivity: Firm-Level Evidence," The Review of Economics and Statistics, MIT Press, vol. 85(4), pages 793-808, November.
    9. 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.
    10. 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.
    11. Forman, Chris & Goldfarb, Avi & Greenstein, Shane, 2005. "How did location affect adoption of the commercial Internet? Global village vs. urban leadership," Journal of Urban Economics, Elsevier, vol. 58(3), pages 389-420, November.
    12. 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.
    13. Borzekowski, Ron, 2009. "Measuring the cost impact of hospital information systems: 1987-1994," Journal of Health Economics, Elsevier, vol. 28(5), pages 938-949, September.
    14. 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.
    15. Dranove, David & Lindrooth, Richard, 2003. "Hospital consolidation and costs: another look at the evidence," Journal of Health Economics, Elsevier, vol. 22(6), pages 983-997, November.
    16. Henderson, J. Vernon, 2003. "Marshall's scale economies," Journal of Urban Economics, Elsevier, vol. 53(1), pages 1-28, January.
    17. Brant Callaway & Vivek Ghosal, 2012. "Adoption and Diffusion of Health Information Technology - The Case of Primary Care Clinics," CESifo Working Paper Series 3925, CESifo Group Munich.
    18. Ann Bartel & Casey Ichniowski & Kathryn Shaw, 2007. "How Does Information Technology Affect Productivity? Plant-Level Comparisons of Product Innovation, Process Improvement, and Worker Skills," The Quarterly Journal of Economics, Oxford University Press, vol. 122(4), pages 1721-1758.
    19. 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.
    20. Dale W. Jorgenson & Mun S. Ho & Kevin J. Stiroh, 2005. "Productivity, Volume 3: Information Technology and the American Growth Resurgence," MIT Press Books, The MIT Press, edition 1, volume 3, number 0262101114, January.
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    Cited by:

    1. Jeffrey S. McCullough & Stephen 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.
    2. Chris Forman & Avi Goldfarb & Shane Greenstein, 2014. "Information Technology and the Distribution of Inventive Activity," NBER Chapters,in: The Changing Frontier: Rethinking Science and Innovation Policy, pages 169-196 National Bureau of Economic Research, Inc.
    3. Karine Lamiraud & Stephane Lhuillery, 2016. "Endogenous Technology Adoption and Medical Costs," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1123-1147, September.
    4. Amalia R. Miller & Catherine Tucker, 2017. "Frontiers of Health Policy: Digital Data and Personalized Medicine," Innovation Policy and the Economy, University of Chicago Press, vol. 17(1), pages 49-75.
    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. Galloway, Emily & Johnson, Erik Paul, 2016. "Teaching an old dog new tricks: Firm learning from environmental regulation," Energy Economics, Elsevier, vol. 59(C), pages 1-10.
    7. Francesco Venturini & Ana Rincon-Aznar & Dr Michela Vecchi, 2013. "ICT as a general purpose technology: spillovers, absorptive capacity and productivity performance," National Institute of Economic and Social Research (NIESR) Discussion Papers 416, National Institute of Economic and Social Research.
    8. Gautam Gowrisankaran & Keith A. Joiner & Jianjing Lin, 2016. "Does Health IT Adoption Lead to Better Information or Worse Incentives?," NBER Working Papers 22873, National Bureau of Economic Research, Inc.
    9. David Dranove & Craig Garthwaite & Christopher Ody, 2013. "How do Hospitals Respond to Negative Financial Shocks? The Impact of the 2008 Stock Market Crash," NBER Working Papers 18853, National Bureau of Economic Research, Inc.
    10. repec:tpr:amjhec:v:4:y:2018:i:1:p:51-79 is not listed on IDEAS
    11. Shin, Seungjae & Eksioglu, Burak, 2015. "An empirical study of RFID productivity in the U.S. retail supply chain," International Journal of Production Economics, Elsevier, vol. 163(C), pages 89-96.
    12. Brant Callaway & Vivek Ghosal, 2012. "Adoption and Diffusion of Health Information Technology - The Case of Primary Care Clinics," CESifo Working Paper Series 3925, CESifo Group Munich.
    13. 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.
    14. 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.

    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • L30 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - General

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