IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/33861.html
   My bibliography  Save this paper

The Effects of Switching Electronic Health Record Developer on Specialty Referrals

Author

Listed:
  • Bingjin Xue
  • Chad Meyerhoefer

Abstract

We use national physician-pair panel data to examine how switching electronic health record (EHR) developers affects out-of-network referrals from primary care physicians (PCPs) to specialists. We estimate a difference-in-differences model, exploiting changes in EHR developer adoption by physicians’ affiliated hospitals. After a change in the PCP’s EHR developer, referrals to same-developer specialists increase by 5.8%, and referrals to specialists using the PCP’s prior EHR decrease by 4.2%. Referrals to the PCP’s most commonly referred-to specialists are not affected by changes in EHR developer, but shifts in referral patterns are particularly pronounced when the PCP is male and the specialist is female, when the PCP has more experience than the specialist and when the new EHR developer has a majority market share. These results are robust to estimation approaches that account for heterogenous treatment effects and physician selection into hospital systems. Our theoretical model indicates that PCP preferences for convenience may reduce referrals to the highest-quality specialists and lead to EHR market agglomeration, presenting a possible economic rationale for antitrust regulation of information blocking.

Suggested Citation

  • Bingjin Xue & Chad Meyerhoefer, 2025. "The Effects of Switching Electronic Health Record Developer on Specialty Referrals," NBER Working Papers 33861, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:33861
    Note: EH
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w33861.pdf
    Download Restriction: Access to the full text is generally limited to series subscribers, however if the top level domain of the client browser is in a developing country or transition economy free access is provided. More information about subscriptions and free access is available at http://www.nber.org/wwphelp.html. Free access is also available to older working papers.
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    More about this item

    JEL classification:

    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L41 - Industrial Organization - - Antitrust Issues and Policies - - - Monopolization; Horizontal Anticompetitive Practices

    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:33861. 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.

    We have no bibliographic references for this item. You can help adding them by using 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.