The Relationship between Investments in Health Information Technology, Provider Efficiency and Health Outcomes
The papers in this session explore the effect of investments by hospitals and outpatient facilities in health information technologies on health care provider efficiency and patient health outcomes. Paper #1 uses a mixed methods approach and data from a large health care network to determine how the installation and integration of an electronic health record (HER) at four outpatient OB/GYN practices affected physician productivity and adverse birth outcomes. The authors find that the new system led to a four year productivity drop, but that it also reduced the severity of adverse events. Interviews with physicians indicate that much of the productivity reduction resulted from additional documentation requirements, as well as from information overload. Paper #2 explores the role of management in the effectiveness of EHRs in the inpatient setting. Using a nationally-representative random sample of acute-care hospitals, the authors determine that management quality modifies the relationship between EHR adoption and cost and quality outcomes for acute myocardial infarction. When hospitals are well managed, having an EHR is associated with greater efficiency, whereas in poorly-managed hospitals, EHRs are associated with lower efficiency. Paper #3 examines the potential for HIT to improve the health of people with diabetes through a screening system for diabetic retinopathy implemented at primary care settings. The authors find that automated screening systems would result in higher detection rates and lower costs relative to conventional examinations. Overall, these papers highlight the potential of new technologies to improve health as well as the disruption they have on work processes.