In this paper, we examine the effect of the adoption of Electronic Medical Records (EMR) systems to neighboring hospitals. We find that although EMR systems increases the operational costs for adopting hospitals, it has significant spillover effects by reducing the health care costs of the other hospitals in the same region (possibly due to patient mobility and better care that is provided by these systems). These regional externalities are stronger especially in the long term. Our results provide support to the role of EMR investments in reducing overall health care costs. Estimates, based on our results, suggest that EMR investments can lead to net reduction in national health care cost by about $47 billion dollars over 4 years.
Although significant research has examined how technology can intensify racial and other outgroup biases, limited work has investigated the role information systems can play in abating them. Racial biases are particularly worrisome in healthcare, where underrepresented minorities suffer disparities in access to care, quality of care, and clinical outcomes. In this paper, we examine the role clinical decision support systems (CDSS) play in attenuating systematic biases among black patients, relative to white patients, in rates of amputation and revascularization stemming from diabetes mellitus. Using a panel of inpatient data and a difference-in-difference approach, results suggest that CDSS adoption significantly shrinks disparities in amputation rates across white and black patients—with no evidence that this change is simply delaying eventual amputations. Results suggest that this effect is driven by changes in treatment care protocols that match patients to appropriate specialists, rather than altering within physician decision making. These findings highlight the role information systems and digitized patient care can play in promoting unbiased decision making by structuring and standardizing care procedures. This paper was accepted by Stefan Scholtes, healthcare management.
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