Working Paper: NBER ID: w21389
Authors: Seth Freedman; Haizhen Lin; Jeffrey Prince
Abstract: We study the effect of hospital adoption of electronic medical records (EMRs) on health outcomes, particularly patient safety indicators (PSIs). We find evidence of a positive impact of EMRs on PSIs via decision support rather than care coordination. Consistent with this mechanism, we find an EMR with decision support is more effective at reducing PSIs for less complicated cases, using several different metrics for complication. These findings indicate the negligible impacts for EMRs found by previous studies focusing on the Medicare population and/or mortality do not apply in all settings.
Keywords: Electronic Medical Records; Patient Safety Indicators; Health Outcomes
JEL Codes: I10; O33
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| EMR adoption (I18) | decrease in the occurrence of preventable adverse events (I14) |
| CPOE adoption (I11) | decrease in the probability of experiencing at least one postoperative adverse event (D81) |
| CPOE adoption (I11) | decrease in the occurrence of postoperative adverse events for noncomplicated cases (K41) |
| CPOE adoption (I11) | no significant effects on more complicated cases (C20) |
| physician documentation (I11) | less pronounced effects on PSIs (I14) |
| EMR adoption (I18) | effectiveness varies based on patient heterogeneity (C90) |