[go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/p/cep/poidwp/018.html
   My bibliography  Save this paper

The impact of healthcare IT on clinical quality, productivity and workers

Author

Listed:
  • Ari Bronsoler
  • Joseph Doyle
  • John Van Reenen
Abstract
Adoption of health information and communication technologies ('HICT') has surged over the past two decades. We survey the medical and economic literature on HICT adoption and its impact on clinical outcomes, productivity and labor. We find that HICT improves clinical outcomes and lowers healthcare costs, but (i) the effects are modest so far, (ii) it takes time for these effects to materialize, and (iii) there is much variation in the impact. More evidence on the causal effects of HICT on productivity is needed to guide further adoption. There is little econometric work directly investigating the impact of HICT on labor, but what there is suggests no substantial negative effects on employment and earnings. Overall, while healthcare is 'exceptional' in many ways, we are struck by the similarities to the wider findings on ICT and productivity stressing the importance of complementary factors (e.g. management and skills) in determining HICT impacts.

Suggested Citation

  • Ari Bronsoler & Joseph Doyle & John Van Reenen, 2021. "The impact of healthcare IT on clinical quality, productivity and workers," POID Working Papers 018, Centre for Economic Performance, LSE.
    • Handle: RePEc:cep:poidwp:018
    as

    Download full text from publisher

    File URL: https://poid.lse.ac.uk/textonly/publications/downloads/poidwp018.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Erik Brynjolfsson & Daniel Rock & Chad Syverson, 2021. "The Productivity J-Curve: How Intangibles Complement General Purpose Technologies," American Economic Journal: Macroeconomics, American Economic Association, vol. 13(1), pages 333-372, January.
    2. David M. Cutler, 2011. "Where Are the Health Care Entrepreneurs? The Failure of Organizational Innovation in Health Care," NBER Chapters, in: Innovation Policy and the Economy, Volume 11, pages 1-28, National Bureau of Economic Research, Inc.
    3. Nicholas Bloom & Renata Lemos & Raffaella Sadun & John Van Reenen, 2020. "Healthy Business? Managerial Education and Management in Health Care," The Review of Economics and Statistics, MIT Press, vol. 102(3), pages 506-517, July.
    4. David, Paul A, 1990. "The Dynamo and the Computer: An Historical Perspective on the Modern Productivity Paradox," American Economic Review, American Economic Association, vol. 80(2), pages 355-361, May.
    5. Nicholas Bloom & Raffaella Sadun & John Van Reenen, 2012. "Americans Do IT Better: US Multinationals and the Productivity Miracle," American Economic Review, American Economic Association, vol. 102(1), pages 167-201, February.
    6. Nicholas Bloom & Charles I. Jones & John Van Reenen & Michael Webb, 2020. "Are Ideas Getting Harder to Find?," American Economic Review, American Economic Association, vol. 110(4), pages 1104-1144, April.
    7. Kai Uwe Kühn & John Van Reenen, 2008. "Interoperability and Market Foreclosure In the European Microsoft Case," CEP Reports 20, Centre for Economic Performance, LSE.
    8. 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.
    9. Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2015. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 82(2), pages 457-489.
    10. Randall D. Cebul & James B. Rebitzer & Lowell J. Taylor & Mark E. Votruba, 2008. "Organizational Fragmentation and Care Quality in the U.S. Healthcare System," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 93-113, Fall.
    11. Zack Cooper & Stuart V Craig & Martin Gaynor & John Van Reenen, 2019. "The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(1), pages 51-107.
    12. Amitabh Chandra & Amy Finkelstein & Adam Sacarny & Chad Syverson, 2016. "Health Care Exceptionalism? Performance and Allocation in the US Health Care Sector," American Economic Review, American Economic Association, vol. 106(8), pages 2110-2144, August.
    13. Nicholas Bloom & John Van Reenen, 2007. "Measuring and Explaining Management Practices Across Firms and Countries," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(4), pages 1351-1408.
    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. David Autor & David Dorn & Lawrence F Katz & Christina Patterson & John Van Reenen, 2020. "The Fall of the Labor Share and the Rise of Superstar Firms [“Automation and New Tasks: How Technology Displaces and Reinstates Labor”]," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 135(2), pages 645-709.
    16. Jinhyung Lee & Jeffrey S. McCullough & Robert J. Town, 2013. "The impact of health information technology on hospital productivity," RAND Journal of Economics, RAND Corporation, vol. 44(3), pages 545-568, September.
    17. Erik Brynjolfsson & Lorin M. Hitt, 2000. "Beyond Computation: Information Technology, Organizational Transformation and Business Performance," Journal of Economic Perspectives, American Economic Association, vol. 14(4), pages 23-48, Fall.
    18. Robert E. Hall & Charles I. Jones, 2007. "The Value of Life and the Rise in Health Spending," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 39-72.
    19. Swan, Philip L, 1973. "The International Diffusion of an Innovation," Journal of Industrial Economics, Wiley Blackwell, vol. 22(1), pages 61-69, September.
    20. 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, President and Fellows of Harvard College, vol. 117(1), pages 339-376.
    21. Leila Agha & Keith Marzilli Ericson & Xiaoxi Zhao, 2020. "The Impact of Organizational Boundaries on Healthcare Coordination and Utilization," NBER Working Papers 28179, National Bureau of Economic Research, Inc.
    22. Daniel A. Ackerberg & Kevin Caves & Garth Frazer, 2015. "Identification Properties of Recent Production Function Estimators," Econometrica, Econometric Society, vol. 83, pages 2411-2451, November.
    23. Eve Caroli & John Van Reenen, 2001. "Skill-Biased Organizational Change? Evidence from A Panel of British and French Establishments," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 116(4), pages 1449-1492.
    24. Hemant K. Bhargava & Abhay Nath Mishra, 2014. "Electronic Medical Records and Physician Productivity: Evidence from Panel Data Analysis," Management Science, INFORMS, vol. 60(10), pages 2543-2562, October.
    25. Ravi Aron & Shantanu Dutta & Ramkumar Janakiraman & Praveen A. Pathak, 2011. "The Impact of Automation of Systems on Medical Errors: Evidence from Field Research," Information Systems Research, INFORMS, vol. 22(3), pages 429-446, September.
    26. David Dranove & Chris Forman & Avi Goldfarb & Shane Greenstein, 2014. "The Trillion Dollar Conundrum: Complementarities and Health Information Technology," American Economic Journal: Economic Policy, American Economic Association, vol. 6(4), pages 239-270, November.
    27. repec:dau:papers:123456789/10093 is not listed on IDEAS
    28. Kartik K. Ganju & Hilal Atasoy & Jeffery McCullough & Brad Greenwood, 2020. "The Role of Decision Support Systems in Attenuating Racial Biases in Healthcare Delivery," Management Science, INFORMS, vol. 66(11), pages 5171-5181, November.
    29. Joseph Doyle & Sarah Abraham & Laura Feeney & Sarah Reimer & Amy Finkelstein, 2019. "Clinical decision support for high-cost imaging: A randomized clinical trial," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-13, March.
    30. Joseph J. Doyle Jr. & John A. Graves & Jonathan Gruber & Samuel A. Kleiner, 2015. "Measuring Returns to Hospital Care: Evidence from Ambulance Referral Patterns," Journal of Political Economy, University of Chicago Press, vol. 123(1), pages 170-214.
    31. Robert E. Hall, 2005. "Employment Efficiency and Sticky Wages: Evidence from Flows in the Labor Market," The Review of Economics and Statistics, MIT Press, vol. 87(3), pages 397-407, August.
    32. 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.
    33. Acemoglu, Daron & Autor, David, 2011. "Skills, Tasks and Technologies: Implications for Employment and Earnings," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 12, pages 1043-1171, Elsevier.
    34. Manuel Arellano & Stephen Bond, 1991. "Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 58(2), pages 277-297.
    35. Susan F. Lu & Huaxia Rui & Abraham Seidmann, 2018. "Does Technology Substitute for Nurses? Staffing Decisions in Nursing Homes," Management Science, INFORMS, vol. 64(4), pages 1842-1859, April.
    36. David M. Cutler, 2011. "Where Are the Health Care Entrepreneurs? The Failure of Organizational Innovation in Health Care," Innovation Policy and the Economy, University of Chicago Press, vol. 11(1), pages 1-28.
    37. Jeffrey S. McCullough & Stephen T. Parente & Robert Town, 2016. "Health information technology and patient outcomes: the role of information and labor coordination," RAND Journal of Economics, RAND Corporation, vol. 47(1), pages 207-236, February.
    38. Papanicolas, Irene & Woskie, Liana R. & Jha, Ashish K., 2018. "Health care spending in the United States and other high-income countries," LSE Research Online Documents on Economics 87362, London School of Economics and Political Science, LSE Library.
    39. Ryan M. McKenna & Debra Dwyer & John A. Rizzo, 2018. "Is HIT a hit? The impact of health information technology on inpatient hospital outcomes," Applied Economics, Taylor & Francis Journals, vol. 50(27), pages 3016-3028, June.
    40. Vasiliki Mantzana & Marinos Themistocleous & Zahir Irani & Vincenzo Morabito, 2007. "Identifying healthcare actors involved in the adoption of information systems," European Journal of Information Systems, Taylor & Francis Journals, vol. 16(1), pages 91-102, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Sutton, Claire & Prowse, Julie & McVey, Lynn & Elshehaly, Mai & Neagu, Daniel & Montague, Jane & Alvarado, Natasha & Tissiman, Chris & O'Connell, Kate & Eyers, Emma & Faisal, Muhammad & Randell, Rebec, 2023. "Strategic workforce planning in health and social care – an international perspective: A scoping review," Health Policy, Elsevier, vol. 132(C).
    2. Diane Coyle, 2022. "Healthcare as social infrastructure: productivity and the UK NHS during and after Covid-19," Working Papers 017, The Productivity Institute.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ari Bronsoler & John Van Reenen & Joseph Doyle, 2022. "The Impact of Health Information and Communication Technology on Clinical Quality, Productivity, and Workers," Annual Review of Economics, Annual Reviews, vol. 14(1), pages 23-46, August.
    2. Erik Brynjolfsson & Wang Jin & Kristina McElheran, 2021. "The power of prediction: predictive analytics, workplace complements, and business performance," Business Economics, Palgrave Macmillan;National Association for Business Economics, vol. 56(4), pages 217-239, October.
    3. Stefan Schweikl & Robert Obermaier, 2020. "Lessons from three decades of IT productivity research: towards a better understanding of IT-induced productivity effects," Management Review Quarterly, Springer, vol. 70(4), pages 461-507, November.
    4. Abhay Nath Mishra & Youyou Tao & Mark Keil & Jeong-ha (Cath) Oh, 2022. "Functional IT Complementarity and Hospital Performance in the United States: A Longitudinal Investigation," Information Systems Research, INFORMS, vol. 33(1), pages 55-75, March.
    5. Brad N. Greenwood & Kartik K. Ganju & Corey M. Angst, 2019. "How Does the Implementation of Enterprise Information Systems Affect a Professional’s Mobility? An Empirical Study," Information Systems Research, INFORMS, vol. 30(2), pages 563-594, June.
    6. Nicholas Bloom & Raffaella Sadun & John Van Reenen, 2012. "Americans Do IT Better: US Multinationals and the Productivity Miracle," American Economic Review, American Economic Association, vol. 102(1), pages 167-201, February.
    7. Hemant K. Bhargava & Abhay Nath Mishra, 2014. "Electronic Medical Records and Physician Productivity: Evidence from Panel Data Analysis," Management Science, INFORMS, vol. 60(10), pages 2543-2562, October.
    8. Gautam Gowrisankaran & Keith A. Joiner & Jianjing Lin, 2016. "How do Hospitals Respond to Payment Incentives?," NBER Working Papers 22873, National Bureau of Economic Research, Inc.
    9. David Dranove & Chris Forman & Avi Goldfarb & Shane Greenstein, 2014. "The Trillion Dollar Conundrum: Complementarities and Health Information Technology," American Economic Journal: Economic Policy, American Economic Association, vol. 6(4), pages 239-270, November.
    10. Jeffrey S. McCullough & Stephen T. 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.
    11. Susan F. Lu & Huaxia Rui & Abraham Seidmann, 2018. "Does Technology Substitute for Nurses? Staffing Decisions in Nursing Homes," Management Science, INFORMS, vol. 64(4), pages 1842-1859, April.
    12. Ian Goldin & Pantelis Koutroumpis & François Lafond & Julian Winkler, 2024. "Why Is Productivity Slowing Down?," Journal of Economic Literature, American Economic Association, vol. 62(1), pages 196-268, March.
    13. Kartik K. Ganju & Hilal Atasoy & Paul A. Pavlou, 2022. "Do Electronic Health Record Systems Increase Medicare Reimbursements? The Moderating Effect of the Recovery Audit Program," Management Science, INFORMS, vol. 68(4), pages 2889-2913, April.
    14. Feld, Lars P. & Schmidt, Christoph M. & Schnabel, Isabel & Truger, Achim & Wieland, Volker, 2019. "Den Strukturwandel meistern. Jahresgutachten 2019/20 [Dealing with Structural Change. Annual Report 2019/20]," Annual Economic Reports / Jahresgutachten, German Council of Economic Experts / Sachverständigenrat zur Begutachtung der gesamtwirtschaftlichen Entwicklung, volume 127, number 201920, February.
    15. Greenstein, Shane, 2010. "Innovative Conduct in Computing and Internet Markets," Handbook of the Economics of Innovation, in: Bronwyn H. Hall & Nathan Rosenberg (ed.), Handbook of the Economics of Innovation, edition 1, volume 1, chapter 0, pages 477-537, Elsevier.
    16. Hilal Atasoy & Pei-yu Chen & Kartik Ganju, 2018. "The Spillover Effects of Health IT Investments on Regional Healthcare Costs," Management Science, INFORMS, vol. 64(6), pages 2515-2534, June.
    17. Annika Campaner & John S. Heywood & Uwe Jirjahn, 2022. "Flexible work organization and employer provided training: Evidence from German linked employer‐employee data," Kyklos, Wiley Blackwell, vol. 75(1), pages 3-29, February.
    18. Maarten de Ridder, 2022. "Market power and innovation in the intangible economy," POID Working Papers 064, Centre for Economic Performance, LSE.
    19. Tomohiro MACHIKITA & Masatsugu TSUJI & Yasushi UEKI, 2010. "How ICTs Raise Manufacturing Performance: Firm-level Evidence in Southeast Asia," Working Papers DP-2010-07, Economic Research Institute for ASEAN and East Asia (ERIA).
    20. 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.

    More about this item

    Keywords

    healthcare; technology; productivity; jobs;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure
    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity
    • O14 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Industrialization; Manufacturing and Service Industries; Choice of Technology

    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:cep:poidwp:018. 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.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with 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://poid.lse.ac.uk/publications/working-papers/ .

    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.