The Value of Health IT Interoperability: Evidence from Interhospital Transfer of Heart Attack Patients

37 Pages Posted: 14 Apr 2020 Last revised: 28 Jan 2021

See all articles by Yao Li

Yao Li

Tsinghua University, School of Economics & Management, Students

Lauren Xiaoyuan Lu

Dartmouth College - Tuck School of Business

Susan F. Lu

Purdue University - Krannert School of Management

Jian Chen

Tsinghua University - School of Economics and Management

Date Written: January 28, 2021

Abstract

Problem definition: Health IT (HIT) interoperability refers to the ability of different electronic health record systems and software applications to communicate, exchange data, and use the information that has been exchanged. U.S. government has invested heavily to promote HIT interoperability in recent years in an attempt to improve patient outcomes and control healthcare expenditure. This study empirically assesses the value of HIT interoperability in the interhospital transfer process of heart attack patients.
Academic/practical relevance: HIT interoperability is supposed to enable health information exchange between disparate providers. However, there exists little evidence about how it affects care delivery processes across providers.
Methodology: Using transfer records of heart attack patients and HIT interoperability adoption records of hospitals in the New York State between 2013 to 2015, we estimate the effect of HIT interoperability on care delivery process measures and patient outcome measures. We demonstrate the robustness of the results using the instrumental variable method, the propensity score matching method, the difference-in-differences method, and a falsification test.
Results: We show that HIT interoperability shortens the throughput time of interhospital transfer by 45.6 minutes on average, or 12.0%. Surprisingly, we find that HIT interoperability has little effect in reducing duplicate EKG testing for transferred patients at receiving hospitals. When HIT interoperability is enabled through a common software vendor, it yields 15.6% more reduction in the throughput time than when it is enabled through different vendors, but it still has no significant effect on duplicate EKG testing. Furthermore, we find that HIT interoperability leads to 3.0 percentage points decrease in the 30-day readmission rate of transferred patients, which can be explained by the reduction of the throughput time.
Managerial Implications: Our findings demonstrate the value of incentivizing HIT adoption and promoting widespread exchange of health information because HIT interoperability indeed improves the efficiency of healthcare delivery across providers, which ultimately translates to improved patient outcomes. Given the lack of reduction in duplicate testing in our study, we call for more provider effort toward realizing the full potential of HIT interoperability by minimizing the gap between technology adoption and utilization.

Keywords: interoperability, health information exchange, heart attack, interhospital patient transfer, throughput time, duplicate tests

Suggested Citation

Li, Yao and Lu, Lauren Xiaoyuan and Lu, Susan Feng and Chen, Jian, The Value of Health IT Interoperability: Evidence from Interhospital Transfer of Heart Attack Patients (January 28, 2021). Available at SSRN: https://ssrn.com/abstract=3557010 or http://dx.doi.org/10.2139/ssrn.3557010

Yao Li (Contact Author)

Tsinghua University, School of Economics & Management, Students ( email )

Beijing
China

Lauren Xiaoyuan Lu

Dartmouth College - Tuck School of Business ( email )

Hanover, NH 03755
United States

Susan Feng Lu

Purdue University - Krannert School of Management ( email )

1310 Krannert Building
West Lafayette, IN 47907-1310
United States

HOME PAGE: http://https://sites.google.com/site/susanluhome/home

Jian Chen

Tsinghua University - School of Economics and Management ( email )

Beijing, 100084
China

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