The Effects of Health Information Exchange Access on Healthcare Quality and Efficiency: An Empirical Investigation

Management Science (forthcoming)

58 Pages Posted: 11 Feb 2017 Last revised: 8 Nov 2021

See all articles by Ramkumar Janakiraman

Ramkumar Janakiraman

University of South Carolina - Darla Moore School of Business

Eunho Park

California State University, Long Beach

Emre M Demirezen

University of Florida - Information Systems and Operations Management

Subodha Kumar

Temple University - Department of Marketing and Supply Chain Management

Date Written: February 10, 2017

Abstract

Health information exchanges (HIEs) are designed to improve the quality and efficiency of healthcare by facilitating improved information sharing between health entities. This study systematically examines the impact of HIE use in emergency departments (EDs) on the quality and efficiency of medical care. We focus on the length of stay (LOS) and the 30-day readmission rate to capture healthcare efficiency and quality, respectively. We also examine whether the breadth of patient health information and physicians’ experience with the HIE moderates these effects. We leverage a unique panel data that tracks actual HIE access by physicians who practice in a set of hospitals that participate in the focal HIE. The patient-level encounter dataset, which involves more than 80,000 ED encounters attended by more than 300 physicians over a 19-month period, comprises detailed medical provider information, patient-level medical information, and various other information related to procedures that were performed. After controlling for a battery of patient-specific, physician-specific, disease-specific, and ED visit-specific variables, our results show that HIE access in information intensive environments (such as EDs) reduces LOS and 30-day readmission rate. We find that breadth of patient health information and physicians’ HIE experience amplify these benefits. We account for endogeneity issues and perform additional falsification tests and robustness checks. We document that the benefits of HIE access are amplified for non-injury, chronic condition, and uncommon diagnoses related patient visits. Based on our results, we offer insights to practitioners and academicians alike on how HIEs can yield better patient-level and provider-level outcomes.

Keywords: Healthcare management, health information exchange (HIE), healthcare and IT, readmission, length of stay, number of doctors involved in a visit.

JEL Classification: I11, I12, I19, C1, C13

Suggested Citation

Janakiraman, Ramkumar and Park, Eunho and Demirezen, Emre M and Kumar, Subodha, The Effects of Health Information Exchange Access on Healthcare Quality and Efficiency: An Empirical Investigation (February 10, 2017). Management Science (forthcoming), Available at SSRN: https://ssrn.com/abstract=2915190 or http://dx.doi.org/10.2139/ssrn.2915190

Ramkumar Janakiraman (Contact Author)

University of South Carolina - Darla Moore School of Business ( email )

1705 College St
Francis M. Hipp Building
Columbia, SC 29208
United States
8037770534 (Phone)

HOME PAGE: http://businessanalyticslens.com/

Eunho Park

California State University, Long Beach ( email )

1250 Bellflower Blvd.
Long Beach, CA 90840
United States

Emre M Demirezen

University of Florida - Information Systems and Operations Management ( email )

PO Box 117165, 201 Stuzin Hall
Gainesville, FL 32610-0496
United States

Subodha Kumar

Temple University - Department of Marketing and Supply Chain Management ( email )

Philadelphia, PA 19122
United States

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