The Impact of Health Information Technology Adoption by Outpatient Facilities on Pregnancy Outcomes

Abstract

Objective. Examine whether health information technology (HIT) at nonhospital facilities (NHFs) improves health outcomes and decreases resource use at hospitals within the same heath care network, and whether the impact of HIT varies as providers gain experience using the technologies. Data Sources. Health Services Researchliterature by determining whether greater use of HIT at nonhospital facilities (NHFs) improves pregnancy outcomes at hospitals in the same health care network, either directly or through spillovers.We focus on pregnancy outcomes because deliveries are one of the most common procedures, so improving either health or cost outcomes may have a large impact. Further, because pregnancy episodes typically require women to make multiple visits to inpatient and outpatient facilities over a relatively short-time period, we expect pregnancy outcomes to be particularly sensitive to HIT investments by NHFs that facilitate transitions across care settings. We use a sample of Pennsylvania patients because detailed inpatient data are available that allow us to combine information on HIT in NHFs with extensive controls for individual patients' characteristics and health status.We find that higher per-facility clinical HIT use by NHFs is associated with lower rates of obstetric trauma and preventable complications, and with longer lengths of stay, at hospitals in the same health care network. Further, the beneficial impacts increase as physicians and staff gain experience with the technologies. However, we find no consistent evidence of whether or how nonclinical HIT adoption by NHFs affects resource use or health outcomes at associated hospitals.Our findings contribute to the burgeoning literature evaluating the impact of investments in HIT. Although incentives and penalties related to the adoption of electronic medical records (EMRs) have already been established in the United States, policy debate over whether to encourage the adoption of other technologies continues. Furthermore, the criteria for establishing whether EMRs and other HIT investments provide "meaningful use" are still evolving. Information on how technology investments in outpatient facilities impact outcomes in the inpatient setting is important in order for policy makers and regulators to formulate requirements for the level of technology integration across care settings.

Statewide Hospital Discharge Data: Collection, Use, Limitations, and Improvements

“…Three studies used inpatient data to examine the effects of outpatient programs or reimbursement (Conti ; Deily et al. ; He and Mellor ). Two studies used discharge data with other data for simulations (Braithwaite et al.…”

“…); pregnancy, delivery, or neonatal care (Deily et al. ; Ghaffarzadegan, Epstein, and Martin ; Morriss ); and a specific category of surgeries (Ghaffarzadegan, Epstein, and Martin ; He and Mellor ; Martin et al. ; Howard and Shen ; Maxwell et al.…”

The impact of healthcare information technology on quality and safety of healthcare: A literature review

“…And then chronic illness included diabetes , heart disease and mental illness, The most of published studies indicate a positive impact of specific health information technology components on chronic illness care [16]. Take Pregnancy as a special example in illness, "Clinical HIT applications at non hospital facilities (NHFs) may reduce the likelihood of adverse birth outcomes, particularly after physicians and staff gain experience using the technologies" [17].…”