Research Abstracts Online
January 2010 - March 2011
University of Minnesota Twin Cities
School of Public Health
Division of Health Policy and Management
PI: Jeffrey S. McCullough
The Effect of Computerized Physician Order Entry and Complementary Organizations Inputs on Quality
Clinical error reduction is among the most pressing issues facing the U.S. healthcare system. Information technology holds the potential to improve hospital quality while reducing costs. Computerized physician order entry (CPOE) systems may remedy communication problems while facilitating clinical guideline implementation. CPOE also captures information for both clinical and management purposes. Among the many requirements for effective CPOE implementation is the need for physicians to invest their own time to learn and use health information technology (HIT).
This project measures the effect of HIT on both quality and costs. The effect of HIT and its organizational complements on medical errors are measured, and those measures are combined with previous research deriving the financial cost of medical errors; thus, the financial value of CPOE-drive errors reductions can be estimated. Also, the project employs identification tests based on different patient safety outcomes that should and should not be affected by HIT. Overall, this study will provide new insight into how HIT creates both financial and clinical value while enhancing the empirical rigor with which that value is measured. Preliminary estimates suggest that the effect of health IT on quality is extremely small. The researchers have not detected reductions in length of stay, mortality, or readmissions; however, they do find some evidence that IT reduces errors. While IT improves quality at the margin, health gains and resultant cost savings are minimal. Furthermore, they find evidence that health IT enhances upcoding. Thus, IT may, in effect, raise the prices paid by Medicare.
Robert J. Town, Co-Principal Investigator
Patrick Bajari, Faculty Collaborator
Eric G. Garrette, Graduate Student
Konstantin Golyaev, Graduate Student
Hawre Jalal, Graduate Student
Stephen T. Parente, Faculty Collaborator