Week 12_Bhargava and Mishra (2014)_Aaron

Electronic Medical Records and Physician Productivity: Evidence from Panel Data Analysis

Bhargava and Mishra (2014) investigated the impact of an electronic medical record (EMR) system on the productivity of physicians. This study is of interest and significant for the following reasons: 1) there is ambiguous evidence on whether and how EMRs could facilitated efficient workflows for physicians, causing practically concerns but receiving little academic attentions. 2) The EMRs’ impact on physician productivity is also related to whether or not the technology fulfills its potential to curtail the rise in healthcare expenditures in U.S.

Drawing on prior literature on physician productivity, IT productivity and task-technology fit theory, the authors examined how two types of EMRs use (information review and information enter) could affect physician productivity, and how those effects are different in specialties (internal medicine specialists (IMs), pediatricians (Peds), and family practitioners (FPs)) across implementation process (pre-entry, learning and stable phases).

They used a panel data set comprising 87 physicians with different specialties in 12 primary care clinics of an academic healthcare system in the western U.S. They employed the Arellano-Bond system GMM estimation technique on their data set with 3186 physician-month productivity observations over 39 months. They found that productivity drops sharply after EMRs implementation and recovers partly over the next few months. The longer-term impact depends on physician specialty. And the impact of EMRs is more benign on IMs than on Peds and FPs.

They postured that the fit provided by an EMR system to the task requirements of physicians of various specialties may be key to disentangling the productivity dynamics. Their finding revealed that, on one hand, EMR systems do not produce immediate productivity gain that could lead to substantial savings in healthcare; at the same time, EMRs do not cause a major productivity loss on a sustained basis, as many physicians fear.