The researchers examined records for hospitals that adopted EMRs from 1996-2009 and found hospitals in “IT-intensive markets” experienced a 3.4% decrease in costs three years after adopting a basic EMR and a 2.2% cost decrease three years after adopting an advanced EMR. However, hospitals in areas with the least amount of IT firms had up to a 4% increase in costs even six years after adoption of EMRs.
“We find the evidence consistent with our reframing of the conundrum, namely, differences in outcomes relate to differences in local conditions,” wrote the authors, who included David Dranove, a professor in the Kellogg School of Management at Northwestern University.
Such findings could help to explain the “uneven” adoption of EMRs, the authors noted, despite a federal program to provide $20 billion in adoption incentives and penalties to non-adopting providers.
The study had sought to identify why EMRs appeared to provide cost savings to some providers, while increasing costs for others.
The findings indicated to the authors that IT adoption's impact on the bottom line in healthcare follows a similar pattern to what other industries experienced when digitizing their data. Specifically, companies that derived profits from technology upgrades were among those that also undertook changes in staff and businesses processes to best use the technology. And such technology staff and business reorganizations were more likely to have occurred when such personnel and knowledge were locally available.
The “EMR may succeed when the necessary complements are present and the complementary components are in place,” the authors wrote. “Until then, the results of EMR implementation, at best, can be only mixed.”