Beyond Adoption: Does Meaningful Use of EHR Improve Quality of Care?

Abstract

Electronic health record (EHR) system holds great promise in transforming healthcare. Existing empirical literature typically focused on its adoption, and found mixed evidence on whether EHR improves care. The federal initiative for meaningful use (MU) of EHR aims to maximize the potential of quality improvement, yet there is little empirical study on the impact of the initiative and, more broadly, the relation between MU and quality of care. IT usage has been an important construct in MIS research and is a key antecedent in realizing the values of IT, considering that IT adoption itself does not always imply use. Leveraging features of the Medicare EHR Incentive Program for exogenous variations, we examine the impact of MU on healthcare quality in acute care hospitals in the United States. We find that EHR adoption alone does not contribute to quality improvement. However, MU significantly and consistently improves quality of care. More importantly, this quality effect from MU is greater in historically disadvantaged hospitals such as small, non-teaching, or rural hospitals. Our results present significant implications not only for health IT research and practice, but more broadly, also for the use and values of IT as well.