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

Abstract

Physician productivity is an important driver of key healthcare outcomes, such as quality of care, treatment costs and patient satisfaction, because physicians influence a vast majority of treatment decisions, and are central to the care delivery process. Thus, it is critical for researchers to understand how transformation technologies, such as electronic medical records (EMRs) impact physician productivity. While researchers and policy makers in the United States have suggested that the implementation of EMRs can have significant beneficial impacts on patient safety, health care quality and overall costs of care delivery, the effects of EMRs on physicians themselves have been understudied in the literature. In this paper, we examine the productivity impacts of EMR implementation on physicians. Our focus is to investigate if productivity impacts of EMR implementation depend on physician specialties and the duration for which the EMR has been implemented. This research is informed by extant work in physician productivity, IT productivity and task-technology fit theory. We use a unique panel dataset comprising 87 physicians specializing in internal medicine, pediatrics and family practice in 12 primary care clinics of an academic hospital in a large state in the western United States. Our dataset contains 3,186 physician-month productivity observations collected over 39 months. We employ random effects model on this panel dataset to estimate the impact of EMR implementation on physician productivity. We find that productivity impacts of EMR are contingent upon physician specialty and the time period for which an EMR has been implemented. Furthermore, we find that the stable stage impacts of EMR on various specialties are different from those in the transitory learning stage. These results emphasize the need for fine-grained analyses of productivity impacts of EMR implementation on physicians. We postulate that the fit provided by an EMR to the task requirements of physicians of various specialties is key to disentangling the productivity dynamics. We contribute to the nascent but emerging stream of literature that examines productivity implications of various information technologies among white color knowledge workers in the service industries.