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The Impact of Health Information Exchanges on Emergency Department Length of Stay

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  • Turgay Ayer
  • Mehmet U. S. Ayvaci
  • Zeynal Karaca
  • Jan Vlachy

Abstract

Health information exchanges (HIEs) are expected to improve poor information coordination in emergency departments (EDs); however, whether and when HIEs are associated with better operational outcomes remains poorly understood. In this work, we study HIE and length of stay (LOS) relationship using a large dataset from the Healthcare Cost and Utilization Project consisting of about 7.4 million treat‐and‐release visits made to 63 EDs in Massachusetts. Overall, we find that HIE adoption is associated with a 10.2% reduction in LOS and the percentage reduction increases to 14.8% when the hospital is part of an integrated health system or to 21.0% when a patient has a previous visit to an HIE‐carrying hospital. We further find that (i) teaching hospitals benefit more from HIE adoption compared with non‐teaching hospitals, (ii) patients with severe or multiple comorbid conditions spend less time in the ED under HIE presence. Together, these results imply that (i) HIE adoption reduces overall ED LOS, (ii) wider HIE adoption would scale up the benefits for individual hospitals, (iii) magnitude of the association between HIE and LOS is higher when financial incentives for HIE adoption are stronger (e.g., integrated health systems), and (iv) the size of the reduction depends on certain contextual moderating factors. Given that HIEs are a key component of healthcare delivery and ongoing reforms, we believe that our findings have important implications and may inform policymakers regarding the nationwide HIE adoption.

Suggested Citation

  • Turgay Ayer & Mehmet U. S. Ayvaci & Zeynal Karaca & Jan Vlachy, 2019. "The Impact of Health Information Exchanges on Emergency Department Length of Stay," Production and Operations Management, Production and Operations Management Society, vol. 28(3), pages 740-758, March.
    • Handle: RePEc:bla:popmgt:v:28:y:2019:i:3:p:740-758
    DOI: 10.1111/poms.12953
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    Citations

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    Cited by:

    1. Shujing Sun & Susan F. Lu & Huaxia Rui, 2020. "Does Telemedicine Reduce Emergency Room Congestion? Evidence from New York State," Information Systems Research, INFORMS, vol. 31(3), pages 972-986, September.
    2. Seokjun Youn & H. Neil Geismar & Michael Pinedo, 2022. "Planning and scheduling in healthcare for better care coordination: Current understanding, trending topics, and future opportunities," Production and Operations Management, Production and Operations Management Society, vol. 31(12), pages 4407-4423, December.
    3. Justin T. Kistler & Ramkumar Janakiraman & Subodha Kumar & Vikram Tiwari, 2021. "The Effect of Operational Process Changes on Preoperative Patient Flow: Evidence from Field Research," Production and Operations Management, Production and Operations Management Society, vol. 30(6), pages 1647-1667, June.
    4. Sriram Somanchi & Idris Adjerid & Ralph Gross, 2022. "To Predict or Not to Predict: The Case of the Emergency Department," Production and Operations Management, Production and Operations Management Society, vol. 31(2), pages 799-818, February.
    5. Ramkumar Janakiraman & Eunho Park & Emre M. Demirezen & Subodha Kumar, 2023. "The Effects of Health Information Exchange Access on Healthcare Quality and Efficiency: An Empirical Investigation," Management Science, INFORMS, vol. 69(2), pages 791-811, February.
    6. Wenjuan Fan & Qiqi Zhou & Liangfei Qiu & Subodha Kumar, 2023. "Should Doctors Open Online Consultation Services? An Empirical Investigation of Their Impact on Offline Appointments," Information Systems Research, INFORMS, vol. 34(2), pages 629-651, June.
    7. Sunil Mithas & Yanzhen Chen & Yatang Lin & Alysson De Oliveira Silveira, 2022. "On the causality and plausibility of treatment effects in operations management research," Production and Operations Management, Production and Operations Management Society, vol. 31(12), pages 4558-4571, December.
    8. Abhay Nath Mishra & Youyou Tao & Mark Keil & Jeong-ha (Cath) Oh, 2022. "Functional IT Complementarity and Hospital Performance in the United States: A Longitudinal Investigation," Information Systems Research, INFORMS, vol. 33(1), pages 55-75, March.
    9. Yingchao Lan & Deepa Goradia & Aravind Chandrasekaran, 2022. "Ancillary Cost Implications of Physicians Multisiting and Inter‐Organizational Collaboration During Healthcare Delivery," Production and Operations Management, Production and Operations Management Society, vol. 31(2), pages 561-582, February.
    10. Tortorella, Guilherme Luz & Fogliatto, Flávio Sanson & Espôsto, Kleber Francisco & Vergara, Alejandro Mac Cawley & Vassolo, Roberto & Mendoza, Diego Tlapa & Narayanamurthy, Gopalakrishnan, 2020. "Effects of contingencies on healthcare 4.0 technologies adoption and barriers in emerging economies," Technological Forecasting and Social Change, Elsevier, vol. 156(C).
    11. Hilal Atasoy & Emre M. Demirezen & Pei‐Yu Chen, 2021. "Impacts of Patient Characteristics and Care Fragmentation on the Value of HIEs," Production and Operations Management, Production and Operations Management Society, vol. 30(2), pages 563-583, February.

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