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The adoption of hospital information systems

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  • Jeffrey S. McCullough

Abstract

This paper empirically examines the diffusion of hospital information systems (ISs), specifically, pharmacy, laboratory, and radiology systems. Given the policy significance of health IS and the widespread perception that it's diffusion is slow, a better understanding of the mechanisms driving IS adoption is needed. A novel data set incorporating both IS adoption and hospital characteristics was constructed. These data follow the behavior of 1965 hospitals for the years 1990–2000. Hypotheses pertaining to hospital characteristics, hospital competition, and strategic behavior are tested utilizing proportional hazard models. I find that IS adoption is related to multi‐hospital system membership, payer mix, and hospital scale. The role of scale, however, significantly diminishes throughout the time period, likely reflecting improved personal computer performance and improved IT scalability. Conversely, I find little that strategic behavior or hospital competition affects IS adoption. Likewise, hospital ownership does not affect the adoption of these systems. Overall, these results suggest that hospital IS diffusion has not been normatively slow. Copyright © 2007 John Wiley & Sons, Ltd.

Suggested Citation

  • Jeffrey S. McCullough, 2008. "The adoption of hospital information systems," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 649-664, May.
    • Handle: RePEc:wly:hlthec:v:17:y:2008:i:5:p:649-664
    DOI: 10.1002/hec.1283
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    2. Eric Lammers, 2013. "The Effect Of Hospital–Physician Integration On Health Information Technology Adoption," Health Economics, John Wiley & Sons, Ltd., vol. 22(10), pages 1215-1229, October.
    3. David Dranove & Chris Forman & Avi Goldfarb & Shane Greenstein, 2014. "The Trillion Dollar Conundrum: Complementarities and Health Information Technology," American Economic Journal: Economic Policy, American Economic Association, vol. 6(4), pages 239-270, November.
    4. McCullough, Jeffrey S. & Snir, Eli M., 2010. "Monitoring technology and firm boundaries: Physician-hospital integration and technology utilization," Journal of Health Economics, Elsevier, vol. 29(3), pages 457-467, May.
    5. Laurence C. Baker & Kate Bundorf & Daniel Kessler, 2014. "Expanding Patients' Property Rights In Their Medical Records," NBER Working Papers 20565, National Bureau of Economic Research, Inc.
    6. Natalia Zhivan & Mark Diana, 2012. "U.S. hospital efficiency and adoption of health information technology," Health Care Management Science, Springer, vol. 15(1), pages 37-47, March.
    7. Awaworyi Churchill, Sefa & Ocloo, Janet Exornam & Siawor-Robertson, Diana, 2015. "Ethnic diversity makes me sick! An examination of ethnic diversity’s effect on health outcomes," EconStor Preprints 123721, ZBW - Leibniz Information Centre for Economics.
    8. Borzekowski, Ron, 2009. "Measuring the cost impact of hospital information systems: 1987-1994," Journal of Health Economics, Elsevier, vol. 28(5), pages 938-949, September.
    9. Fareed, Naleef & Bazzoli, Gloria J. & Farnsworth Mick, Stephen S. & Harless, David W., 2015. "The influence of institutional pressures on hospital electronic health record presence," Social Science & Medicine, Elsevier, vol. 133(C), pages 28-35.
    10. Ashley Hodgson & Chloe Mitchell & Alec Paulson, 2017. "Diffusion of Minimally Invasive Procedures across Hospitals and Traits of Fast Adopting Hospitals," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 45(4), pages 473-484, December.
    11. Patricia Ex & Cornelia Henschke, 2019. "Changing payment instruments and the utilisation of new medical technologies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(7), pages 1029-1039, September.
    12. Bourke, Jane & Roper, Stephen, 2014. "The influence of experiential learning on medical equipment adoption in general practices," Health Policy, Elsevier, vol. 118(1), pages 37-47.
    13. Sefa Awaworyi Churchill & Janet Exornam Ocloo & Diana Siawor-Robertson, 2017. "Ethnic Diversity and Health Outcomes," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 134(3), pages 1077-1112, December.
    14. Ritu Agarwal & Guodong (Gordon) Gao & Catherine DesRoches & Ashish K. Jha, 2010. "Research Commentary ---The Digital Transformation of Healthcare: Current Status and the Road Ahead," Information Systems Research, INFORMS, vol. 21(4), pages 796-809, December.

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