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Can Healthcare IT Save Babies?

Catherine Tucker

Catherine TuckerCatherine Tucker is the Mark Hyman, Jr. Career Development Professor and an Associate Professor of Marketing

Each year, more than 18,000 babies in this country die within their first 28 days of life. This grim statistic ranks the United States 43rd in the world in terms of neonatal mortality—tied with Montenegro, Slovakia, and the United Arab Emirates, and behind 24 of the 27 members of the European Union.

In addressing these and other disparities in U.S. healthcare, much policy emphasis has been placed on moving the country toward digital medical records and abandoning the current paper-based system. This effort culminated in 2009 with the Health Information Technology for Economic and Clinical Health (HITECH) Act, which promised large subsidies for healthcare providers who moved to digital records. However, there was little broad-scale evidence about the effectiveness of these investments.

To determine whether the United States would see a marked improvement in neonatal mortality if it were to adopt electronic medical records (EMRs), my colleague Professor Amalia Miller from the University of Virginia and I examined 12 years of birth and death records for all American counties. We combined these with national data on the adoption of EMRs by U.S. hospitals. Then we ran a regression analysis—a statistical technique for estimating the relationships among variables—to include controls for hospital and county characteristics.

We found that a 10 percent increase in basic EMR adoption would reduce neonatal mortality rates by 16 deaths per 100,000 live births. Beyond this, a 10 percent increase in EMR adoption plus the same increase in obstetric-specific computing technology would cut neonatal mortality by 40 deaths per 100,000 live births. We documented that this increase was driven by the kind of conditions that could be helped by detailed documentation, such as those stemming from difficulties during a pregnancy, rather than by conditions that EMRs were less likely to help, such as congenital defects and accidents. Our study provides cautious optimism about the potential value of healthcare IT and EMRs in improving neonatal health outcomes.

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