Electronic medical records and medical procedure choice: Evidence from cesarean sections

Abstract

This paper examines how hospital adoption of electronic medical records (EMRs) impacts medical procedure choice in the context of cesarean section deliveries. It provides a unique contribution by tying the literature on EMR diffusion to the literature on the utilization of expensive medical technology and provider practice style. Exploiting within‐hospital variation in three types of EMR adoption, we find that computerized physician order entry, an advanced EMR system that typically incorporates decision support, reduces C‐section rates for low‐risk mothers by 2.5%. Obstetric‐specific EMR systems and physician documentation have no statistically significant effect on C‐section rates. In addition, we find that the computerized practitioner order entry effect occurs predominantly in hospitals that were already performing fewer C‐sections and does not change the behavior of already high‐intensity providers.