Electronic Medical Records and Medical Procedure Choice : Evidence from Cesarean Sections

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 CPOE effect occurs predominantly in hospitals that were already performing fewer C-sections, and does not change the behavior of already high-intensity providers