Can Health Information Technology Save Lives During a Pandemic

During the COVID-19 pandemic, US deaths per case decreased from 7.46% in April 2020 to 1.82% in September 2020. In addition to increased testing, a leading explanation for this decline is that hospitals learned over time how to better treat patients diagnosed with COVID-19. Hospitals use health information technologies (IT) to develop dynamic capabilities that enable greater organizational resilience based on health information sharing across providers. This suggests that health IT helps hospitals to save lives during a pandemic, especially during periods when knowledge about the disease improves over time. Using county-level data on health IT intensity, COVID-19 cases and deaths, we show that counties with greater hospital IT intensity exhibit fewer COVID-19 deaths. This result is strengthened when instrumenting for health IT intensity with measures of local internet quality. Using a battery of controls, we are able to exclude several non-causal explanations of health IT’s relationship to deaths, including county prosperity, demographics, COVID-19 cases, pre-COVID-19 hospital mortality rates, mobility and timing of pandemic exposure. Using fixed effects estimation, we observe that a standard deviation increase in a county’s health IT intensity is associated with .043 (95% CI [.068, .018]) fewer COVID-19 deaths per 1000 residents. Consistent with the learning hypothesis, we show that high-IT intensity counties are only significantly better at treating COVID-19 cases several months into the pandemic. Counties with hospitals that participate in COVID-19 related clinical trials also experienced faster learning. We provide evidence that faster learning from clinical trials is, locally, a substitute for learning from health IT, while health IT plays a role in helping hospitals learn from clinical trials in other counties, providing evidence of a spillover effect.