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Charles and Elizabeth Prothro Regents Chair in Health Care Management in the McCombs School of Business, Professor of Medical Education in the Dell Medical School, The University of Texas at Austin
Can Information Sharing Reduce Diagnostic Disparate Impact? Evidence from a Health Information Exchange
Abstract: The prior literature has documented qualitative evidence of disparities in physician diagnoses, which negatively impact minority groups and lead to disparities in healthcare delivery, patient perceptions of care, and health outcomes. In this study, we seek to understand whether (a) disparities in physician diagnoses can be attributed to disparate impact based on patient race, and (b) IT-enabled health information sharing among healthcare providers can mitigate such disparate impact. Our empirical context focuses on racial disparities in diagnoses of heart disease between Hispanic patients and Non-Hispanic, White patients. Utilizing patient-level emergency room (ER) encounter data from 2015 to 2022, we find statistical evidence of diagnostic disparate impact where the likelihood of Hispanic patients being diagnosed with heart disease was around 3 percentage points lower than White patients, after accounting for their underlying race-specific, risk of heart disease. However, based on hospital-level data on information sharing between healthcare providers, we observe that health information sharing can reduce the likelihood of diagnostic disparate impact by 5% and severe disparate impact by 12%. Our results are robust to a range of robustness checks using instrumental variable estimations and falsification tests based on subsample analyses. We also find that low-skilled physicians benefit more significantly from health information sharing than highly-skilled physicians. Our study underscores the significant potential of health information sharing and critical role of implementing common health data standards for sharing patient health data across healthcare providers in mitigating disparate impact in healthcare delivery and promoting health equity.
Bio: Indranil Bardhan is the Charles and Elizabeth Prothro Regents Chair in Health Care Management in the McCombs School of Business at The University of Texas at Austin. He teaches courses in the MBA program as well as the M.S. program at UT Dell Medical School. His research focuses on health care analytics and digital health innovation, and involves close collaboration with the University of Texas Southwestern Medical Center and Dell Med. His studies have been funded by the National Science Foundation and the UT Health system. Bardhan's research has won seven best paper or runner-up awards and includes more than 50 publications in premier scholarly journals. He has also served as senior editor of several prestigious journals, including MIS Quarterly, Information Systems Research, and Production and Operations Management. He currently serves as associate editor at Management Science. Bardhan holds a Ph.D. in management science and information systems from Texas McCombs. He was inducted as a distinguished fellow of the INFORMS Information Systems Society in 2019.