A Simple Method for Causal Analysis of Return on IT Investment.

This paper proposes a method for examining the causal relationship among investment in information technology (IT) and the organization's productivity. In this method, first a strong relationship among (1) investment in IT, (2) use of IT and (3) organization's productivity is verified using correlations. Second, the assumption that IT investment preceded improved productivity is tested using partial correlation. Finally, the assumption of what may have happened in the absence of IT investment, the so called counterfactual, is tested through forecasting productivity at different levels of investment. The paper applies the proposed method to investment in the Veterans Health Information Systems and Technology Architecture (VISTA) system. Result show that the causal analysis can be done, even with limited data. Furthermore, because the procedure relies on overall organization's productivity, it might be more objective than when the analyst picks and chooses which costs and benefits should be included in the analysis.

[1]  C. Goldzweig,et al.  Costs and benefits of health information technology: new trends from the literature. , 2009, Health affairs.

[2]  J. McCullough,et al.  The effect of health information technology on quality in U.S. hospitals. , 2010, Health affairs.

[3]  Michael Joffe,et al.  Complex causal process diagrams for analyzing the health impacts of policy interventions. , 2006, American journal of public health.

[4]  J. Sidorov It Ain't Necessarily So: The Electronic Health Record And The Unlikely Prospect Of Reducing Health Care Costs. , 2006, Health affairs.

[5]  K. F. Schmitt,et al.  Financial analysis projects clear returns from electronic medical records. , 2002, Healthcare financial management : journal of the Healthcare Financial Management Association.

[6]  Maurice G. Kendall,et al.  The advanced theory of statistics , 1945 .

[7]  Jeffrey S McCullough,et al.  Health information technology and patient safety: evidence from panel data. , 2009, Health affairs.

[8]  Steven John Simon,et al.  An examination of the financial feasibility of Electronic Medical Records (EMRs): a case study of tangible and intangible benefits , 2006, Int. J. Electron. Heal..

[9]  Anne F. Kittler,et al.  A cost-benefit analysis of electronic medical records in primary care. , 2003, The American journal of medicine.

[10]  N. Menachemi,et al.  Hospital Information Technology and Positive Financial Performance: A Different Approach to Finding an ROI , 2006, Journal of healthcare management / American College of Healthcare Executives.

[11]  Stephen H. Cohen,et al.  A pilot study to document the return on investment for implementing an ambulatory electronic health record at an academic medical center. , 2007, Journal of the American College of Surgeons.

[12]  R J Little,et al.  Causal effects in clinical and epidemiological studies via potential outcomes: concepts and analytical approaches. , 2000, Annual review of public health.

[13]  Sander Greenland,et al.  Causal Diagrams , 2011, International Encyclopedia of Statistical Science.

[14]  P. Heagerty,et al.  Potential Confounding by Exposure History and Prior Outcomes: An Example From Perinatal Epidemiology , 2007, Epidemiology.

[15]  J. Pearl Causality: Models, Reasoning and Inference , 2000 .

[16]  R. Sachdeva Measuring the impact of new technology: An outcomes-based approach , 2001, Critical care medicine.

[17]  R. Shibata,et al.  PARTIAL CORRELATION AND CONDITIONAL CORRELATION AS MEASURES OF CONDITIONAL INDEPENDENCE , 2004 .

[18]  Susan Xu Advancing return on investment analysis for electronic health record investment. Impacts of payment mechanisms and public returns. , 2007, Journal of healthcare information management : JHIM.

[19]  Ron Borzekowski Measuring the Cost Impact of Hospital Information Systems: 1987-1994 , 2002, Journal of health economics.

[20]  J. Perlin,et al.  The Veterans Health Administration : Quality , Value , Accountability , and Information as Transforming Strategies for Patient-Centered Care , 2004 .

[21]  Johnathan B Perlin,et al.  The Veterans Health Administration: quality, value, accountability, and information as transforming strategies for patient-centered care. , 2005, HealthcarePapers.

[22]  M. Kendall,et al.  The advanced theory of statistics , 1945 .

[23]  E. Keeler,et al.  Costs and benefits of health information technology. , 2006, Evidence report/technology assessment.

[24]  Rushika Fernandopulle,et al.  How the electronic health record did not measure up to the demands of our medical home practice. , 2010, Health affairs.

[25]  Alain Bernard,et al.  Methods and Tools for Effective Knowledge Life-Cycle-Management , 2008 .

[26]  Steffie Woolhandler,et al.  Hospital computing and the costs and quality of care: a national study. , 2010, The American journal of medicine.

[27]  Lorin M. Hitt,et al.  Productivity, Business Profitability, and Consumer Surplus: Three Different Measures of Information Technology Value , 1996, MIS Q..

[28]  N. Powe,et al.  Clinical information technologies and inpatient outcomes: a multiple hospital study. , 2009, Archives of internal medicine.

[29]  Blackford Middleton,et al.  The value from investments in health information technology at the U.S. Department of Veterans Affairs. , 2010, Health affairs.

[30]  Rainu Kaushal,et al.  Technology Evaluation: Return on Investment for a Computerized Physician Order Entry System , 2006, J. Am. Medical Informatics Assoc..

[31]  Christopher E. West,et al.  The value of electronic health records in solo or small group practices. , 2005, Health affairs.