The Role of Decision Support Systems in Attenuating Racial Biases in Healthcare Delivery

• 成果类型: Article
• 署名作者: Ganju, Kartik K.; Atasoy, Hilal; McCullough, Jeffery; Greenwood, Brad
• 署名单位: McGill University; Rutgers University System; Rutgers University New Brunswick; University of Michigan System; University of Michigan; George Mason University
• 刊物名称: MANAGEMENT SCIENCE
• ISSN/ISSBN: 0025-1909
• DOI: 10.1287/mnsc.2020.3698
• 发表日期: 2020
• 页码: 5171-5181
• 关键词: healthcare bias; racial bias; electronic health records; clinical decision support systems; amputation protocols

摘要

Although significant research has examined how technology can intensify racial and other outgroup biases, limited work has investigated the role information systems can play in abating them. Racial biases are particularly worrisome in healthcare, where underrepresented minorities suffer disparities in access to care, quality of care, and clinical outcomes. In this paper, we examine the role clinical decision support systems (CDSS) play in attenuating systematic biases among black patients, relative to white patients, in rates of amputation and revascularization stemming from diabetes mellitus. Using a panel of inpatient data and a difference-in-difference approach, results suggest that CDSS adoption significantly shrinks disparities in amputation rates across white and black patients-with no evidence that this change is simply delaying eventual amputations. Results suggest that this effect is driven by changes in treatment care protocols that match patients to appropriate specialists, rather than altering within physician decision making. These findings highlight the role information systems and digitized patient care can play in promoting unbiased decision making by structuring and standardizing care procedures.