Learning from COVID-19: Clinical Trials, Health Information Technology, and Patient Mortality

During the COVID-19 pandemic, deaths per case in the US decreased from 7.46% in April 2020 to 1.76% in April 2021. One possible mechanism that explains this decline is the learning effect about effective treatments that occurs in hospitals over time. Hospitals learn from their participation in clinical trials to develop better organizational capabilities in diagnosing and treating COVID-19 patients. Simultaneously, hospitals use health information technologies (IT) to facilitate greater learning and sharing of best practices based on health information integration across providers. In this research, we study whether participation in clinical trials and hospital IT reduced COVID-19 mortality rates. Using county-level data on clinical trial participation, health IT use, and COVID-19 cases and deaths, we show that hospitals in counties that participated in clinical trials and those with greater IT capabilities exhibited a lower rate of COVID-19 deaths. Consistent with the learning effect hypothesis, we observe that counties with greater hospital IT capabilities performed relatively better at treating COVID-19 cases several months into the pandemic. Counties with hospitals that participated in COVID-19 clinical trials also learned faster, with the learning effect of clinical trials being moderated by hospital IT capabilities. Using LASSO regressions, we observe that counties with high IT capability hospitals learned faster through knowledge sharing and experimentation, while counties with low IT hospitals learned only based on their prior experience in treating COVID-19 patients. We posit that clinical trials and hospital IT can help hospitals achieve better health outcomes in the long run by enhancing learning effects.