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Article JAMA Network Open Association of the Meaningful Use Electronic Health Record Incentive Program with Health Information Technology Venture Capital Funding |
IMPORTANCE
Although the Health Information Technology for Economic and Clinical Health
(HITECH) Act has accelerated electronic health record (EHR) adoption since its passage, clinician
satisfaction with EHRs remains low, and the association of HITECH with health care information
technology (IT) entrepreneurship has remained largely unstudied.
OBJECTIVE
To determine whether the passage of the HITECH Act was associated with an increase
in key measures of health care IT entrepreneurship.
DESIGN, SETTING, AND PARTICIPANTS
This economic evaluation of venture capital (VC) activity
in the US from 2000 to 2019 examined funding trends in health care IT, EHR-related companies, and
all VC investments before and after the passage of HITECH. A difference-in-differences analysis
compared investments in health care IT companies with those of companies in 3 categories: general
health care (non-IT), IT (non–health care), and all US VC transactions. Data were analyzed from
September 2018 to August 2019.
EXPOSURES
Venture capital funding received by US companies before and after the HITECH Act.
MAIN OUTCOMES AND MEASURES
Venture capital investment in health care IT companies and
the proportion of those investments going to seed-stage companies, a proxy for very early-stage
entrepreneurship and innovation.
RESULTS
The data included 70 982 investments, of which 9425 (13.3%) were seed stage, 10 706
(15.1%) were early stage, and 50 851 (71.6%) were growth stage. After passage of the HITECH Act,
investment in both health care IT companies and EHR-related companies increased at a rate much
faster (13.0% and 11.4%, respectively) than VC as a whole (6.9%). In addition, the proportion of
investments going to seed-stage health care IT companies increased compared with both overall VC
investments and non-IT health care investments. Health care IT companies saw increased
probabilities of transactions being seed-stage of 5.1% (SE, 2.2%; 95% CI, 0.8% to 9.3%; P = .02)
compared with the entire sample of VC transactions and 13.6% (SE, 1.9%; 95% CI, 9.9% to 17.2%;
P < .001) compared with non-IT health care VC transactions. Health care IT had essentially 0
increased probability of a transaction being seed stage compared with IT companies outside health
care (−0.8% probability; SE, 2.4%; 95% CI, −5.4% to 3.9%; P = .75).
CONCLUSIONS AND RELEVANCE
Although widespread clinician dissatisfaction with EHR systems
remains a challenge, the HITECH Act’s incentive program may have catalyzed early-stage
entrepreneurship in health care IT, suggesting an important role for incentives in promoting
innovation.
Keywords: Health Care and Treatment; Information Technology; Laws and Statutes; Innovation and Invention; Entrepreneurship; Venture Capital;
Lite, Samuel, William J. Gordon, and Ariel Dora Stern. "Association of the Meaningful Use Electronic Health Record Incentive Program with Health Information Technology Venture Capital Funding." JAMA Network Open 3, no. 3 (March 2020).
