Learning from COVID-19: clinical trials, health information technology, and patient mortality

During the COVID-19 pandemic, deaths per case in the United States decreased from 7.46% in April 2020 to 1.76% in April 2021. One mechanism that could explain this decline is a learning effect associated with testing of new treatments by hospitals. Hospitals that participated in clinical trials developed better organizational capabilities to diagnose and treat COVID-19 patients. Simultaneously, hospitals used health information technologies (IT) that integrated health information across healthcare providers to facilitate greater learning and sharing of best practices. Using US county-level data on clinical trial participation, use of health IT, 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, counties with greater hospital IT capabilities performed relatively better at treating COVID-19 patients 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 health IT capability. We posit that clinical trials and use of health IT systems can help hospitals to achieve lower mortality rates in the long run by enhancing learning effects.