Too much information? The use of extraneous information to support decision-making in emergency settings

Decision-makers in emergency settings need to employ the breadth of evidence available so as to inform critical judgments, yet the acute time pressure suggests that in some cases only partial information could be employed. Investigating this tension, the current study focuses on the usefulness of extraneous information that arrives from outside the organization and supplements the information that is available through local information systems. Namely, we explore the extent to which the use of Health Information Exchanges (HIEs)—a network that integrates patients’ clinical information across medical organizations and points of care—facilitates diagnosis decisions in hospitals’ emergency departments (EDs). Adopting the lens of cognitive decision-making theory, we advance hypotheses regarding the moderating effects of the tasks’ cognitive requirements (diagnosis complexity) and clinicians’ time availability (ED crowdedness) on the relation between the use of extraneous information (in the form of HIE data) and decision quality (ED revisit rate). Our empirical investigation employs complete field data collected from a network of hospitals, capturing over half-a-million patient ED encounters. The results reveal that, in general, ED clinicians’ use of the HIE improves decision quality, as reflected in reduced patient revisits to the ED. However, when diagnosis complexity is low, this effect is reversed, such that HIE use is associated with increased ED revisit rates. Our discussion highlights the conditions under which extraneous information contributes to better decision-making and calls for a mindful use of interorganizational information exchanges in emergency settings.