Healthcare ITValueHierarchy Framework for the Small Physician Practices Context

In 2015, $3.2 trillion was spent in the US and the Center for Medicare and Medicaid is projecting that spending will grow at an average rate of 5.6% a year in the next decade. Researchers have found that organizations with higher IT maturity tend to show better operational and financial performance. While there have been multiple studies on HIT in hospitals and large practices, there have been few studies that have directly examined HITs in Small Physician Practices (SPP). The purpose of this study is to explore maturity of HIT use using multiple case study methodology to observe how SPP have matured through their use of HIT. Hence, the goal of this study is to answer the following question: How is the IT maturity of use different for small physician practices? To answer this question, we conducted multiple case studies with five SPP. This study developed a modified IT Value Hierarchy and highlights the importance of both IT security and inter-organizational integration on these healthcare organizations

A review of the healthcare-management (modeling) literature published at Manufacturing and Service Operations Management

Healthcare systems throughout the world are under pressure to widen access, improve efficiency and quality of care, and reduce inequity. Achieving these conflicting goals requires innovative approaches, utilizing new technologies, data analytics, and process improvements. The operations management community has taken on this challenge: more than 10% of articles published in M&SOM in the period from 2009 to 2018 has developed analytical models that aim to inform healthcare operational decisions and improve medical decision-making. This article presents a review of the research published in M&SOM on healthcare management since its inception 20 years ago and reflects on opportunities for further research

ICT-Enabled Service Innovation in Human-Centered Service Systems: A Systematic Literature Review

In numerous studies, information and communications technology (ICT) has been shown to be an enabler of service innovations in human-centered service systems (HCSSs). The resulting findings, however, have not been presented in a systematic way. Therefore, we present an integrated and representative overview of the literature on ICT-enabled service innovation in HCSSs. To show the existing findings, we reviewed papers from top journals in the fields of management science, information systems, service research, and innovation management. By using a systematic literature review, we identified 37 relevant papers. We systematically assessed the papers based on an analytical framework that consists of a four-phase management process and the components of service systems. We showed that the research background and the research methods used in the papers are very diverse, representing a large research field with a varying degree of knowledge. Based on our findings, we derived a specific agenda for future research

Understanding information exchange in healthcare operations:evidence from hospitals and patients

Coordination–or the information exchange among physicians and hospital staff–is necessary for desirable patient outcomes in healthcare delivery. However, coordination is difficult because healthcare delivery processes are information intensive, complex and require interactions of hospitals with autonomous physicians working in multiple operational systems (i.e. multiple hospitals). We examine how three important variables distinctive of the healthcare operations context–use of IT for dissemination of test results (ITDR) (i.e. Electronic Health Records systems) by physicians and hospital staff, social interaction ties among them, and physician employment–influence information exchange and patient perceptions of their care. Drawing from the literature on process inter-dependencies and coordination, vertical integration and social exchange, we develop and test research hypotheses linking ITDR, social interaction ties and physician employment to information exchange relationship, and information exchange relationship to provider-patient communication. Using a paired sample of primary survey data and secondary archival data from CMS HCAHPS for 173 hospitals in the U.S.A., we find that increased information exchange relationship drives provider-patient communication, and increased social interaction ties drives information exchange relationship. Social interaction ties fully mediates the relationship between ITDR and information exchange relationship. Physician employment amplifies the link between ITDR and social interaction ties, but does not have an effect on the link between ITDR and information exchange. We do not find a direct relationship between ITDR, and information exchange relationship or provider-patient communication

Linking electronic medical records use to physicians’ performance:a contextual analysis

Electronic Medical Records (EMR) studies have broadly tested EMR use and outcomes, producing mixed and inconclusive results. This study carefully considers the healthcare delivery context and examines relevant mediating variables. We consider key characteristics of: 1) interdependence in healthcare delivery processes, 2) physician autonomy, and 3) the trend of hospital employment of physicians, and draw on theoretical perspectives in coordination, shared values, and agency to explain how the use of EMR can improve physicians’ performance. In order to examine the effects of physician employment on work practices in the hospital, we collected 583 data points from 302 hospitals in 47 states in the USA to test two models; one for employed and another for non-employed physicians. Results show that information sharing and shared values among healthcare delivery professionals fully mediate the relationship between EMR use and physicians’ performance. Next, physician employment determines which mediating variable constitutes the pathway from EMR use to physicians’ performance. Finally, we highlight the impact of shared values between the hospital and physicians in enhancing information sharing and physicians’ performance, extending studies of these behaviors among network partners in industrial settings. Overall our study shows that EMR use should be complemented by processual (information sharing), social (shared values) and structural (physician employment) mechanisms to yield positive effects on physicians’ performance

Health information technology (HIT) in small and medium sized physician practices: examination of impacts and HIT maturity

Small and medium sized physician practices (SMPP) are medical practices that consist of a staff of less than 10 physicians. Nearly 60% of the US physicians work in SMPP and face more barriers to HIT adoption and implementation than their larger counterparts. The dissertation is on the use and impact of Health Information Technology (HIT) on SMPP. The dissertation will also explore the effects of IT maturity on health care organizations’ abilities to impact outcomes. It will examine how SMPP have grown through the use of IT and how this has impacted the organization’s use of HIT. While previous work has observed some organizational impacts of HIT, they have only studied a single phenomenon that had been impacted and not how the organization as a whole is impacted. While researchers have found that organizations with higher IT maturity tend to show better operational and financial performance, very little prior studies have shown the impact of HIT maturity on SMPP. The dissertation’s goal is to answer the following questions: 1. How does HIT usage influence the organizational impacts on Small and Medium Sized Physician Practices? 2. How does the SMPP’s HIT maturity influence these impacts? To answer these questions, the dissertation used a framework derived from DeLone and McLean’s (1992, 2003) IS Success Model and the IT Value Hierarchy (Urwiler & Frolick, 2008). The dissertation employed a multiple case study approach by collecting and analyzing data from various members of five different SMPP. The dissertation found that the process of HIT documentation had a major influence on the SMPP. While it has a positive impact on the patient’s Quality of Care, it has a negative impact on Productivity and User Satisfaction. While prior HIT research found that communication was a final outcome of HIT use, this dissertation found that communication is a mitigating factor influencing organizational impacts

An investigation of analytics and business intelligence applications in improving healthcare organization performance: a mixed methods research

The healthcare ecosystem in the US is currently undergoing series of refinement and reformation due to the need to (i) improve quality of care and (ii) reduce cost. To achieve their key objective, healthcare organizations (HCOs) currently face a fundamental challenge: how to best use or optimize limited resources while providing better care and services to patients? The answer to this question might lie within HCO’s massive data and the ability to identify and apply appropriate analytics and business intelligence (A&BI) techniques and technologies to discern and extract relevant information and knowledge from that data. However, despite the increasing interest in the implementation and utilization of A&BI techniques and technologies by various organizations to improve operational efficiencies and financial performance, HCOs still lag behind other sectors in the adoption and use of A&BI capabilities. Motivated by the “data rich but information poor” syndrome currently facing HCOs, this dissertation applies a mixed method research–case study (interpretivist) and survey (positivist) – to investigate how healthcare organizations can leverage A&BI techniques and technologies to improve their overall performance. In achieving this objective, I illustrate an exemplar of how A&BI techniques and technologies can effectively be applied by specifically answering this high-level research question (RQ): How can A&BI techniques, methods, and technologies be developed and leveraged to improve performance in healthcare organizations? This high-level RQ has been broken down into four sub-questions that will be answered in two different studies in this dissertation. In the first study, I investigate what combination of A&BI techniques and technologies HCOs are currently applying to create value. This study was conducted by using content/literature analysis and case study methods in a large healthcare organization. The second study builds on the first study to investigate, using both interview and survey data, how A&BI capabilities can be developed, cultivated and nurtured as a core competency or capability that significantly helps improve healthcare organizations’ overall performance (such as cost reduction, quick access to providers and treatment, effective diagnostics, etc.). I found very novel and interesting results in both studies that not only address the research questions, but also provide significant theoretical and practical contributions. Major contributions of study 1 include: revising and remodeling of an outdated healthcare value chain (HCVC) framework that is more realistic and applicable to current care delivery practices in the healthcare industry and mapping of A&BI capabilities to the different domains of the revised HCVC framework. Study 2 provides theoretical contribution to the existing literature by conceptualizing and empirically validating A&BI capability as a third-order multi-dimension construct and its significant influence on performance