Extracting Business Value of IT and Identifying IT Innovation in Large Institutional Settings Undergoing Regulatory Change

While information technology (IT) has been established as a key element for firm performance, it is unclear how firms can use various IT capabilities to achieve a diverse set of often conflicting performance outcomes, as well as how firms can successfully encourage IT-enabled innovations in the context of a changing institutional environnt. The objective of this three-essay dissertation is to develop an in-depth perspective of the business value of IT in large institutional settings with changing regulatory conditions. Drawing on a diverse set of theories, two of the essays, one situated in the U.S. electric utility context and the other situated in the U.S. healthcare context, investigate how firms use IT capabilities to achieve simultaneous outcomes that are in tension, while also experiencing significant change in their institutional environment. The third essay, again situated in the U.S. healthcare context, focuses on identifying the influence of a cost aspiration shortfall on IT-enabled Clinical Process Management Innovativeness, and by identifying how the nature of this relationship changes based on the progression of a federal regulation. For each of the three essays, multi-source archival databases were constructed for multiple years (2005-2014 for essay 1, 2008-2014 for essay 2, and 2007-2014 for essay 3). Multiple methods were also employed to analyze the data and test hypotheses (stochastic frontier analysis for essay 1, panel data analysis for essay 2, and multi-level modeling for essay 3). All together, these three essays contribute to the IS literature by elaborating our understanding of the business value of IT – the impact of IT innovations, resources, and capabilities – under a changing institutional environment and suggests new directions for research in the antecedents and consequences of IT innovations, resources, and capabilities

How do Aspiration Shortfalls Interact with Regulatory Incentives and Controls to Drive Innovation in U.S. Hospitals?

Strategic choices about innovation are becoming increasingly relevant in the healthcare industry to meet the changing needs of the marketplace. We draw on the Behavioral Theory of the Firm and Institutional Theory to (1) identify the influence of aspiration shortfalls of Patient Quality and Cost of Care on IT-enabled Clinical Process Innovation and Services Innovation, and (2) identify how the nature of these relationships change based on regulation at the federal (American Recovery and Reinvestment Act of 2009) and state (Certificate of Need programs) level. Our empirical study is situated in the U.S. healthcare industry. We draw on multiple sources of data, such as the American Hospital Association Annual Survey and IT Supplement as well as the Centers of Medicare and Medicaid, to construct a panel dataset of 3,500 hospitals from 2008—2013. We identify measures for our constructs and propose analysis methods to test our model and hypotheses

Fit and Misfit of Plural Sourcing Strategies and IT-Enabled Process Integration Capabilities: Consequences of Firm Performance in the U.S. Electric Utility Industry

Recent work has shown that a firm’s plural sourcing strategy, which determines how much it chooses to make versus how much it chooses to buy, requires consideration of the complementarities and constraints that affect the differential advantages of making and buying. Elaborating on this perspective, we theorize how (mis)fit between a firm’s plural sourcing strategy of simultaneously making and buying and its development of information technology (IT) enabled interfirm and intrafirm process integration capabilities influences firm performance in deregulated markets. We position our theory development and empirical tests in the context of the power-generation segment of the U.S. electric utility industry (EUI), an asset-intensive industry that has been deregulated to promote the separation of key value chain activities (i.e., generation, transmission, and distribution) and the development of wholesale energy markets. We draw on the transaction cost economics, coordination costs, and IT capabilities perspectives to theorize that a firm achieves fit (realizing performance benefits) by increasing market sourcing intensity (MSI)—or, how much it buys relative to how much it makes— and developing IT-enabled interfirm process integration capability for external coordination with the market, or misfit (realizing performance penalties) by increasing MSI and developing IT-enabled intrafirm process integration capability for coordinating internal production. We collated data from archival sources for 342 utility firms in the power-generation segment to construct a panel dataset for the period 1994–2004 on (1) firms’ MSI from wholesale electricity markets, (2) firms’ IT investment decisions to develop interfirm and intrafirm process integration capabilities, (3) measures of firm performance, and (4) several control variables related to exogenous shocks (i.e., regulatory change, oil crisis), region of operation, and firm-level factors. Our results suggest that fit between MSI and the development of IT-enabled interfirm process integration capability improves firm profitability, assessed by return on assets, and misfit between MSI and the development of IT-enabled intrafirm process integration capability extracts penalties in firm profitability. We also find evidence that fit between MSI and the development of IT-enabled interfirm process integration capability improves market valuation, assessed by Tobin’s Q, and asset turnover, assessed by operating revenue/total assets. We discuss the implications of our findings for the development of IT capabilities to accompany a firm’s plural sourcing strategy and the literature on IT business value

Health Information Technology in U.S. Hospitals: How Much, How Fast?

Hospitals are now faced with delivering value-based care (high quality patient care at a reduced cost) rather than volume-based care. To investigate the impact of IT on value-creation in health care, we identify and theorize how the extent of use and rate of growth in use for three HIT capabilities (Clinical Process Management, Patient Engagement, and Patient Transition) may independently and jointly affect cost and patient quality outcomes in the context of the U.S. health care industry. Our empirical data is based on multiple archival sources from 2008-2013, including data on implementation and use of HIT functionalities, hospital characteristics, quality of patient care outcomes, and cost of care outcomes. We identify measures for our constructs and propose analysis methods to test our model and hypotheses. We seek to contribute to our understanding of how portfolios of HIT capabilities and associated complementarities may contribute to the delivery of value-based care

Are Strengths the Solution? An Exploration of the Relationships among Teacher-rated Strengths, Classroom Behaviour, and Academic Achievement of Young Students

Strength-based approaches are being increasingly validated for use in clinical settings with children and youth. However, the role that strengths play in educational settings with typically-achieving students has yet to be examined. The present study explored the relationship among strengths, classroom behaviour, and academic achievement for a sample of 54 students in Grades 1 and 2. Results showed that teachers rated female students as having more strengths than male students. For both sexes, academic achievement was most highly related to strengths in School Functioning and prosocial behaviour. Strengths in Peer Relationships were significantly related to achievement only for male students. Discussion of these findings, as well as implications for practice are presented.Les approches fondées sur les forces sont de plus en plus reconnues et utilisées dans les milieux cliniques oeuvrant auprès d’enfants et de jeunes. Cependant, le rôle joué par les forces dans le domaine éducationnel avec des élèves habituellement performants demeure encore à explorer. La présente étude analyse les relations existant entre les forces, le comportement en classe et la réussite académique d’un échantillon de 54 élèves de première et deuxième années. Les résultats indiquent que les enseignants évaluent les élèves féminines comme possédant davantage de forces que leurs collègues masculins. Pour les élèves des deux sexes, la réussite académique est fortement liée aux forces relatives au fonctionnement à l’école et au comportement pro-social. Les forces apparentées aux relations avec les pairs ont un effet sur la réussite uniquement dans le cas des élèves masculins. Ces résultats ainsi que leurs implications pratiques sont présentés dans cet article