Physician Learning and Clinical Decision Support Systems

Despite the documented benefits of clinical decision support systems in reducing the number of adverse drug events (ADEs) and medication errors, their adoption has been very limited. In this paper, we propose a clinical learning model that incorporates the use of a Clinical Decision Support System (CDSS) to improve the decisions on the initial drug selection and ongoing dosage and application. The model allows for the analytical investigation of the effects of different CDSS functionalities on clinical learning. The analytical results suggest that using CDSS to improve drug selection decisions positively influences the importance of the patient-level information for the physician. On the other hand, absent improvements in successful drug selection, the use of CDSS may in fact negatively influence the clinical learning

Competition among Experts via Face-to-Face and Online Channels

Online experts increasingly compete against traditional, face-to-face experts by offering many consulting and customer services. In turn, some traditional high-quality experts consider offering online services to defend their markets. In this research, we investigate how a traditional high-quality expert should modify its business model to respond to the new competition arising due to the Internet. We find that the Internet impacts the high-quality traditional expert more adversely than the low-quality traditional expert due to losses in the second opinion market. If the online transaction costs are low, the online expert with an intermediate quality charges a lower price and obtains a higher profit compared to the traditional highquality expert

Adoption of Electronic and Personal Health Records: An Ecconomic Analysis

We investigate strategic issues surrounding the adoption of electronic health records (EHR) and personal health records (PHR) using an economic framework. Through our analysis, we find evidence that health care providers do not have an incentive to implement interoperable EHR systems even though the implementation of EHR systems (interoperable or otherwise) will increase consumer surplus. In this context, we conjecture that PHR platforms can fundamentally alter the incentives of health care providers, potentially leading to increased EHR adoption under some conditions. In a pluralistic health care system like that which exists in the United States, where health care providers have varying incentives to implement interoperable electronic health records, an online PHR platform can provide an alternative means for consumers to freely exchange their health records among different providers

A Belief Revision Framework For Probabilistic Object-Oriented Databases

While past research extended the conventional object-oriented data model using probability theory to better capture the uncertainty of the real world, database modification has not been addressed to date.  This paper builds on previous work by Kornatzky and Shimony (1994) to address database modification for probabilistic object-oriented databases and proposes a framework for belief revision.  According to the framework, beliefs on data values are revised with the arrival of new information.  The proposed belief revision framework can be used to update data stored in an object-oriented database

Essays on electronic commerce in higher-education and expert opinion sectors

This dissertation is composed of two essays, each of which examines the use of electronic commerce in a sector. The first one explores the incentives of different types of institutions in adopting Technology-Mediated Distance Education (TMDE) by developing and testing an analytical model. The model studies the problem of an institution that chooses an admission policy, tuition policy, and the extent of TMDE to be incorporated into its curriculum. Using two extensive data sets on 1997–1998 and 2000–2001 academic years, our empirical work supports the main hypotheses of the model, including the significance of the quality of on-campus education, the relevant market (national vs. regional), and public/private status in determining the extent of TMDE adoption. The results have direct implications on the design of degree programs. The second essay focuses on the online consultation market. Although online consultations are convenient for consumers, the diagnostic accuracy may be lower. Still, reputed institutions such as Harvard University hospitals and the Cleveland Clinic provide online opinions. We develop a duopoly model and study the strategies of high-quality experts in business-to-consumer consultation markets. Experts decide to provide first or second opinions and whether to serve face-to-face or online. The experts\u27 skills and the offered quality levels differ. We show that both the transaction cost and the reduction in the diagnostic precision in online markets impact the value of the first opinion more adversely than that of the second opinion, which provides incentives for the high-quality experts to specialize as second opinion providers. We also show that high-quality experts can charge higher face-to-face prices by adopting the online channel

The Diffusion of Internet-Based Distance Education Technology Among US Associate Colleges

This paper analyzes the diffusion of internet-based distance education technology (NETDE) among the US associate colleges. The study finds that an institution with experience in using an earlier generation distance education technology is more likely to adopt NETDE than an institution without such an experience. The finding supports the view of Cohen and Levinthal (1990) that an organization\u27s \u27absorptive capability\u27 plays a significant role in its innovative activities. Institution size also facilitates the adoption of NETDE. We relate this size effect to market power because the size effect is partly caused by customer switching costs present in the NETDE market. Finally, we find that, among public institutions, the presence of close competitors motivates an institution to adopt NETDE earlier