Two Essays on Analytical Capabilities: Antecedents and Consequences

Although organizations are rapidly embracing business analytics (BA) to enhance organizational performance, only a small proportion have managed to build analytical capabilities. While BA continues to draw attention from academics and practitioners, theoretical understanding of antecedents and consequences of analytical capabilities remain limited and lack a systematic view. In order to address the research gap, the two essays investigate: (a) the impact of organization’s core information processing mechanisms and its impact on analytical capabilities, (b) the sequential approach to integration of IT-enabled business processes and its impact on analytical capabilities, and (c) network position and its impact on analytical capabilities. Drawing upon the Information Processing Theory (IPT), the first essay investigates the relationship between organization’s core information processing mechanisms–i.e., electronic health record (EHRs), clinical information standards (CIS), and collaborative information exchange (CIE)–and its impact on analytical capabilities. We use data from two sources (HIMSS Analytics 2013 and AHA IT Survey 2013) to test the theorized relationships in the healthcare context empirically. Using the competitive progression theory, the second essay investigates whether organizations sequential approach to the integration of IT-enabled business processes is associated with increased analytical capabilities. We use data from three sources (HIMSS Analytics 2013, AHA IT Survey 2013, and CMS 2014) to test if sequential integration of EHRs –i.e., reflecting the unique organizational path of integration–has a significant impact on hospital’s analytical capability. Together the two essays advance our understanding of the factors that underlie enabling of firm’s analytical capabilities. We discuss in detail the theoretical and practical implications of the findings and the opportunities for future research

Personalization-Privacy Paradox: Personal Health Information Context

While healthcare institutions continue to invest in personal health information (PHI) capabilities, consumers are increasingly becoming concerned about the use and storage of PHI. At the same time, consumers are increasingly becoming aware of the benefits that accrue from the use of PHI –i.e., the benefits of getting personalized healthcare. We use the Information Boundary Theory (IBT) to examine the effect of this tension–personalization-privacy paradox-on consumers’ willingness to share PHI. We contextualize the theoretical model by integrating the role of discrete contextual factors at play – trust in the electronic medium, information type, requesting stakeholder, and health status. In doing so, our research contributes to theory as well as practice. We expand and enrich the IBT by contextualizing it to the healthcare domain. The research contributes to practice by providing insights that can be used as a guide to craft healthcare IT implementation policy. Our/my research also addresses IS communities’ call for more research on consumer perspective

Impact of HIT-Induced Error on Practice-Level EHR Use

Even though there is a strong recognition of the benefits of healthcare IT (HIT), the actual usage of electronic healthcare record (EHR) is low. What explains such inconsistency? Prior research on EHR use has mostly focused on the human element and largely ignored the technical element. One such technical aspect that can potentially impede EHR usage behavior is the HIT-Induced error - errors arising from the design, development, implementation, and use of HIT. Guided by the theoretical position of “Technology frame viewpoint”, the proposed research explores the mechanism through which HIT-induced error influences practice level EHR use. Simultaneously, we also examine the effect of HIT-induced error on technology avoidance behavior. We propose three relationship to be tested empirically in the healthcare settings. Insights from this study can potentially advance our understanding of the nature of relationship between HIT-induced error and practice level EHR usage

Sharing Personal Health Information: Personalization versus Privacy

Personal health information (PHI) is increasingly becoming a critical component of personalized healthcare. However, investment in PHI capabilities may be severely undermined if consumers are unwilling to share PHI. While consumers are concerned about potential compromise of PHI, they also value the personalization benefits of PHI use. In light of the limited understanding of this tension, this research develops a parsimonious model to predict consumer’s willingness to share PHI as a result of the tradeoff between concern for privacy and value for personalization. Grounded on theoretical positions of Information Boundary Theory, we examine the mechanism through which privacy concern and personalization influence willingness to share PHI. Results of the study suggests that the attitude towards sharing PHI is shaped by two competing forces of privacy concerns and value for personalization. Insights from the study can be used to craft future healthcare implementation policies

Understanding EHR Assimilation Using Social Information Processing Cues

Despite the impressive scale of growth in Electronic Health Record (EHR) platform implementation across healthcare organizations, appropriating benefits from such transformative digital artifacts remain a complex and challenging process. While significant focus of academics and policy makers on pre-implementation stages of EHR integration, little or insignificant focus has been on the critical phase of post-implementation EHR assimilation. The post-implementation stage of EHRs is a critical stage because it is in this phase that EHR users stabilize the usage behavior and pattern into their care delivery routine. This phase involves the process of understanding how a set or subset of process functionalities can be fit and adapted into the immediate healthcare task environment. The post-implementation stage consists of extensive interactions and exchange of information among the stakeholders as they learn to adapt and innovate the platform to the needs of their healthcare tasks associated with the care delivery process. \ \ In such circumstances, social relations and influences associated with these relationships becomes a critical mechanism and driver of EHR assimilation and its subsequent impact on appropriate of healthcare benefits. While IS literature predominantly focuses on adoption and pre-implementation stages, we have limited understanding on the post-implementation phases-i.e., EHR assimilation. While the first two stages leads to understanding and comprehension of EHR in the task environment context, it is the post-implementation phase where the caregivers assimilate the functionality in a routine or innovative ways. Knowledge of functionality assimilation patterns thus becomes critical to the success of EHR implementation and assimilation across the healthcare domain. \ \ Motivated by the need to understand the post-implementation aspect of emerging practices and innovation related to EHRs, we examine the drivers of EHR assimilation and the mechanisms through which such drivers enable key healthcare outcomes-i.e., patient satisfaction and quality of care. Drawing from the social information processing theory (Salancik and Pfeffer 1978), we propose that social cues emanating from two distinct form or ties-i.e., instrumental ties and expressive ties- are critical to understanding the mechanisms of EHR assimilation and its subsequent role in enabling healthcare outcomes. Thus, social contexts facilitate or constraints the impact of such interactions on the outcomes of EHR assimilation. This study can enhance our understanding of the role of social context in enabling EHR assimilation across healthcare organization.

Architectural Drivers of EHR Integration and Assimilation

The digital transformation of healthcare is increasingly dependent on digitizing the clinical task environment across the healthcare supply chain by implementing standardized healthcare process platforms-i.e., electronic healthcare record (EHR) systems. Same time, the rush to digitizing the healthcare through the implementation of a multitude of HIT is having a catalyzing effect on the healthcare industry. While we do have substantial evidence supporting the argument that HIT can improve healthcare performance, we know little about the relationship between hospitals’ existing HIT and its ability to deploy, integrate, and assimilate EHRs. Given the fact that EHRs are digital innovation platform that is built over organization’s existing HIT capabilities, current IS research provides very limited insights to whether and under what conditions hospital’s EHR capabilities will spur improvement in overall healthcare performance. While process digitization through EHRs is in preliminary stages of incorporation across the healthcare ecosystem, these digital innovation artifacts hold vital importance to academics, practitioners, and policymakers in understanding how hospitals can leverage digital innovations towards the digital transformation of healthcare. Moreover, the scarcity of theory-driven research limits our understanding of the mechanisms through which hospital’s HIT capability enables EHR integration and assimilation towards improved performance outcome. While the focus of IS literature has been on the positive impact of HIT on the healthcare ecosystem, these work, along with may prior studies are limited in their ability to explain how organizations existing portfolio of HIT capabilities interrelate with EHRs for better performance outcome. \ \ In our effort to understand the drivers, we examine two unique architectural concepts-i.e., the extent of HIT integration and process routine rigidity-as the differentiating factors that can explain beyond other indicators. Evaluating the impact of the digital transformation of healthcare is incomplete without having a deeper understanding of assimilation and integration of HIT at a granular level. Drawing upon the competitive progression theory, we develop a conceptual model that links organizational approach to the sequential integration of HIT and hospital’s ability to assimilate EHRs into the clinical and administrative task environment. Using an event sequencing technique, we investigate if certain sequences of HIT-i.e., reflecting the unique path of HIT implementation-have significant impact on hospital’s ability to integrate and assimilate EHRs into the healthcare workflow. Same time, we also investigate the unexplored relationship between hospitals clinical process rigidity and hospitals’ ability to integrate and assimilate EHRs. Furthermore, we extend the research to investigate the mechanism through which these configurations or sequences affect hospital’s overall performance indicators (i.e., length of stay, quality of care, mortality, etc.).Using three data sources, we investigate the sequential order in which HIT are integrated and whether a specific configurational pattern of HIT yield greater value in the appropriation of performance benefits. Our preliminary results indicate that certain configuration or sequences of HIT may provide a plausible explanation as to why EHR assimilation and appropriation of benefits varies across hospitals. \ \ Our research contributes to the extant literature by bridging the gap between the complex relationship between hospital’s existing HIT capabilities and its ability to leverage EHRs. By doing so, we formulate a theoretically grounded framework to understand the interplay between these critical concepts, and hence lay a theoretical foundation for future studies at the HIT architecture level.

Internally or Externally-oriented IT Competencies: A Configuration Theory Perspective on How to Build Demand Management Agility

With the increase in the pace of business, responding to demand disruptions quickly and effectively is essential for realizing superior performance. Information technologies are critical for creating a quick and effective response. However, the pressures on performance, strategic focus, or organizational preferences restrict firms’ efforts to build IT competencies through selective use of ITs and matching business initiatives, restricting the scope of use to internal or external domains. Therefore, we examine if firm’s internal or external IT competencies are sufficient for building three types of agile demand management capabilities–resilient, adaptive, or entrepreneurial. Alternatively, the firm may need a firm-wide IT competency to build these agile capabilities. Configurational analysis using the survey data reveals that effects of IT competencies vary based on the type of agile capability