Health Information Exchanges (HIE) are becoming integral parts of the national healthcare reform efforts, chiefly because of their potential impact on cost reduction and quality enhancement in healthcare services. However, the potential of an HIE platform can only be realized when its multiple constituent users actively participate in using its variety of services. In this research, we model HIE systems as multisided platforms that incorporate self-service technologies whose value to the users depends on both user-specific and network-specific factors. We develop a model of adoption, use, and involvement of clinical practices in the coproduction of the HIE services. This model is grounded in social network theory, service operations theory, and institutional isomorphism theory. A longitudinal study of actual adoption and use behaviors of 2,054 physicians within 430 community medical practices in Western New York over a three-year period has been carried out to evaluate the proposed model. This study has been supported by HEALTHeLINK, the Regional Health Information Organization of Western New York, which has an extensive database comprising over half a million transactions on patient records by the HIE users. We extracted panel data on adoption, use, and service coproduction behaviors from this database and carried out a detailed analysis using metrics derived from the foundational theories. Positioning practices within two distinct but interrelated networks of patients and practitioners, we show that adoption, use, and service coproduction behaviors are influenced by the topographies of the two networks, isomorphic effects of large practices on the smaller ones, and practice labor inputs in HIE use. Our findings provide a comprehensive view of the drivers of HIE adoption and use at the level of medical practices. These results have implications for marketing and revenue management of HIE platforms, as well as public health and national/regional healthcare policy making.
Online storage service providers grant a way for companies to avoid spending resources on maintaining their own in-house storage infrastructure and thereby allowing them to focus on their core business activities. These providers, however, follow a fixed, posted pricing strategy that charges the same price in each time period and thus bear all the risk arising out of demand uncertainties faced by their client companies. We examine the effects of providing a spot market with dynamic prices and forward contracts to hedge against future revenue uncertainty. We derive revenue-maximizing spot and forward prices for a single seller facing a known set of buyers. We perform a simulation study using publicly available traffic data regarding Amazon S3 clients from Alexa.com to validate our analytical results. Our field study supports our analysis and indicates that spot markets alone can enhance revenues to Amazon, but this comes at the cost of increased risks due to the increased market share in the spot markets. Furthermore, adding a forward contract feature to the spot markets can reduce risks while still providing the benefits of enhanced revenues. Although the buyers incur an increase in costs in the spot market, adding a forward contract does not cause any additional cost increase while transferring the risk to the buyers. Thus, storage grid providers can greatly benefit by applying a forward contract alongside the spot market.
With the rapid growth of rich-media content over the Internet, content and service providers (SP) are increasingly facing the problem of managing their service resources cost-effectively while ensuring a high quality of service (QoS) delivery at the same time. In this research we conceptualize and model an Internetbased storage provisioning network for rich-media content delivery. This is modeled as a capacity provision network (CPN) where participants possess service infrastructures and leverage their topographies to effectively serve specific customer segments. A CPN is a network of SPs coordinated through an allocation hub. We first develop the notion of discounted QoS capabilities of storage resources. We then investigate the stability of the discount factors over time and the network topography using a test-bed on the Internet through a longitudinal empirical study. Finally, we develop a market maker mechanism for optimal multilateral allocation and surplus sharing in a network. The proposed CPN is closely tied to two fundamental properties of Internet service technology: positive network externality among cooperating SPs and the property of effective multiplication of capacity allocation among several distributed service sites. We show that there exist significant incentives for SPs to engage in cooperative allocation and surplus sharing. We further demonstrate that intermediation can enhance the allocation effectiveness and that the opportunity to allocation and surplus sharing can play an important role in infrastructure planning. In conclusion, this study demonstrates the practical business viability of a cooperative CPN market.