Based on our interactions with the key personnel of three different healthcare information exchange (HIE) providers in Texas, we develop models to study the sustainability of HIEs and participation levels in these networks. We first examine how heterogeneity among healthcare practitioners (HPs) (in terms of their expected benefit from the HIE membership) affects participation of HPs in HIEs. We find that, under certain conditions, low-gain HPs choose not to join HIEs. Hence, we explore several measures that can encourage more participation in these networks and find that it might be beneficial to (i) establish a second HIE in the region, (ii) propose more value to the low-gain HPs, or (iii) offer or incentivize value-added services. We present several other interesting and useful results that are somewhat counterintuitive. For example, increasing the highest benefit the HPs can get from the HIE might decrease the number of HPs that want to join the HIE. Furthermore, since the amount of funds from the government and the other agencies often changes (and will eventually cease), we analyze how the changes in the benefit HPs obtain from the HIE affect (i) participation in the network, (ii) the HIE subscription fee and the fee for value-added service, (iii) the number of HPs that request value-added service, and (iv) the net values of the HIE provider and HPs. We also provide guidelines for policy makers and HIE providers that may help them improve the sustainability of HIEs and increase the participation levels in these networks.
Building models for problem solving is a common practice for many disciplines. Model formulation is a complex process. Researchers have in the past approached this process from a variety of angles including planning, model structuring, model integration, and model representation, among others. Here we use observations of expert modelers in an attempt to understand the process. The observations, made in the form of protocol analysis, identified three important facets to this process: formulation tasks, control considerations, and the opportunism in the process of formulation. Using these observations, the AEROBA system was constructed, based on the blackboard paradigm. The system design and implementation details are presented. A consultation trace with AEROBA is also provided.
This article presents a systematic methodology for requirements analysis in database design. The procedure begins with an interview with the user/decision maker. The responses collected during the interview are analyzed to represent, by means of a diagram, the data and processing requirements for the activity under consideration. The diagram uses two fundamental constructs, events and states, as building blocks. It depicts any temporal or causal relationships, as well as logical operators, that may be present in the process underlying the activity. The representation is compact and easy to follow. An experimental study is described to illustrate the applicability of the methodology.