Health Information Exchange as a Multisided Platform: Adoption, Usage, and Practice Involvement in Service Co-Production

Author List: Yaraghi, Niam; Du, Anna Ye; Gopal, Ram D.; Ramesh, Ram;
Information Systems Research, 2015, Volume 26, Issue 1, Page 1/18/2017.
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.
Keywords: health information exchange ; multisided platforms ; network externalities
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#196 0.168 health healthcare medical care patient patients hospital hospitals hit health-care telemedicine systems records clinical practices physician electronic physicians longitudinal outcomes
#108 0.157 model research data results study using theoretical influence findings theory support implications test collected tested based empirical empirically context paper
#174 0.122 use support information effective behaviors work usage examine extent users expertise uses longitudinal focus routine revealed volume constructs contributes operations
#98 0.074 platform platforms dynamics ecosystem greater generation open ecosystems evolution two-sided technologies investigate generations migration services implications interplay disruptive control markets
#211 0.067 service services delivery quality providers technology information customer business provider asp e-service role variability science propose logic companies especially customers
#49 0.065 adoption diffusion technology adopters innovation adopt process information potential innovations influence new characteristics early adopting set compatibility time initial current
#24 0.062 institutional pressures logic theory normative embedded context incumbent contexts forces inertia institutionalized environment pressure identify mimetic dominant coupling board newly
#249 0.061 network networks social analysis ties structure p2p exchange externalities individual impact peer-to-peer structural growth centrality participants sharing economic ownership embeddedness