Paccar Hall, Room 292

SPEAKER: Subodha Kumar
AFFILIATION:  Temple University
AREA:  Information Systems

TITLE: Sustainability of Healthcare Information Exchanges and Their Impact on Healthcare Quality and Efficiency

ABSTRACT:
Based on our interactions with 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 likelihood that more than one 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. 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.

Next, we empirically examine the impact of HIE use in emergency departments (EDs) on quality and efficiency of medical care. We focus on 30-day readmission rate to capture healthcare quality. From hospitals’ efficiency perspective, we examine if HIE access reduces the length of stay (LOS) and the doctor would be consulted for a treatment. Drawing on the arguments of complementarity theory, we adopt a contingency framework and examine the moderating role of patient-specific prior information (breadth of focal patient’s information and prior interaction between a focal patient and attending doctor) and doctor’s experience with the HIE on the effectiveness of HIE access on quality and efficiency of medical care. To accomplish our objectives, we leverage a unique panel data of actual HIE access by physicians who practice in a hospital system that participate in an HIE. Leveraging this unique and comprehensive data on physicians’ access of HIE system, we examine the effect of HIE use on the three outcome variables at the individual patient encounter level. Based on our results, we offer insights to practitioners and academicians alike on how adopting and sustaining HIE can yield better patient-level and provider-level outcomes.