My research program focuses on the business value of IT in large institutional settings (the U.S. Electric Utility Industry and Healthcare Industry). Specifically, my program of study has focused on developing complementary competencies in the following areas: IT-enabled process innovation, HIT innovation, individual and group decision-making processes, socio-psychological and organizational behavior theories, theory development, and advanced research methods (i.e., structural equation modeling, hierarchical linear modeling, social network analysis, data mining, and econometric methods).
As such, I have developed economic as well as the socio-psychological theoretical perspectives along with the methodological competencies required to examine IT phenomena from an interdisciplinary perspective to shed light on how IT innovations need to be designed, implemented, and utilized differently than other traditional innovations.
Extracting Business Value of IT and Identifying IT Innovation in Large Institutional Settings Undergoing Regulatory Change
Adviser: Dr. Arun Rai
Proposal Defended July 2015 - Dissertation Defended December 2017
Summary of Dissertation
While IT has been established as a key element for firm performance, it has been unclear how firms can use various IT capabilities to achieve a diverse set of often conflicting performance outcomes, as well as how firms can successfully encourage IT-enabled innovations in the context of a changing institutional environment. I have developed a three-essay dissertation which provides an in-depth perspective of the business value of IT in large institutional settings with changing regulatory conditions. Drawing on a diverse set of theories, two of the essays, one situated in the U.S. electric utility context and the other situated in the U.S. healthcare context, investigate how firms use IT capabilities to achieve simultaneous outcomes that are in tension, while also experiencing significant change in their institutional environment. The third essay, again situated in the U.S. healthcare context, focuses on identifying the influence of performance aspiration shortfalls in two areas—Patient Quality of Care and Patient Cost of Care— on IT-enabled Clinical Process Innovation and Services Innovation, and by identifying how the nature of these relationships change based on regulation at the federal and state level. These three essays together will elaborate our understanding of the business value of IT – the impact of IT innovations, resources, and capabilities – under a changing institutional environment and suggests new directions for research in the antecedents and consequences of IT innovations, resources, and capabilities.
Essay 1: How Can IT Capabilities Enable the Simultaneous Pursuit of Green and Business Outcomes?: An Investigation of Smart Grid Innovations
Sustainability has emerged as a key area of interest in response to a growing concern surrounding the adverse effects of pollution, such as climate change and health problems. Given these concerns, firms need to re-evaluate their traditional bottom line measures. I conceptualize production/distribution technologies (PDTs) and sense-making technologies (SMTs) as information technology (IT) innovations, whose combination allows firms to simultaneously achieve green and business outcomes. I focus on investments directed at PDTs and SMTs, which allows for a better understanding of the nature of the interdependencies between these two types of IT innovations. I situate our study in the context of the U.S. Electric Utility Industry (EUI). This industry has been investing heavily in the Smart Grid over the past decade to improve efficiency and facilitate environmental sustainability. The final data set will contain 200 firms from 2000-2010, with approximately 200,000 IT investment decisions. I plan to use stochastic frontier analysis (SFA) to measure the relative efficiency of the firm with respect to its peers. Our study contributes to the IT business value, IT capabilities and IS environmental sustainability literatures by uncovering how investments in PDTs can be combined with SMTs to simultaneously achieve business and green outcomes. The results have the potential to inform policy discourse on smart grid technologies. An early version of this essay was accepted at the America’s Conference on Information Systems 2013 as a research-in-progress. A complete manuscript is expected to be submitted to a premier IS journal in Summer 2017.
Essay 2: Health Information Technology in U.S. Hospitals: How Much, How Fast?
Hospitals are now faced with delivering value-based care (high quality patient care at a reduced cost) rather than volume-based care. To investigate the impact of IT on value-creation in health care, I identify and theorize how the extent of use and rate of growth in use for three HIT capabilities (Clinical Process Management, Patient Engagement, and Patient Transition) may independently and jointly affect cost and patient quality outcomes in the context of the U.S. health care industry. Our empirical data contains approximately 3,500 general surgical and medical hospitals based on multiple archival sources from 2008-2013, including data on implementation and use of HIT functionalities, hospital characteristics, quality of patient care outcomes, and cost of care outcomes. I identify measures for our constructs and propose analysis methods to test our model and hypotheses. This essay seeks to contribute to our understanding of how HIT capabilities and associated complementarities may contribute to the delivery of value-based care. A preliminary version of this essay was accepted at the International Conference on Information Systems 2014 and won Best Research-In-Progress. A complete manuscript is expected to be submitted to a premier IS journal by Spring 2017.
Essay 3: How do Aspiration Shortfalls Interact with Regulatory Incentives and Controls to Drive Innovation in U.S. Hospitals
Strategic choice and innovation are becoming increasingly relevant in the healthcare industry to meet the changing needs of the marketplace. Although the U.S. government has spent close to $30 billion in the past several years to promote electronic health records and other clinical process improvements (Centers for Medicare and Medicaid 2015), U.S. hospitals still face significant tensions on where to allocate limited resources. In particular, they have to contend with a variety of demands (such as patient quality and cost of care and government incentives/penalties) levied on them by a myriad of stakeholders (patients, internal board, system affiliates, and regulatory bodies). I theorize that a hospital’s search for solutions to address their aspirational shortfalls, where performance falls below aspiration level, in quality of patient care or cost of patient care can be directed at IT-enabled process innovations or services innovations. The U.S. healthcare industry is regarded as a regulated marketplace and as such, process and services innovation may be stimulated by the federal government with incentives and penalties, and/or monitored by state regulators with programs such as Certificates of Need (CON). I source data from the American Hospital Association (AHA) Annual Survey, AHA IT supplement, and several databases from the Centers of Medicare and Medicaid. The final, merged dataset contains approximately 3,500 general surgical and medical hospitals from 2008-2013. This essay contributes to the literature in the following ways: (1) by identifying the influence of aspiration shortfalls on Patient Quality of Care and Patient Cost of Care on IT-enabled Clinical Process Innovation and Services Innovation, and (2) by identifying how the nature of these relationships change based on regulation at the federal level (incentives vs. penalties) and on state regulation for certificates of need. A complete manuscript is expected to be submitted to a premier IS journal by Spring 2017.
In addition to my dissertation, I am currently working on other research projects. Currently, I am developing a paper with Dr. Arun Rai and Dr. Aaron Baird where we examine how U.S. hospitals must strategically choose whether or not to participate in Accountable Care Organizations (ACOs) and how this decision is affected by IT-enable care coordination mechanisms, as well as how these choices affect patient experience. In this paper we draw on a rich dataset from 2013-2014 of approximately 1,200 U.S. hospitals and leverage a two-stage endogenous treatment effects model to account for the endogeneity of self-selecting into an ACO. A complete manuscript is expected to be resubmitted to Production and Operations Management by Fall 2016.
Furthermore, I plan to continue my current path of research to uncover the different ways in which IT can be leveraged, along with other capabilities and governance mechanisms, to create business value. Among other areas, I am very interested in the role of digital platforms that can be used to co-create value. I plan to situate my studies in different markets and regulatory contexts and intend to undertake these investigations by using (1) interdisciplinary perspectives that bring together IS, strategy, and economics, (2) constructing large, multi-source datasets, and (3) using multiple methods to analyze the data.