As the United States expends extraordinary efforts toward the digitization of its health-care system, and as policy makers across the globe look to information technology (IT) as a means of making health-care systems safer, more affordable, and more accessible, a rare and remarkable opportunity has emerged for the information systems research community to leverage its in-depth knowledge to both advance theory and influence practice and policy. Although health IT (HIT) has tremendous potential to improve quality and reduce costs in healthcare, significant challenges need to be overcome to fully realize this potential. In this commentary, we survey the landscape of existing studies on HIT to provide an overview of the current status of HIT research. We then identify three major areas that warrant further research: (1) HIT design, implementation, and meaningful use; (2) measurement and quantification of HIT payoff and impact; and (3) extending the traditional realm of HIT. We discuss specific research questions in each domain and suggest appropriate methods to approach them. We encourage information systems scholars to become active participants in the global discourse on health-care transformation through IT.

Research Commentary---The Digital Transformation of Healthcare: Current Status and the Road Ahead

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 that was signed into law as part of the “stimulus package” represents the largest US initiative to date that is designed to encourage widespread use of electronic health records (EHRs). In light of the changes anticipated from this policy initiative, the purpose of this paper is to review and summarize the literature on the benefits and drawbacks of EHR systems. Much of the literature has focused on key EHR functionalities, including clinical decision support systems, computerized order entry systems, and health information exchange. Our paper describes the potential benefits of EHRs that include clinical outcomes (eg, improved quality, reduced medical errors), organizational outcomes (eg, financial and operational benefits), and societal outcomes (eg, improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system. Moreover, EHRs are associated with potential perceived privacy concerns among patients, which are further addressed legislatively in the HITECH Act. Overall, experts and policymakers believe that significant benefits to patients and society can be realized when EHRs are widely adopted and used in a “meaningful” way.

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Benefits and drawbacks of electronic health record systems

Information politics

Much research in the last two decades has demonstrated that human responses deviate from the performance deemed normative according to various models of decision making and rational judgment (e.g., the basic axioms of utility theory). This gap between the normative and the descriptive can be interpreted as indicating systematic irrationalities in human cognition. However, four alternative interpretations preserve the assumption that human behavior and cognition is largely rational. These posit that the gap is due to (1) performance errors, (2) computational limitations, (3) the wrong norm being applied by the experimenter, and (4) a different construal of the task by the subject. In the debates about the viability of these alternative explanations, attention has been focused too narrowly on the model response. In a series of experiments involving most of the classic tasks in the heuristics and biases literature, we have examined the implications of individual differences in performance for each of the four explanations of the normative/descriptive gap. Performance errors are a minor factor in the gap; computational limitations underlie non-normative responding on several tasks, particularly those that involve some type of cognitive decontextualization. Unexpected patterns of covariance can suggest when the wrong norm is being applied to a task or when an alternative construal of the task should be considered appropriate.

Individual differences in reasoning: Implications for the rationality debate?-Open Peer Commentary-Differences, games, and pluralism

Digital transformation in healthcare: Analyzing the current state-of-research

Drawing upon the concept of governance, this dissertation refers to the two most commonly employed mechanisms that ensure high quality knowledge in electronic repositories as expert-governance and community-governance. In three related but distinct essays, the dissertation examines the governance concept, and investigates contributing knowledge to and using knowledge from electronic repositories governed by these two mechanisms. The first essay sets the conceptual foundations of knowledge governance in repositories, and examines the salient aspects of expertand communitygovernance that contribute to knowledge quality. The essay adopts an interpretive research methodology and analyzes empirical data collected from a range of organizations using interviews and online questionnaires. Findings suggest that executing governance functions thoroughly, experts’ credibility, and experts’ ownership of content contribute to knowledge quality in expert-governed repositories; and executing governance functions continuously and by a diverse set of members, and members’ involvement in governance contribute to knowledge quality in community-governed repositories.

/pdf/contribution-to-and-use-of-online-knowledge-repositories-the-1mju6pks24.pdf

Contribution to and use of online knowledge repositories: The role of governance mechanisms

Predicting the point spread of a professional basketball game is difficult but important for many stakeholders. We propose a new approach to predict the point spread in real time using in-g...

Predicting the point spread in professional basketball in real time: a data snapshot approach

Two governance mechanisms employed by organizations to improve the perceptions and usage of their online knowledge repositories among knowledge workers are employing experts to control or edit users’ contributions (refereed repositories), and allowing a community of users to review, rate, or edit existing contributions (community wikis). Although these mechanisms are purported to improve the quality of knowledge assets, actual usage of online knowledge repositories still tend to vary widely among organizational employees. The goals of this paper are to understand how the above governance mechanisms influence and/or moderate knowledge repository usage patterns within organizations. To that end, we employ the elaboration-likelihood model from the social psychology literature to derive twelve hypotheses formalizing the main and moderation effects related to organizational knowledge repository usage. An online field experiment is proposed to test these hypotheses. Data collection is in progress, and the final results will be presented at the conference.

https://aisel.aisnet.org/cgi/viewcontent.cgi?article=1127&context=ecis2010

Usage of Online Knowledge Repositories: A Comparison of Two Governance Mechanisms

Expert- and community-governance are becoming popular mechanisms to verify contributions in electronic repositories. This study examines the conditions under which employees make contributions to expert- and community-governed repositories. We conduct a qualitative study using data collected through interviews. Analysis of data using the grounded theory approach reveals that two groups of categories are salient for contribution behaviors: content-based, and need-based. Content-based categories concern the type of content provided for each contribution and involve whether contributions are suggestions/ideas and whether they have sensitive content. Need-based categories concern the different needs of employees and involve whether employees have a need for peer input, expert opinion, or recognition. Findings suggest that employees are more likely to contribute to community-governed repositories if contributions are suggestions/ideas and there is a need for peer input. On the other hand, employees are more likely to contribute to expert-governed repositories if contributions have sensitive content and there is a need for expert opinion and recognition. This study contributes to extant work by distinguishing between two types of governance mechanisms and identifying the salient categories in contributing to repositories that employ these mechanisms.

The salience of governance mechanisms in contributingto electronic repositories

Two mechanisms employed by organizations to motivate the reuse of knowledge from knowledge repositories is using experts to control or edit users’ contributions (such as in a refereed repository), or using a community of users to review, rate, or edit existing contributions (such as in a community-driven wiki). The goal of this paper is to explore these two mechanisms and study their impact on knowledge reuse by organizational members. Propositions are suggested by drawing upon the dual-process theory from cognitive psychology.

Varol O. Kayhan

Papers

Contribution to and use of online knowledge repositories: The role of governance mechanisms

Predicting the point spread in professional basketball in real time: a data snapshot approach

Usage of Online Knowledge Repositories: A Comparison of Two Governance Mechanisms

The salience of governance mechanisms in contributingto electronic repositories

Knowledge Reuse in Organizations: The Role of Governance Mechanisms