Sustainability of Healthcare Information Exchanges: A network externalities approach
Based on our interactions with several Healthcare Information Exchange (HIE) providers in Texas, we study a setting where the HIE provider can offer value-added services to participating Healthcare Practitioners (HPs) in addition to base HIE connectivity. We find that costs related to maintaining the HIE and offering value-added services affect whether the HIE is established or not, whereas heterogeneity among HPs influence the participation levels. We find that, in some cases, low-gain HPs choose not to join HIEs. Therefore, in order to encourage more participation in HIE networks, it might be beneficial for the policy-makers and/or HIE providers to (i) establish another HIE, (ii) increase the value proposition to low-gain HPs, or (iii) offer and incentivize HIE related value-added services. We also find that an increase in the highest benefit HPs can get from the HIE can even decrease the level of participation in the HIE. Moreover, we examine how the changes in benefits of HPs influence the (i) participation in the network, (ii) HIE subscription fee and the value-added service fee, (iii) number of HPs that request value-added service, and (iv) the net benefits of the HIE provider and HPs. We also present other insights and provide guidelines for the policy-makers that may help them improve the sustainability of HIEs and increase the participation levels in these networks.
author list (cited authors)
Demirezen, E. M., Kumar, S., & Sen, A.