Essays on health information exchange: Adoption, Usage and Patient Privacy
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Health Information Exchange (HIE) platforms have the potential to radically reduce the costs and at the same time, increase the quality of the healthcare system. Despite these benefits, the extent to which healthcare providers adopt and use the HIE is far behind the expectations. In this dissertation, I address this problem by investigating the drivers of value on the HIE systems from three perspectives: ( i ) How does the flow of patients and physicians between medical practices create network externalities among the constituent users of the HIE? ( ii ) How do the network externalities drive the adoption and use of the HIE? ( iii ) How do patients decide to disclose their medical information on the HIE? Moreover, how can I translate my research into policy recommendations and real-world applications? My research is based on methodologies from econometrics, Bayesian modeling and social networks analysis. All of the models in this dissertation are empirically validated based on a longitudinal data-set provided by the Regional Heath Information Organization of Western New York. This data-set consists of 505203 medical records of 30626 unique patients requested by 2054 physicians within 430 medical practices from August 2008 through July 2011.