Interlinked network effects in healthcare information exchange growth

The importance of Healthcare Information Exchange (HIE) in increasing healthcare quality and reducing risks and costs has naturally led to interest in the identification of factors that enhance adoption and meaningful use of HIE by healthcare providers. In this research we study the interlink effects between two different groups of physicians-primary care and secondary care physicians - as significant factors in increasing the growth of each group in an exchange. An analytical model of inter-group and intra-group influences on adoption is developed using the Bass diffusion model as a basis. Adoption data on 1060 different primary and secondary care physicians over 32 consecutive months were used to test the model. Three stage nonlinear least squares method is used to estimate the coefficients of the simultaneous equation model. The results indicate not only the presence of interlink effects, but also that the inter-group influence is stronger than that of intra-group. Further, the influence of primary care physicians on specialists is stronger than that of specialists on primary care physicians. Together the findings provide important guidelines on triggers that enhance the overall growth of HIE.