Event sequence modeling of IT adoption in healthcare

Information systems research is replete with examples of the importance of business processes defining IT adoption. Business processes are influenced by both organizational and operational concerns. We evaluate the comparative importance of operational and organizational influences for complementary IT systems. In the context of acute-care hospitals the analysis shows that an organizational approach to automating a process is related to different financial outcomes than an operational approach. Six complementary systems supporting a three-stage medication management process are studied: prescribing, dispensing, and administration. The analysis uses firm-level, panel data extracted from the HIMSS Analytics database spanning ten years of IT adoption for 140 hospitals. We have augmented the HIMSS dataset with matching demographic and financial details from the American Hospital Association and the Centers for Medicare and Medicaid Services. Using event sequence analysis we explore whether organizations are more likely to adopt organization boundary spanning systems and if the sequence of adoption follows the temporal ordering of the business process steps. The research also investigates if there is a relationship between the paths to IT adoption and financial performance. Comparison of the two measures suggests that the organizational model of adoption is observed more often in the data. Following the organizational model of adoption is associated with approximately $155 dollar increase in net income per patient day; whereas the operational model of adoption is associated with approximately $225 dollars decrease in net income per patient day. However, this effect diminishes with the adoption of each additional system thus demonstrating that the adoption path effects may only be relevant in the short-term.