The Dynamics of Information Collaboration: A Case Study of Blended IT Value Propositions for Health Information Exchange in Disability Determination*

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Abstract

Recent developments in health information technology (health IT) for health information exchange suggest that successful public-private collaborations should devote more attention to understanding the dynamics of collaboration. In the context of health information sharing for disability determination, this case study examines early instances of public-private interorganizational sharing of health information. The theoretical focus of the paper is on the construction of blended value propositions and their role in collaboration for health information exchange. For this purpose, we performed a case analysis of a prototype health IT application to be shared between the United States Social Security Administration and Beth Israel Deaconess Medical Center. The case analysis found that business, socio-organizational, and technical dynamics were operative during the planning and execution of the prototype. From a theoretical perspective, the case study provides insight into blended value propositions in terms of understanding and potentially predicting the success of newly established Health Information Exchanges (HIEs). The findings have implications for further development of collaboration value propositions and their evolution over the course of IT deployments for health information exchange.

Keywords: Interorganizational Systems, HIE Value, Disability Determination, Public-Private Partnerships

1. Introduction

The exchange of information is a fundamental organizational function that is necessary for coordinating tasks and making decisions (Barrett & Konsynski, 1982; Galbraith, 1974). In the last half-century, information systems have facilitated and fostered efficient information exchange by bringing together disparate data to build information and knowledge sets that can be used to increase organizational efficiency (Davenport et al., 2001). Initially, such gains in efficiency were tightly held within an organization. Later, businesses began to leverage information sharing among private organizations to create strategic advantages and increase the value of the shared information (Fairchild & Peterson, 2003; Hartono & Holsapple, 2004; Legner & Schemm, 2008). The last decade has seen information sharing extend beyond business-to-business strategic alliances into public-private collaborations. However, successful information sharing may lie in understanding each stakeholder's value proposition (Faerman et al., 2001; HIMSS, 2006; Malepati et al., 2007; Widdus, 2001).

Limited research has been done on the dynamics of public-private information exchange to produce successful and sustainable results for health data exchange, particularly for nonclinical use (Kern et al., 2009; Malepati et al., 2007). Moreover, most of the lessons have been learned from failures of such collaborations (Adler-Milstein et al., 2008; Miller & Miller, 2007; Walker et al., 2005). Indeed, national attention is now focused on Health Information Exchange (HIE) and concerns over whether state and federally subsidized growth will translate into sustainable operations (Frohlich, 2010). With under-performing information exchange endeavors costing organizations millions of dollars, prototyping a successful information exchange application has value for organizations as well as for the United States (Tiwana & Keil, 2004).

The United States Social Security Administration (SSA) has long been a proponent of prototyping innovative methods of information exchange. In keeping with this approach, SSA recently developed a prototype to address the inefficiencies of paper practices in disability determination. SSA spends more than $500 million annually gathering medical records for more than three million disability applicants. Applications for disability benefits are filed when a person has a disability that is terminal or expected to last longer than one year and affects the person's ability to work. …