The impact of information technology on organizational control and cost management in the health care context

This dissertation consists of three essays on the impacts of information technology (IT) on control and cost management in the health care context. In the first essay ("Concertive Control in the Health Care Context: A Field Experiment"), we test the effectiveness of an IT-enabled control strategy known as "informating the clan" in the management of autonomous professionals. In an extension of the Kohli and Kettinger (2004) action research case study on controlling physicians' costs and outcomes, we perform a field experiment that compares the performance of two hospitals---one that implemented the IS-based control strategy of "informating the clan" and the other that did not. Through a longitudinal analysis of four outcome variables at the two hospitals over a 7 year period, we provide quantitative evidence on the effectiveness of "informating the clan" as a means of managing autonomous professionals. In the second essay ("Understanding the Relationship among Strategy, Information Technology, and Performance in the Health Care Context"), we focus on the role of strategic groups as a moderating factor in the relationship between IT investment intensity and hospital performance. In this study, we identify strategic groupings of U.S. hospitals based on strategies of cost leadership and differentiation and test a proposition that strategic groups will moderate the relationship between IT investment intensity and hospital performance. We find that a strategic group representing a combinational strategy rather than strategically striving for two extremes will have the strongest impact of IT investment intensity on hospital performance. In the third essay ("Mobile Asset Management: The Impact of Location-Aware Systems in Hospitals"), we focus on the impact of information systems that provide real-time or near real-time knowledge of location. We draw upon Swanson's (1994) tri-core model of innovation as the theoretical framework and utilize a multi-method approach (case study and simulation) to understand the benefits associated with the increased information transparency made available with location-aware information systems.