David Gefen, PhD - LeBow College of Business, Decision Sciences & MIS

Abstract

At the core of many models of technology adoption is the recognition that new adopters are influenced by earlier ones. That recognition is at the core of the Bass model and is implied in the theory base of much MIS research. This study adds to that theme how information access inequality among the early adopters changes the behavior of the second wave of users of a Health Information Exchange (HIE) in an emergency room setting. Information access inequality measures, as an adapted Gini coefficient, the relative number of participating clinicians across medical sites. Specifically, the monthly rate of this user-base Gini coefficient in the first wave implementation hospitals, theoretically showing that a broader participation of previous adopter clinicians across sites is more valuable, directly predicted the adoption rate of how many clinicians used the HIE in the second wave implementation hospitals that month over and above the expected month on month increase and the effect of more patients. And, this Gini coefficient indirectly, through the number of adopters in both implementation waves, predicted how much information was accessed in the second wave implementation hospitals that month. Implications are discussed also in the broader context of other types of IT.

Keywords: Health Information Exchange (HIE), Base Model, Second wave implementation, Gini Coefficient, Information Access Inequality.

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