{"id":{"repo_id":"buffalo","oai_identifier":"oai:ubir.buffalo.edu:10477/79805"},"canonical_url":"https://search.dev.ndltd.org/etd/buffalo/oai:ubir.buffalo.edu:10477/79805","repository":{"repo_id":"buffalo","name":"Buffalo","base_url":"https://ubir.buffalo.edu/oai/request"},"display":{"title":"Health Information Exchanges: Impact on Healthcare Costs, Referral Networks, and Referral Decision Making Processes","abstract":"Ph.D.","abstract_html":"Ph.D.","abstract_has_math":false,"creators":["Eftekhari, Saeede; 0000-0001-9818-612X"],"institution":"State University of New York at Buffalo","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Ramesh, Ram","Management Science and Systems"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2019,"date_issued":"2019-07-25T21:55:19Z","date_published":"2019-07-25T21:55:19Z","updated_at":"2026-07-27T19:05:19Z","subjects":["management"],"languages":["eng"],"rights":["Users of works found in University at Buffalo Institutional Repository (UBIR) are responsible for identifying and contacting the copyright owner for permission to reuse. University at Buffalo Libraries do not manage rights for copyright-protected works and cannot assist with permissions.","Copyright retained by author."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/10477/79805","outbound_label":"Handle","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Ramesh, Ram","Management Science and Systems"]},{"key":"dc:creator","label":"Author","values":["Eftekhari, Saeede; 0000-0001-9818-612X"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2019-07-25T21:55:19Z","2019","2019-03-14 13:06:05"]},{"key":"dc:publisher","label":"Institution","values":["State University of New York at Buffalo"]},{"key":"dc:type","label":"Dc Type","values":["Text","Dissertation"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["management"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["eng"]},{"key":"dc:rights","label":"Dc Rights","values":["Users of works found in University at Buffalo Institutional Repository (UBIR) are responsible for identifying and contacting the copyright owner for permission to reuse. University at Buffalo Libraries do not manage rights for copyright-protected works and cannot assist with permissions.","Copyright retained by author."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["http://hdl.handle.net/10477/79805"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Ph.D.","Health Information Exchange (HIE) platforms have become an important part of the United States healthcare reform since the enactment of Health Information Technology for Economic and Clinical Health Act (Vest et al. 2010). The main purpose of an HIE is to enable healthcare providers to access and share all relevant clinical information pertaining to patients’ care. The absence of previous clinical information adversely affects the clinical quality and economic efficiency of healthcare services (Forster et al. 2003; Kohn et al. 2000b). Through the HIE platforms, patients’ medical history can be shared electronically with providers and organizations across the continuum of care (Vest et al. 2015). Availability of earlier medical information through HIE leads to more inclusive information and enhancement of quality of care (Branger et al. 1994; Kaelber et al. 2007; Smith et al. 2005). This dissertation is focused on demonstrating the effectiveness of the HIE in reducing the cost and improving the quality of healthcare. The first part of the dissertation is a research in investigating the effect of physicians’ tenure in the HIE system on the procedural repetitions on Medicare beneficiaries in Western New York. Our analyses show that a practice's tenure with HIE significantly lowers the repetition of therapeutic medical procedures in the physicians’ office. The second part of the dissertation focuses on exploring the impact of HIE on physicians’ referral network. Using Social Network Analysis (SNA) and longitudinal data on physicians’ referral and HIE adoption, we have shown that HIE adoption and referral patterns evolve concomitantly. The third part is focused on exploring the impact of HIE membership on the referral decision making by primary care physicians. Using a two-stage decision making model, we have shown that similarity with regards to HIE participation is an important factor on primary care physicians’ referral choices. The findings of this dissertation has significant theoretical and managerial implications for healthcare policy-making, development of innovative HIE business models and healthcare service organizations, and enabling effective referral processes.","**To request an accessible version of the file(s) associated with this item, contact library@buffalo.edu. Please include the item's persistent URL [http://hdl.handle.net/. . .] in your request.**"]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Health Information Exchanges: Impact on Healthcare Costs, Referral Networks, and Referral Decision Making Processes"]}]}],"canonical_facts":{"dc:contributor":["Ramesh, Ram","Management Science and Systems"],"dc:creator":["Eftekhari, Saeede; 0000-0001-9818-612X"],"dc:date":["2019-07-25T21:55:19Z","2019","2019-03-14 13:06:05"],"dc:description":["Ph.D.","Health Information Exchange (HIE) platforms have become an important part of the United States healthcare reform since the enactment of Health Information Technology for Economic and Clinical Health Act (Vest et al. 2010). The main purpose of an HIE is to enable healthcare providers to access and share all relevant clinical information pertaining to patients’ care. The absence of previous clinical information adversely affects the clinical quality and economic efficiency of healthcare services (Forster et al. 2003; Kohn et al. 2000b). Through the HIE platforms, patients’ medical history can be shared electronically with providers and organizations across the continuum of care (Vest et al. 2015). Availability of earlier medical information through HIE leads to more inclusive information and enhancement of quality of care (Branger et al. 1994; Kaelber et al. 2007; Smith et al. 2005). This dissertation is focused on demonstrating the effectiveness of the HIE in reducing the cost and improving the quality of healthcare. The first part of the dissertation is a research in investigating the effect of physicians’ tenure in the HIE system on the procedural repetitions on Medicare beneficiaries in Western New York. Our analyses show that a practice's tenure with HIE significantly lowers the repetition of therapeutic medical procedures in the physicians’ office. The second part of the dissertation focuses on exploring the impact of HIE on physicians’ referral network. Using Social Network Analysis (SNA) and longitudinal data on physicians’ referral and HIE adoption, we have shown that HIE adoption and referral patterns evolve concomitantly. The third part is focused on exploring the impact of HIE membership on the referral decision making by primary care physicians. Using a two-stage decision making model, we have shown that similarity with regards to HIE participation is an important factor on primary care physicians’ referral choices. The findings of this dissertation has significant theoretical and managerial implications for healthcare policy-making, development of innovative HIE business models and healthcare service organizations, and enabling effective referral processes.","**To request an accessible version of the file(s) associated with this item, contact library@buffalo.edu. Please include the item's persistent URL [http://hdl.handle.net/. . .] in your request.**"],"dc:format":["application/pdf"],"dc:identifier":["http://hdl.handle.net/10477/79805"],"dc:language":["eng"],"dc:publisher":["State University of New York at Buffalo"],"dc:rights":["Users of works found in University at Buffalo Institutional Repository (UBIR) are responsible for identifying and contacting the copyright owner for permission to reuse. University at Buffalo Libraries do not manage rights for copyright-protected works and cannot assist with permissions.","Copyright retained by author."],"dc:subject":["management"],"dc:title":["Health Information Exchanges: Impact on Healthcare Costs, Referral Networks, and Referral Decision Making Processes"],"dc:type":["Text","Dissertation"]},"updated_at":"2026-07-27T19:05:19Z"}