A s the United States expends extraordinary efforts toward the digitization of its health-care system, and as policy makers across the globe look to information technology (IT) as a means of making health-care systems safer, more affordable, and more accessible, a rare and remarkable opportunity has emerged for the information systems research community to leverage its in-depth knowledge to both advance theory and influence practice and policy. Although health IT (HIT) has tremendous potential to improve quality and reduce costs in healthcare, significant challenges need to be overcome to fully realize this potential. In this commentary, we survey the landscape of existing studies on HIT to provide an overview of the current status of HIT research. We then identify three major areas that warrant further research: (1) HIT design, implementation, and meaningful use; (2) measurement and quantification of HIT payoff and impact; and (3) extending the traditional realm of HIT. We discuss specific research questions in each domain and suggest appropriate methods to approach them. We encourage information systems scholars to become active participants in the global discourse on health-care transformation through IT.

BackgroundAmericans increasingly post and consult online physician rankings, yet we know little about this new phenomenon of public physician quality reporting. Physicians worry these rankings will become an outlet for disgruntled patients.ObjectiveTo describe trends in patients’ online ratings over time, across specialties, to identify what physician characteristics influence online ratings, and to examine how the value of ratings reflects physician quality.MethodsWe used data from RateMDs.com, which included over 386,000 national ratings from 2005 to 2010 and provided insight into the evolution of patients’ online ratings. We obtained physician demographic data from the US Department of Health and Human Services’ Area Resource File. Finally, we matched patients’ ratings with physician-level data from the Virginia Medical Board and examined the probability of being rated and resultant rating levels.ResultsWe estimate that 1 in 6 practicing US physicians received an online review by January 2010. Obstetrician/gynecologists were twice as likely to be rated (P < .001) as other physicians. Online reviews were generally quite positive (mean 3.93 on a scale of 1 to 5). Based on the Virginia physician population, long-time graduates were more likely to be rated, while physicians who graduated in recent years received higher average ratings (P < .001). Patients gave slightly higher ratings to board-certified physicians (P = .04), those who graduated from highly rated medical schools (P = .002), and those without malpractice claims (P = .1).ConclusionOnline physician rating is rapidly growing in popularity and becoming commonplace with no evidence that they are dominated by disgruntled patients. There exist statistically significant correlations between the value of ratings and physician experience, board certification, education, and malpractice claims, suggesting a positive correlation between online ratings and physician quality. However, the magnitude is small. The average number of ratings per physician is still low, and most rating variation reflects evaluations of punctuality and staff. Understanding whether they truly reflect better care and how they are used will be critically important.

We analyze how online reviews are used to evaluate the effectiveness of product differentiation strategies based on the theories of hyperdifferentiation and resonance marketing. Hyperdifferentiation says that firms can now produce almost anything that appeals to consumers and they can manage the complexity of the increasingly diverse product portfolios that result. Resonance marketing says that informed consumers will purchase products that they actually truly want. When consumers become more informed, firms that provide highly differentiated products should experience higher growth rates than firms with less differentiated offerings. We construct measures of product positioning based on online ratings and find supportive evidence using sales data from the craft beer industry. In particular, we find that the variance of ratings and the strength of the most positive quartile of reviews play a significant role in determining which new products grow fastest in the market-place. This supports our expectations for resonance marketing.

The striking growth of online communities in recent years has sparked significant interest in understanding and quantifying benefits of participation. While research has begun to document the economic outcomes associated with online communities, quantifying the social value created in these collectives has been largely overlooked. This study proposes that online health communities create social value by addressing rural-urban health disparities via improved health capabilities. Using a unique dataset from a rare disease community, we provide one of the first empirical studies of social value creation. Our quantitative analysis using exponential random graph models reveals patterns of social support exchanged between users and the variations in these patterns based on users' location. We find that, overall, urban users are net suppliers of social support while rural participants are net recipients, suggesting that technologymediated online health communities are able to alleviate rural-urban health disparities. This study advances extant understanding of value production in online collectives, and yields implications for policy.

D espite the significant potential for performance gains from health IT (HIT), there has been limited study of the mechanisms underlying successful HIT implementations. We conducted an extensive longitudinal field study to gain an understanding of the interplay between technology and patterns of clinical work embodied in routines. We use the analytical device of narrative networks to identify where and how HIT influences patterns of work. We further draw upon adaptive structuration theory to conceptualize HIT as an intervention that alters the flow of events in a narrative network. Our findings suggest that the key to successful implementation is to manage the co-evolution process between routines and HIT and to actively orchestrate a virtuous cycle through agentic action. We propose a dynamic process model of adaptive routinization of HIT that delineates the major channels through which HIT and routines interact, identifies the different stages in the dynamic co-evolution process, and isolates the pivotal role of two forms of agency in enabling the virtuous cycle of co-evolution. This is one of the first studies to offer a processual, microlevel analysis of HIT implementation in a clinical setting.

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Consumer-generated ratings typically share an objective of illuminating the quality of a product or service for other buyers. While ratings have become ubiquitous and influential on the Internet, surprisingly little empirical research has investigated how these online assessments reflect the opinion of the population at large, especially in the domain of professional services where quality is often opaque to consumers. Building on the word-ofmouth literature, we examine the relationship between online ratings and population perceptions of physician quality. We leverage a unique dataset which includes direct measures of both the offline population's perception of physician quality and consumer-generated online reviews. As a result, we are able to examine how online ratings reflect patients' opinions about physician quality. In sharp contrast to the widely voiced concerns by medical practitioners, we find that physicians who are rated lower in quality by the patient population are less likely to be rated online. Although ratings provided online are positively correlated with patient population opinions, the online ratings tend to be exaggerated at the upper end of the quality spectrum. This study is the first to provide empirical evidence of the relationship between online ratings and the underlying consumer-perceived quality, and extends prior research on online word-of-mouth to the domain of professional services.

We analyze how online reviews are used to evaluate the effectiveness of product differentiation strategies based on the theories of hyperdifferentiation and resonance marketing. Hyperdifferentiation says that firms can now produce almost anything that appeals to consumers and they can manage the complexity of the increasingly diverse product portfolios that result. Resonance marketing says that informed consumers will purchase products that they actually truly want. When consumers become more informed, firms that provide highly differentiated products should experience higher growth rates than firms with less differentiated offerings. We construct measures of product positioning based on online ratings and find supportive evidence using sales data from the craft beer industry. In particular, we find that the variance of ratings and the strength of the most positive quartile of reviews play a significant role in determining which new products grow fastest in the market-place. This supports our expectations for resonance marketing.