The Interplay of Top-Down and Bottom-Up: Approaches for Achieving Sustainable Health Information Exchange

Till Winkler, Carol V. Brown, Pinar Ozturk

    Research output: Chapter in Book/Report/Conference proceedingArticle in proceedingsResearchpeer-review


    The exchange of patient health information across different organizations involved in healthcare delivery has potential benefits for a wide range of stakeholders. However, many governments in Europe and in the U.S. have, despite both top-down and bottom-up initiatives, experienced major barriers in achieving sustainable models for implementing health information exchange (HIE) throughout their healthcare systems. In the case of the U.S., three years after stimulus funding allocated as part of the 2009 HITECH Act, the extent to which government funding will be needed to sustain health information organizations (HIOs) that facilitate HIE across regional stakeholders remains an unanswered question. This research investigates the impacts of top-down and bottom-up initiatives on the evolutionary paths of HIOs in two contingent states in the U.S. (New Jersey and New York) which had different starting positions before the HITECH funding. Based on our analyses of interview data collected from 34 leaders at the state, HIO, and provider level, our objective is to develop a model of contextual and operational factors that influence the sustainability of HIOs. The implications of our findings for other networks of heterogeneous healthcare systems, such as in the European landscape, will also be explored.
    Original languageEnglish
    Title of host publicationECIS 2014 Proceedings
    EditorsMichel Avital, Jan Marco Leimeister, Ulrike Schultze
    Number of pages7
    Place of PublicationAtlanta, GA
    PublisherAssociation for Information Systems. AIS Electronic Library (AISeL)
    Publication date2014
    ISBN (Print)9780991556700
    Publication statusPublished - 2014
    Event22nd European Conference on Information Systems, ECIS 2014: Digital Work, Digital Life - David Intercontinental Hotel, Tel Aviv, Israel
    Duration: 9 Jun 201411 Jun 2014
    Conference number: 22


    Conference22nd European Conference on Information Systems, ECIS 2014
    LocationDavid Intercontinental Hotel
    CityTel Aviv
    Internet address
    SeriesProceedings of the European Conference on Information Systems

    Cite this