Modeling the adoption of identification standards within the healthcare supply chain

The adoption of identification standards and its associated technology in the healthcare supply chain has been slow over the past twenty five years, despite the evidence of the benefits that can be achieved. The widespread use of identification standards in the form of barcode labeled medical products can contribute to the reduction of point of care errors and can increase the efficiency of healthcare supply chain related processes. This research is focused on the analysis of the adoption of identification standards in the healthcare supply chain with a particular focus on the healthcare provider adoption challenges. The research is divided into two phases. The first phase develops an extensive literature review on technology adoption with a particular focus on data standards. This adoption process is compared with the adoption of Electronic Health Records (EHR) and Electronic Data Interchange (EDI); main conclusions from the identification standards literature are presented, and a conceptual model to explain the identification-standards adoption process is proposed. The second phase proposes a model for identification standards adoption using a system dynamics modeling approach. The model builds on previous findings associated to the factors affecting identification standards adoption and relates the specific elements to the adoption rate via a causal loop diagram (CLD). The model is formulated in two stages. In the first stage, the Bass Diffusion Model (BDM) of technology adoption is adapted to simulate the adoption of identification standards supporting technologies. The second stage uses most of the factors defined in the CLD to develop a simulation model. A sensitivity analysis identifies relevant model parameters that facilitated the design of interventions to move the adoption process forward. Finally, the effects of some possible interventions are simulated using the validated model. The model provides an illustration of the use of system dynamics models and diffusion theory to understand an important policy problem reported in the literature and not yet solved. Also this research informs real world practitioners and the academic community on issues like the lack of data and other challenging aspects of empirical research that can be addressed with the proposed model and methodology. This dissertation is approved for recommendation to the Graduate Council. Dissertation Director: ______________________________________________ (Dr. Ronald Rardin) Dissertation Committee: ______________________________________________ (Dr. Ed Pohl) ______________________________________________ (Dr. Nebil Buyurgan) ______________________________________________ (Dr. Bill Hardgrave) DISSERTATION DUPLICATION RELEASE I hereby authorize the University of Arkansas Libraries to duplicate this dissertation when needed for research and/or scholarship. Agreed_________________________________ (Angelica Burbano Collazos) Refused_________________________________ (Angelica Burbano Collazos) ACKNOWLEDGMENTS I want to especially thank Dr. Ronald Rardin for his support and guidance. Without his support, this dissertation would not have been possible. My work at the Center for Innovation on Healthcare Logistics (CIHL) was fulfilling and gave me a new perspective about my profession and my role as a researcher. I want to thank Dr. Edward Pohl, who was an important part in this process because his comments and suggestions kept me moving in the right direction. I also want to thank my committee members Dr. Nebil Buyurgan and Dr. Bill Hardgrave for their support. I want to thank my sponsor institution Universidad Icesi and Fulbright Colombia as well as LASPAU. At the University of Arkansas, I especially want to thank the Office of Sponsored Student Programs and my writing tutor at the Quality Writing Center, Amy Hodges. One way or another, they made me feel that I was not alone in this endeavor and encouraged me to keep working hard. I want to express my deepest gratitude to my family: my parents Nelly and Jorge and my bothers Adrian and Adolfo, as well as my cousin David. Their love and constant support made the road easier to walk. And last but not least, I want to thank the companions on my journey: Ignacio, Juan Pablo and Ana Sofia, for they deserve a lot of credit for this work. They mean the world to me and I will always be thankful to them for allowing me to achieve my dream. DEDICATION This dissertation is dedicated to my beloved husband Ignacio and my two little ones Juan Pablo and Ana Sofia. It took a lot of effort on my side but also a lot of patience and support from their side. We grew together in the process, and I am sure we will keep wonderful memories about this journey forever.