Exploring the impacts of locating capabilities technologies on healthcare performance

Abstract

Healthcare uses locating capabilities technologies (LCTs) such as radio-frequency identification and real-time location systems to track assets and people. Healthcare firms have struggled to understand LCTs’ impact on firm performance. This dissertation explores the effects of LCTs by applying the dynamic capabilities theory and testing the hypothesized relationships. My dissertation is comprised of two essays. In Essay 1, I focus on exploring LCTs’ influence on healthcare organizations’ financial performance by analyzing secondary data from healthcare firms that had and had not deployed LCTs using a matched-pair approach. I conducted independent sample t-tests and difference in differences analysis to compare the two groups. The results indicated that healthcare firms using LCTs did worse based on three financial measures: return on assets, net operating profit margin, and net income margin. In Essay 2, I investigate the relationships between LCTs and healthcare performance by analyzing survey data from respondents with current or prior experience in healthcare decision-making. Drawing from the dynamic capabilities theory, I theorized: (a) location-based intelligence (LBI) capability as a second-order construct containing four lower-order constructs (location infrastructure capability, asset tracking capability, patient and staff locating capability, and information visibility capability); (b) LBI capability directly and indirectly positively affects healthcare performance (employee, patient, and technology benefits); (c) business process optimization (BPO) mediates the relationship between LBI capability and healthcare performance; (d) managerial capabilities have a direct and positive effect on BPO, which moderates the relationship between LBI capability and BPO; (e) employee and patient healthcare performance is a second-order construct comprised of employee and patient healthcare benefits, and (f) hospital characteristics such as size and location positively moderate the relationship between BPO and healthcare performance. The research model tested survey data from healthcare staff in the United States with current and prior experience in decision-making or using health information technology. The analysis results show that (a) LBI capability is a second-order construct that directly and indirectly affects healthcare performance; (b) BPO mediates the relationship between LBI capability and healthcare performance; (c) although managerial capabilities do not moderate the relationship between LBI capability and BPO, they have a positive and direct effect on BPO; (d) employee and patient healthcare performance is a second-order construct; (e) hospital size positively moderates the relationship between BPO and employee and patient healthcare performance; and (f), hospital location positively moderates the relationship between BPO and healthcare performance in technology. This study’s findings have significant research implications regarding LCTs impacting healthcare performance.