Title

Essays on healthcare information systems

Date of Completion

January 2005

Keywords

Business Administration, Management|Information Science|Health Sciences, Health Care Management

Degree

Ph.D.

Abstract

This dissertation explores two ways information systems can be used to improve the efficiency of healthcare delivery. The first study addresses the problem of providing access to individually identifiable micro-data. To increase the flexibility and availability of information to the users, a number of healthcare agencies are disseminating information in microdata format that includes individual identifiers. The resulting security threats are defined and a model to protect against them is developed. The threats to the confidentiality of the data subjects come from the information that relates the revealed microdata to suppressed confidential information. The microdata provided to the users is truthful in that every subject of the dataset is accurately defined by the data associated with it. The problem of releasing as much data as possible, subject to the security constraints, is formulated as a linear program. Extensive computational results show that the proposed method is practical and viable, and that useful data can be released even when the level of risk in the data is high. ^ In the second study a decision support system is developed that provides a hospital bed manager with recommendations on where to assign new patients and staff, or transfer existing patients and staff, in order to reduce the cost of transferring admitted patients from the emergency department to the floors and improve capacity utilization. A set of policies is evaluated using a two-stage Markov decision process in which the problem of optimally allocating patients and staff in response to their arrivals and departures is formulated as an integer program. The policy that places the hospital in the most advantageous position to handle future events is recommended to the user. Actual implementation results show a decrease of almost 50% in the average amount of time required to transfer an admitted patient from the emergency department to the floor once the decision had been made to admit them as well as a significant increase in capacity utilization. ^