Graduation Year

2025

Document Type

Dissertation

Degree

D.B.A.

Degree Granting Department

Information Systems and Decision Sciences

Major Professor

Sunil Mithas, Ph.D.

Committee Member

Manish Agrawal, Ph.D.

Committee Member

Lu Kong, Ph.D.

Committee Member

Victor Weeden, Ph.D.

Keywords

healthcare locus of control, IT affordance, PTSD, reminder affordance, reminder preference, locus of control, IT affordance, PTSD

Abstract

The healthcare community faces numerous challenges concerning patients and their ability to attend appointments as scheduled. Reports indicate that annually, between 23% and 34% of appointments are missed. This challenge creates a cascading effect of wasted time, resources, and valuable appointment slots in an already strained environment. The investigation of this phenomenon is not new and has been extensively researched in the operations management literature. While numerous solutions have been proposed over the past decade, there remains a need to continually advance this research. Beyond merely recognizing missed appointments and potential modalities to alleviate this issue within the care framework, we often overlook the behavioral aspects related to the patient. This research examines various attributes that could be integrated into the reminder system to enhance its relevance to patients and improve healthcare access utilization. Primarily, we explore the adaptive nature of reminders based on the patient’s preferences and the frequency of those reminders. Following this examination, we investigate the implementation of enhanced technological infrastructure that supports the incorporation of virtual healthcare mechanisms, commonly known as telemedicine. Through this perspective, we propose that such a robust modality within the healthcare setting enables a more convenient care structure tailored to specific patient demographics, while also helping to reduce overhead and complexity within the patient population. To study both phenomena, we utilize an extensive proprietary dataset containing over two million observations gathered over eight years, providing insights into the dynamics of appointment reminders and telemedicine utilization. Finally, we extrapolate these findings and focus on an underserved community within the mental health sector to apply our previous results and assess how, when leveraged, we can enhance care for patients with Post-Traumatic Stress Disorder (PTSD) within the Department of Defense. We aim to understand the use of virtual care within this patient community, which leads to a higher propensity of multiple diagnoses. For this analysis, we draw on data collected from 12 different clinics and hospital settings within the Department of Defense over eight years, yielding 107,000 observations for evaluation. In summary, this dissertation will provide new and valuable information to build upon existing knowledge. It does not fill a gap but enhances the current understanding of multiple phenomena. Through this dissertation, I contribute to the information systems literature regarding information technology use and the operations management literature, particularly addressing the persistent issue of missed appointments in healthcare.

Download

Share

COinS