Healthcare Informatics Research and Innovation Essay
Healthcare Informatics Research and Innovation Essay
Topic: Healthcare Informatics Research and Innovation
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Understanding the intellectual structure of health informatics is crucial to the whole
health informatics community. In general, the intellectual structure of a discipline bespeaks the
topics and paradigms selected by a field, the research themes that emerge over time, the thought
leaders who direct the efforts of its various research programs, and the relationships between
various structural components. Gaining deep insights into the intellectual structure of a
discipline can lead to defining moments for a community of scholars (Kuhn 1962). Whereas this
structure often reifies what is already known in the knowledge base or else increments (Kuhn
1962), it can also shape the epistemologies that frame knowledge development work and alter
the philosophical basis of these efforts (Crane 1972). Structural knowledge can help scholars set
their future research directions by seeing patterns of work that have existed in the past and noting
trend lines into the future (Platt 1964).Healthcare Informatics Research and Innovation Essay
Although in-depth intellectual structure analyses have been conducted for the entire field
of information systems (IS) in journals such as MIS Quarterly and Management Science (Culnan
1986; Culnan 1987), IS research intellectual structure analyses are notably lacking in the
growing discipline of health informatics (HI) and its sub-discipline health information
technology (HIT). Given that HI literature reviews and citation analyses have been conducted in
HI journals and the HIT literature has been reviewed in information systems (IS) journals
(Chiasson and Davidson 2004; Gallivan and Tao 2014; Raghupathi and Nerur 2010; Romanow
et al. 2012), such articles are either becoming dated (especially in the case of many HI analyses)
and/or use only one primary method (e.g., citation analysis, social network analysis, or latent
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semantic analysis). We contend that future progress is dependent on: (1) a more complete
understanding of how the HI and HIT disciplines have grown and evolved in the context of IS
research over the past two decades, (2) multi-method analyses of the structural relationships
between and cohesion of research themes and thought leaders (we use citation and co-citation
analysis, social network analysis, and latent semantic analysis), and (3) leveraging these
intellectual structure analyses to guide future research.
The first essay of the current dissertation represents such an effort of more recent, more
complete, and more thorough analyses of HI and, particularly, HIT intellectual structures.
Deeper understanding of the evolving intellectual structures of HI and HIT provides a means by
which to further expand, consolidate, and renew the discipline in a systemic and informed
manner while also theoretically contributing back to coordinate and reference disciplines. Given
that an in-depth intellectual structural analysis of HIT focused on research in top IS journals had
not appeared before our study, we fill an important research gap in this essay. Using the multiple
statistical methods including citation and co-citation analysis, social network analysis (SNA),
and latent semantic analysis (LSA), we show how HIT research has emerged in IS journals and
distinguished itself from the larger HI context.
The second essay of the current dissertation zooms in one specific emerging HIT research
theme, online health communities, which are defined as social networks where people with
common health interests can share experiences, request questions, seek or provide emotional
support (Eysenbach et al. 2004). A 2011 national survey conducted in the U.S. by the Pew
Research Center’s Internet & American Life Project found that 80% of U.S. Internet users have
looked for health information online, 34% of Internet users have read others’ commentary or
experience about health issues online, and 18% have sought online to find others with similar
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health concerns (Fox 2011). A more recent national survey by the same project found that 72%
of U.S. Internet users have looked online for health Healthcare Informatics Research and Innovation Essay information within the past year (Fox and
Duggan 2013). Another survey showed that social media sites are emerging as a potential source
of online health information, with 42% Internet users consulting online rankings or reviews and
32% using social networking sites for health (Thackeray et al. 2013). These statistics suggest
that online health communities, or the Internet in general, are becoming a common source for
health information seeking. As an inseparable part of the personalized preventative medicine
(Swan 2012), online health communities are changing the way patients treat and/or manage their
health.
Two major purposes of participants joining online health communities are to seek health
information regarding self-management options and to receive emotional support by knowing
that their peers care (Hajli et al. 2014). People can discuss conditions, symptoms, and treatments
as well as seek and provide health-related advice and emotional support from each other.
Moreover, advanced services such as posing questions to physicians, quantified self-tracking of
health conditions, and clinical trials access can also be provided to consumers (Swan 2009).
When individuals are sharing their personal health information with other online community
peers, they are “crowdsourcing” the collective wisdom of a huge number of community members
(Eysenbach 2008). This can significantly lower the cost of health care and alleviate burdens on
the health care system. Ultimately, online health communities open up new opportunities for the
health care industry to obtain the “triple aim” (Berwick et al. 2008, p. 760) including: (1) cutting
costs, (2) enhancing the individual’s experience of care, and (3) improving the health of
populations. The wide use of online health communities leads naturally to the need to better
understand the social relations in this context.
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The rise of health social networks such as PatientsLikeMe, DailyStrength, and MedHelp
provides unique opportunities for research focusing on healthcare decision support and patient
empowerment (Miller 2012). User-generated content on these online communities is accessible
not only to the patients and caregivers but also researchers. Specifically, digital trace data on the
online communities are available for scholars to better address more complicated research
questions proposed. Digital trace data are records of activities that are undertaken through an
online information systems (Howison et al. 2011). Here, a trace represents an event occurred in
the past. Following proper and rigorous ways, digital trace data can be used to measure
theoretically interesting constructs (Howison et al. 2011). With the abundant big digital trace
data being generated by online health communities, scholars are able to obtain insights into
highly detailed, contextualized, and rich contexts, thereby obtaining insights that address the
heterogeneous needs of individual patients. However, there is a lack of research in IS field that
empirically addresses this phenomenon and its underlying theoretical relationships via analyses
of big health data.
The second essay of the dissertations tends to fill such knowledge gap by probing the
impact of social support provided and consumed in online health communities on individual
health promotion outcomes through the analyses of big online health digital trace data.
Contributions of this research not only extend current understanding of micro-mechanisms of
social support exchange in online health communities as well as the catalytic role of social
support in health promoting, but also shed light on the design and management of such online
health communities.Healthcare Informatics Research and Innovation Essay
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1.2 Scope of Inquiry
This dissertation follows the multi-paper model and is comprised of two separate essays
that respectively investigate: (1) the intellectual structure of the discipline health informatics (HI)
and its sub-discipline health information technology (HIT), and (2) an emerging and interesting
area of HIT research that explores the impact of social support on health promotion outcomes in
online health communities. Table 1.1 summarizes the key characteristics of the two essays.
Table 1.1 Summary of Two Essays
Research
Design
Essay 1: Intellectual Structure
of Health Informatics
Essay 2: Online Health
Communities
Research Topic
Intellectual structure of health
informatics discipline
The effect of social support on health
promotion outcomes
Data Source Archival data Digital trace data
Raw Data
Volume
24,897 health informatics
papers
324 health information
technology articles
2,305,288 online discussion posts
238,617 threads
32,405 members
Analytical
Method
Citation analysis
Co-citation analysis
Social network analysis
(SNA)
Latent semantic analysis
(LSA)
Cluster analysis
Natural language processing
(NLP)
Latent Dirichlet allocation (LDA)
Support vector machine (SVM)
Unified medical language system
(UMLS)
Social network analysis (SNA)
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CHAPTER 2
THE EVOLVING INTELLECTUAL STRUCTURE OF THE HEALTH
INFORMATICS DISCIPLINE: A MULTI-METHOD INVESTIGATION OF
A RAPIDLY-GROWING SCIENTIFIC FIELD1
Abstract
Scientific disciplines are self-defined and self-evolving to a large extent, but
acknowledging that disciplines develop organically does not diminish the continuing need to
more fully understand the underlying dynamics of their intellectual structures. Intellectual
structures bespeak the topics (including paradigms) that a discipline selects, the sub-disciplines
and sub-communities that emerge, the thought leaders who direct the efforts of its various
research programs, and the relationships between these various structural components. One such
discipline, the discipline of health informatics (HI), is not only a vitally important discipline for
societies worldwide, but is also an enormous field that manifests itself in the natural and social
sciences as well as in the information systems (IS) and applied disciplines including
professionals such as physicians, nurses, paramedics, and so forth.Healthcare Informatics Research and Innovation Essay
A subset of the HI field especially important to IS scholars is identified here as health
information technology (HIT). The current study analyzes the intellectual underpinnings of the
field of HI and, in particular, focuses on its sub-discipline HIT. Using the multiple statistical
methods including citation and co-citation analysis, social network analysis (SNA), and latent
semantic analysis (LSA), we show how HIT research has emerged in IS journals and
1 Chen, L., Baird, A., and Straub, D. 2015. “The Evolving Intellectual Structure of the Health Informatics Discipline:
A Multi-Method Investigation of a Rapidly-Growing Scientific Field,” Working Paper, Georgia State University.
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distinguished itself from the larger HI context. The research themes, intellectual leadership,
cohesion of these themes and networks of researchers, and journal presence revealed in our
longitudinal intellectual structure analyses foretell how, in particular, these HI and HIT fields
have evolved to date and also how they could evolve in the future. Our findings identify which
research streams are central (versus peripheral) and which are cohesive (as opposed to disparate).
Suggestions for vibrant areas of future research emerge from our analyses.
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