To investigate the value of expanding screening and treatment for hepatitis C virus (HCV) infecti... more To investigate the value of expanding screening and treatment for hepatitis C virus (HCV) infection in the United States. Discrete-time Markov model. We modeled HCV progression and transmission to analyze the costs and benefits of investment in screening and treatment over a 20-year time horizon. Population-level parameters were estimated using National Health and Nutrition Examination Survey data and published literature. We considered 3 screening scenarios that vary in terms of clinical guidelines and physician awareness of guidelines. For each screening scenario, we modeled 3 approaches to treatment, varying the fibrosis stage of treatment initiation. Net social value was the key model outcome, calculated as the value of benefits from improved quality-adjusted survival and reduced transmission minus screening, treatment, and medical costs. Expanded screening policies generated the largest value to society. However, this value is constrained by the availability of treatment to dia...
Hepatitis C virus (HCV) treatment incentives for private payers may be misaligned because payers ... more Hepatitis C virus (HCV) treatment incentives for private payers may be misaligned because payers must bear immediate costs and may not realize long-term benefits. However, these benefits may accrue to future payers, including Medicare. We examined how and to what extent private payers' current HCV treatment coverage decisions impact Medicare's and private payers' future costs. Discrete-time Markov model. We modeled HCV disease progression and transmission to simulate the economic and social effects of different private-payer HCV treatment scenarios on Medicare. The model examined differences between a baseline scenario (current practice guidelines) and 2 alternative scenarios that expand treatment coverage. Spillover effects were measured as reduced HCV treatment costs and medical expenditures in Medicare. We calculated the spillover effects and net social value of each scenario (total value of quality-adjusted life-years accrued over time minus cumulative treatment and ...
Information systems are increasingly interconnected. They evolve through a sequence of projects t... more Information systems are increasingly interconnected. They evolve through a sequence of projects that are affected by, and subsequently modify, this interconnectedness. We suggest that decision makers can influence emergent information systems by closely managing only a subset of their applications. We define this set of applications as the architectural control points (ACPs).To help architects manage their architecture, we develop a
This paper builds on the absorptive capacity model to analyze the implications of relaxing the as... more This paper builds on the absorptive capacity model to analyze the implications of relaxing the assumption that information search costs are free. A model is developed and solved to optimize the allocation of research resources between own R&D and search. The results are that search and own R&D efforts are complementary. The optimal allocation depends upon industry characteristics.
The modern-day enterprise has an information system architecture that changes as a result of dist... more The modern-day enterprise has an information system architecture that changes as a result of distributed decisions made in response to change s in the firm's environment. Architects have a difficult time making decisions about such system s under their control. To help them with this process, we develop a conceptual model of architect ure as a network comprising of a set of nodes linked by dependencies. Furthermore, we class ify changes to it via addition or subtraction of nodes and links. As changes are made to the set of nodes and links, the underlying architecture of the system evolves. A ke y question is -- can we control the emergence of this complex network by closely managi ng and monitoring a subset of nodes? We define this set of nodes as architectural control p oints. IT management can influence the evolution of the ne twork; however, given time and cost constraints, IT management can most directly influe nce only a few of the components in the network, the architectur...
Hawaii International Conference on System Sciences, 2005
A firm's innovative capabilities depend on its ability to learn from the environment. To lea... more A firm's innovative capabilities depend on its ability to learn from the environment. To learn from the environment a firm must have access to external knowledge, and it must have the absorptive capacity to identify, assimilate and exploit such knowledge. While previous research recognized that firms must invest to acquire absorptive capacity, it assumed that access to knowledge spillovers is
Hawaii International Conference on System Sciences, 2006
IS Architecture emerges as a result of a sequence of IS project implementations. The architecture... more IS Architecture emerges as a result of a sequence of IS project implementations. The architecture that emerges can be viewed as a network of software components linked by their interdependencies. The network influences, and is influenced by, the intra-organizational interdependencies in which it is embedded. IT management can influence the evolution of the network, and, by extension, the evolution of
Information systems are increasingly interconnected. They evolve through a sequence of projects t... more Information systems are increasingly interconnected. They evolve through a sequence of projects that are affected by, and subsequently modify, this interconnectedness. We suggest that decision makers can influence emergent information systems by closely managing only a subset of their applications. We define this set of applications as the architectural control points (ACPs).To help architects manage their architecture, we develop a
To investigate the value of expanding screening and treatment for hepatitis C virus (HCV) infecti... more To investigate the value of expanding screening and treatment for hepatitis C virus (HCV) infection in the United States. Discrete-time Markov model. We modeled HCV progression and transmission to analyze the costs and benefits of investment in screening and treatment over a 20-year time horizon. Population-level parameters were estimated using National Health and Nutrition Examination Survey data and published literature. We considered 3 screening scenarios that vary in terms of clinical guidelines and physician awareness of guidelines. For each screening scenario, we modeled 3 approaches to treatment, varying the fibrosis stage of treatment initiation. Net social value was the key model outcome, calculated as the value of benefits from improved quality-adjusted survival and reduced transmission minus screening, treatment, and medical costs. Expanded screening policies generated the largest value to society. However, this value is constrained by the availability of treatment to dia...
Hepatitis C virus (HCV) treatment incentives for private payers may be misaligned because payers ... more Hepatitis C virus (HCV) treatment incentives for private payers may be misaligned because payers must bear immediate costs and may not realize long-term benefits. However, these benefits may accrue to future payers, including Medicare. We examined how and to what extent private payers' current HCV treatment coverage decisions impact Medicare's and private payers' future costs. Discrete-time Markov model. We modeled HCV disease progression and transmission to simulate the economic and social effects of different private-payer HCV treatment scenarios on Medicare. The model examined differences between a baseline scenario (current practice guidelines) and 2 alternative scenarios that expand treatment coverage. Spillover effects were measured as reduced HCV treatment costs and medical expenditures in Medicare. We calculated the spillover effects and net social value of each scenario (total value of quality-adjusted life-years accrued over time minus cumulative treatment and ...
Information systems are increasingly interconnected. They evolve through a sequence of projects t... more Information systems are increasingly interconnected. They evolve through a sequence of projects that are affected by, and subsequently modify, this interconnectedness. We suggest that decision makers can influence emergent information systems by closely managing only a subset of their applications. We define this set of applications as the architectural control points (ACPs).To help architects manage their architecture, we develop a
This paper builds on the absorptive capacity model to analyze the implications of relaxing the as... more This paper builds on the absorptive capacity model to analyze the implications of relaxing the assumption that information search costs are free. A model is developed and solved to optimize the allocation of research resources between own R&D and search. The results are that search and own R&D efforts are complementary. The optimal allocation depends upon industry characteristics.
The modern-day enterprise has an information system architecture that changes as a result of dist... more The modern-day enterprise has an information system architecture that changes as a result of distributed decisions made in response to change s in the firm's environment. Architects have a difficult time making decisions about such system s under their control. To help them with this process, we develop a conceptual model of architect ure as a network comprising of a set of nodes linked by dependencies. Furthermore, we class ify changes to it via addition or subtraction of nodes and links. As changes are made to the set of nodes and links, the underlying architecture of the system evolves. A ke y question is -- can we control the emergence of this complex network by closely managi ng and monitoring a subset of nodes? We define this set of nodes as architectural control p oints. IT management can influence the evolution of the ne twork; however, given time and cost constraints, IT management can most directly influe nce only a few of the components in the network, the architectur...
Hawaii International Conference on System Sciences, 2005
A firm's innovative capabilities depend on its ability to learn from the environment. To lea... more A firm's innovative capabilities depend on its ability to learn from the environment. To learn from the environment a firm must have access to external knowledge, and it must have the absorptive capacity to identify, assimilate and exploit such knowledge. While previous research recognized that firms must invest to acquire absorptive capacity, it assumed that access to knowledge spillovers is
Hawaii International Conference on System Sciences, 2006
IS Architecture emerges as a result of a sequence of IS project implementations. The architecture... more IS Architecture emerges as a result of a sequence of IS project implementations. The architecture that emerges can be viewed as a network of software components linked by their interdependencies. The network influences, and is influenced by, the intra-organizational interdependencies in which it is embedded. IT management can influence the evolution of the network, and, by extension, the evolution of
Information systems are increasingly interconnected. They evolve through a sequence of projects t... more Information systems are increasingly interconnected. They evolve through a sequence of projects that are affected by, and subsequently modify, this interconnectedness. We suggest that decision makers can influence emergent information systems by closely managing only a subset of their applications. We define this set of applications as the architectural control points (ACPs).To help architects manage their architecture, we develop a
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