Statistical measures of correlation of it spending, including controlling for early adoption of SOA platforms, will be entered into the analysis. Finally, the results will be analyzed and recommendations made on specific strategies for attaining higher levels of efficiency in both patient care and operational contexts based on the analysis. Methodology

Lacking operational system integration that ultimately leads to higher mortality rates from diseases, accidents and HIV / AIDS, hospitals and healthcare centers in counties throughout Arizona in 2000 initiated a comprehensive program to install healthcare systems in hospitals and healthcare centers in Apache, Cochise, Santa Crux, Navaho, and Yuma counties. Maricopa and Pima counties also received upgrades to existing healthcare systems in place. Forty-six hospitals and healthcare centers' five-year spending on it software, hardware, and systems, mortality rates attributable to disease, accidents, and HIV / AIDS is the data set used in the regression analysis. The three hypotheses of this project are as follows:

H1: System integration and SOA architectures have a positive influence on reduction of mortality rates

H2: Unmet needs of hospitals and healthcare providers are more process-based than cost-based

H3: Long-term investments in strategic management systems including SOA architectures are positively related to hospital financial performance

The data set is analyzed using Minitab Version 15 for completing stepwise linear regression, multiple regression and least-squares regression. Bivariate correlations, frequencies and cross-tabulations were completed using SPSS Version 13 for Windows.

Analysis of Results

The catalyst of this study is the evaluation of how processes within healthcare providers can be made more efficient from a process standpoint first, and then through the use of it, more capable of scaling to respond to a greater breadth of patients' unmet needs. The value of any it investment will only be as effective as the processes they automate. When SOA architectures serve as the foundation of BPM and ECM systems, healthcare providers have the flexibility of re-designing processes so they are more responsive and patient-centered. The intent of the three hypotheses of this study is to measure how investments in SOA architectures ultimately positively influence the development of greater treatment strategies for patients, delivering higher levels of treatment success as a result. Ultimately the more patient-centered, efficient and lean the processes are in a healthcare organization, the greater the profitability as well. The three hypotheses of this study cover these specific aspects of how investments in SOA architectures, BPM frameworks and ECM systems are transforming healthcare providers.

The intent of this section is to evaluate each of the hypotheses based on the results of the research completed. Starting with the first hypothesis of system integration and SOA architectures having a positive influence on the reduction of mortality rates due to more efficient patient-based processes being enabled through tighter process and system integration is statistically proven valid from the research completed when a longitudinal data analysis representing five years of investment in software, hardware, and services and then completing a regression analysis yielding statistically significant results. The cumulative investment in Enterprise Content Management (ECM) systems across all categories (systems software, hardware and services) showed the greatest potential to reduce fatalities caused by diseases first and accidents second. Completely unforeseen when this hypothesis was first defined was the effect of system integration and SOA architectures on increasing information and knowledge sharing outside the healthcare providers. In the sample data provided awareness of HIV / AIDS significantly increased as a result of the ECM systems within healthcare providers being more equipped to respond to patients' questions on these diseases. This finding was derived from an analysis of respondents by age groups by their use of the contents of ECM systems throughout healthcare providers. Those in the late teens and twenties were given HIV / AIDS information from their healthcare providers as preventative strategies mentioned by those interviewed during this study. The surprising finding however was the high demand placed on ECM systems...

The use of system integration to capture ECM system-use statistics highlighted how the content regarding HIV / AIDS was of significant interest to the parents of patients in their late teens and twenties. The unmet need of delivering this content in their specific native languages and in more clinical, less popularized or trendy in discussion, was not anticipated. As a result, healthcare providers were able to respond to this information needs of parents in their forties and fifties to educate them as to the preventative measures needed by their children to prevent HIV / AIDS occurrences. Given the data set it was not possible to measure how increasing knowledge over time had contributed to a reduction in HIV / AIDS mortality, yet the regression analyses completed of it spending relative to mortality rates did show significant statistical correlation, as is shown below.
Completing a linear regression of cumulative it spending (in total) to the dependent variable mortality rate due to disease produced the following results shown in the Model Summary table and histogram.

It is significant to point out that integrating ECM and healthcare systems within an SOA architecture does lead to greater distribution of HIV / AIDS information and an increased knowledge of the disease overall. It was unforeseen that the effects of system integration within healthcare providers would actually generate higher levels of information and knowledge demand outside the healthcare organizations as well, in the surrounding communities. The network effect (Setia, Sambamurthy, Closs, 2008) is evident in how quickly the HIV / AIDS data has permeated the community surrounding the healthcare providers who provided data as part of this research effort. The essence of the network effect is that when a greater number of users are participating and contributing and using the content, the greater the ability of the network to match their unmet needs. The following histogram illustrates how tightly the it spending levels align with the reduction in mortality from HIV / AIDS (std. deviation.986) suggesting a high clustering of data.

Further, the strength of the correlation between it spending over time and the reduction of HIV / AIDS mortality suggest that there is a lifecycle that gets created when the network effect begins to nurture information sharing both within and outside a healthcare organization. The integration of healthcare systems, development of ECM and BPM applications and their use to streamline processes within healthcare organizations, synchronized by an SOA platform creates the foundation for the network effect to bring knowledge to not only patients but also surrounding communities.

The network effect created from the integration of systems and the adoption of SOA platform over the long-term also support the second hypothesis. Health care providers are in fact much more process-based relative to cost-based, and when process improvements are found they are quickly transformed into broader network effects, as the AIDS/HIV example shows. The most complex and difficult processes to streamline within any healthcare organization is the diagnosis and treatment of disease. To first define a suitable diagnosis and treatment plan and then execute on it requires tight integration of ECM and patient monitoring systems. There is also the need of supporting non-standard processes that can be applied selectively to assist patients in getting back on their treatment plans, ensuring a high level of success with their prescribed treatments. In addition, system integration across patient monitoring and ECM systems when combined with analytics and enterprise performance management (EPM) give physicians the opportunity to monitor, over time, the progress of their treatment programs. This is a critical step forward in long-term care and alleviating mortalities related to disease. The following statistical analysis of it investment relative to mortality related to disease is shown in the Model.

Note that the correlation coefficient of.682 signifies a high level of statistical significance that over time the level of it spending does in fact drive down disease-related mortality rates. While the reduction in HIV / AIDS is more of a preventative measure of how effective systems integration is, the measure of treatment programs effectiveness is just as significant. In this scenario, the development of treatment programs requires intensively high levels of system integration, requiring the continual use of BPM and EPM-based applications to align treatment programs with the specific needs of the patients. What also emerges from this analysis is that ECM systems organized on an SOA architecture are critical for applying all available knowledge to a given disease diagnosis and treatment plan. While the HIV / AIDS finding shows the effects of system integration on preventative healthcare, the use of SOA architectures and achieving a high level of database integration specifically yields statistically significant results in defining and completing longer-term treatment programs. As a result of the amount of data that needs to be part of any successful diagnosis and treatment program, and given the fact there are many more variables to contend with, there is more dispersion of data throughout the analysis. The following histogram illustrates this point, showing the…