Date

7-21-2026

Department

School of Health Sciences

Degree

Doctor of Philosophy in Health Sciences (PhD)

Chair

Mallory Ball

Keywords

Digital System of Scale (DSS), In Office Management (IOM), Incentives, Information, Interactions, Internet of Things (IoTs), Market Inefficiencies (MIs), Perturbation, Remote Patient Monitoring (RPM), Secondary Issues (Sis), Surface Level Problems (SLPs), Systems

Disciplines

Health Information Technology | Medicine and Health Sciences

Abstract

The importance of this study was due to the market inefficiencies hindering US healthcare. The three market inefficiencies of excessive cost, access challenges, and low outcome yields have puzzled industry stakeholders for years. These inefficiencies continue gobbling up resources now accounting for around 20% of American GDP. The inefficiencies are symptomatic results of two surface level problems in the US healthcare market: financial misalignments and informational fragmentation. The financial mismatches and informational gaps have caused havoc to the natural market’s daily flow since making their way to the surface and remain firmly connected to the root cause of US healthcare’s inefficiencies: a non-systematic design. This study describes how healthcare’s market inefficiencies are linked to the surface level financial and informational problems spawned from the root cause of non-systematic design as well as how it has impacted the interactions and alignment of providers, payers, and patients for years. Insights were gathered by researching secondary issues including provider reimbursement extracted from cost inefficiencies and payer denials extracted from access inefficiencies. Provider reimbursement and payer denials were analyzed and reported to showcase the impact each inefficiency had on the financial and informational components. The analysis was quantified by researching the differences between a digitally scaled system (DSS) moving towards the patient (remote patient monitoring) versus the current non-systematic conglomerate detached from the patient (in office management). The methodology used was a quantitative design that explored data within Medicare’s public use files consisting of claim level information. A t-test was used to compare independent, non-randomized samples. The data was analyzed using ANCOVA to account for covariate influence. In the end, this research explains that by acknowledging the root cause of non-systematic design coupled with the market’s desire and great fortune of digital expansion, stakeholders willing to work together have the rare window of opportunity to intentionally perform a magnificent reset and realignment. This realignment would occur by turning the market’s exhausting financial and informational problems into the very catalysts driving newly found efficiency by attaching them to the internet of things (IoTs) via a digital system of scale (DSS). This digital reset window could authentically become: the first US Healthcare System.

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