The effect of network centrality of medical specialists on their performance: evidence from an Italian health information exchange

Health information exchanges (HIEs) are multi-sided platforms that exhibit network properties, whose value for each user resides in the information that “spills over” from the other users. Most of the studies fail to recognize that much of the institutional performance improvements due to the adoption of HIEs could be realized at the level of an actual user. Multisided platforms have the potential to decrease costs of neighboring organizations but this presumption is not clear at the service delivery unit of analysis. It does not take into account the network characteristics through which the information is exchanged. We analyze HIE system as a social network and put forward a claim that a single medical specialist can be a part of several distinct networks simultaneously. Social embeddedness approach allows us to understand the mechanisms through which economic transactions become embedded in social relations, which in turn affects the allocations of resources and of the costs. We investigate how centrality in different networks affects medical specialists' performance through facilitated information sharing in multi-sided platforms. We use OLS regression to test our hypotheses. Our unit of analysis is a single medical specialist.