All ETDs from UAB

Advisory Committee Chair

Nancy Borkowski

Advisory Committee Members

Seongwon Choi

Ganisher Davlyatov

Allyson Hall

Robert Weech-Maldonado

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


Increasing competition in the healthcare industry is compelling organizations to adopt new strategies to obtain and/or maintain a competitive advantage. To obtain a competitive advantage, healthcare organizations may need either more efficient processes or offer new or improved products and services through the utilization of these strategies. In competitive market environments, technological innovations can be a key competitive advantage to reduce expenses, improve quality, attract more customers, or a combination of all. All healthcare organizations can benefit from technological innovations, especially those with limited resources. One type of healthcare organization that highlights the disparity in resources is the Federally Qualified Health Centers (FQHCs), which is a core component of the American “social safety net” and provides care to medically underserved population. This study explores the association between innovation, being defined as the advanced application of existing technology, and quality outcomes in FQHCs based on the Porter’s generic strategies. We defined innovation in FQHCs as the higher use of technology for advanced functionalities including quality improvement, population health management, program evaluation, and research. A quantitative approach is adopted to explore variations in quality outcomes in FQHCs using secondary data sources. The first source is the Uniform Data System, which collects annual information on FQHCs, iv including their scope, volume, and health information systems. The second dataset is the Area Health Resource File, which includes county-level data. The Badge Awards-related information was retrieved from Health Resources and Services Administration (HRSA). Lastly, we used the Kaiser Family Foundation website to obtain data on the status of Medicaid expansion. The results indicated that although there was not a significant association between the high use of Health Information Technology (HIT) and Electronic Health Records (EHRs) use and quality outcomes in FQHCs, a sensitivity analysis of the subcategories showed a significant association for two subcategories, namely quality improvement & program evaluation & population health management, and other, and quality improvement & population health management. Furthermore, Health Center Controlled Networks (HCCN) membership, gender, and Medicaid expansion status emerged as important factors for improving quality outcomes.



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