Thesis Title: "Essays on Digital Economics"
UT Dallas Best Dissertation Award
Committee:Daniel Arce (Chair), Catherine Tucker, Anne M. Burton, Anton Sobolev
Methodology: Causal Inference, Econometrics, Observational Data, Game Theory
Topics: Health IT, Cybersecurity, Privacy, AI
Working Papers
Abstract:
Hospital data breaches have been shown to disrupt care, incur costs for remediation, and under
mine investor confidence. However, less attention has been paid to the causes of these data breaches. This
study explores the effects of mergers on hospital data breaches. Drawing upon U.S. hospital merger data over
ten years, I empirically show that data breach rates double during merger execution. The results suggest that
increases in data breach risk during merger execution are mainly caused by intensified external threats. I
present some evidence revealing online visibility and information system integration increase external threats.
These findings have managerial implications for predicting and managing the risk of data breaches.
Mergers and Data: Evidence From Healthcare with Catherine Tucker and Amalia Miller
Abstract:
Antitrust concerns often arise when firms that possess stores of customer data combine, because of
the data agglomeration potential to increase market power and foreclose competition. However, this depends
on the combined firm being able to seamlessly pool the customer data. In practice, merging firms often deploy
IT systems that are not compatible with one another, which can raise the costs of data integration. This
study empirically examines how compatibility between data systems affects merger outcomes, by comparing
outcomes before and after mergers and acquisitions among U.S. hospitals, using data from 2008-2019. We find
that only mergers with compatible digital medical record systems achieve cost savings, while incompatible
mergers display no significant cost savings. We provide some evidence showing that the cost savings are
likely to be from patient-facing cost centers, but no evidence on quality reduction. We also find that health
information exchange participation could help incompatible mergers reduce costs, while cloud does not provide
similar moderating effects. These findings highlight that the specific technology used to process data itself
can be an impediment to realizing benefits from consolidation across firms, and show that mergers involving
data can differ substantially in their efficiency, and by implication, competitive effects.
Marketing, AI and Data: Evidence from Medical Devices with Catherine Tucker
Abstract:
It is unclear how privacy policies shape the development of AI technologies. On the one hand, when
a state passes a privacy policy, compliance costs and legal risks increase. On the other hand, an established
set of privacy regulations may give consumers and firms confidence about how training data sets will be
used in the development of AI. We explore these questions empirically in the setting of radiology software, a
frontier setting for the use of AI in medicine. In states with stronger privacy protections, companies are
less
aggressive in marketing AI-powered devices. Using detailing records from the Open Payment project, FDA
documents, national demographic data on doctors and clinicians, and the FDA’s list of radiology AI/ML
Software as Medical Devices, we explore how current AI and privacy law shape how firms approach marketing
payments to physicians. Our analysis reveals that payments from AI medical device manufacturers decrease
by 22.6% when the physician’s primary residency state enacts new privacy policies.
Marketing to Individuals within an Organization: Evidence from Physician Ownership Transitions with Yaa Akosa
Antwi and Catherine Tucker
Abstract:
Many marketing activities in business-to-business focus on individuals within an organization;
however, little is known about how these activities shift as an individual’s organizational role changes. We
explore drivers of this using a novel dataset linking physician ownership of ambulatory surgical centers
(ASCs)
to open payment records from 2013 to 2019 to examine how ownership status influences industry marketing
behavior to that individual. Using differences-in-differences, we find that ownership status significantly
increases the likelihood, frequency, and dollar value of marketing payments to that individual. However,
only male physician-owners are more likely to receive these marketing payments. The increase is driven by
large pharmaceutical firms, suggesting that resource-rich firms crowd out smaller competitors by dominating
physician-owners’ limited time. Larger firms fail to increase attention to new female owners while smaller
firms disproportionately reduce female engagement. The largest marketing response is directed to physicians
with little prior industry engagement, indicating that firms expand their network of contacts rather than
deepening
existing relationships. Our findings highlight the strategic importance of a client individual’s role within
an organization in determining marketing practices and shed light on the adaptation of business-to-business
marketing efforts in response to organizational changes.
Prescription Without Pressure: Voluntary Use, Interstate Spillovers, and Interoperability in PDMP Effectiveness with Xiru Pan, Niam Yaraghi, and Catherine Tucker
Abstract:
The U.S. opioid crisis has led states to enact Prescription Drug Monitoring Programs (PDMPs), which use information systems to improve prescribing safety and measurement of controlled substance prescriptions. However, their efficacy depends on both uptake rates and availability of appropriate data. This study exploits a natural experiment created by stricter PDMP mandates in California, where data is not shared with Oregon, and Washington, where data is shared with Oregon, to examine physician and patient behavior in Oregon, where PDMP use is discretionary. Using comprehensive physician-level data from the Oregon Health Authority, we show that mandates in neighboring states drive substantial patient inflows into Oregon. In response, Oregon physicians significantly increase voluntary PDMP engagement, especially in regions with access to interoperable, cross-state data. Increased PDMP use is associated with safer prescribing patterns, including reduced opioid prescribing and less doctor shopping. These findings demonstrate that the efficacy of PDMPs, especially when their use is not required, depends on interoperability.
Chasing the Winner’s Trail: Radiology Information System Vendor Response to Competitor
Installations with Catherine Tucker
Abstract:
This study examines information system vendors’ competitive reactions when competitors secure
new contracts. We do this in the context of radiology information systems (RIS) using a unique dataset
on US hospitals from 2017–2024. When vendors observe competitors successfully installing their technology,
they could interpret the event in two ways. On the one hand, vendors might see such an adoption as a sign
that the client is off the market and move on to redirect their attention to alternative hospitals or untapped
markets. On the other hand, a successful installation may be informative about the potential customer’s
technological readiness, managerial priorities, and budget availability. We explore these competing effects
using a difference-in-difference empirical approach where we compare outcomes for hospitals that recently
installed an RIS system relative to those that didn’t. We look particularly at vendor detailing activity (that
is paid marketing activities) to potential champions at each hospital. The results indicate a significant
increase
in outreach following competitor installations. This is important because the fact that competition occurs
even after installation helps inform the competitive landscape and the extent of perceived lock-in within
healthcare IT.
Publications
Information Systems Research 36, no. 2 (2025): 916-943.
Abstract:
Cloud services exist under a shared security environment with a dynamic nature; users trade fixed costs for variable costs over time and both cloud service providers (CSP) and users contribute to overall security. We investigate the nature of shared security in a dynamic game where users' security contribution takes into account both their users as well as competition with other CSPs. The Markov Perfect Equilibrium reveals the long-term time patterns of security of the cloud. In particular, we identify a novel form of time-path strategic complementary between usage and a CSP's Markov state of security. This implies cloud security is an unusual form of impure public good whereby individual contributions bolstering a CSP's security endow a selective incentive (private benefit) on others, rather than on the contributor alone. Since this increases usage, CSP vulnerability increases over time. At the same time, CSP competition on security may lead to both welfare improvements for users and lock-in.
Selected Works in Progress
Opioid and Information Systems, with Catherine Tucker, Funded by MIT Sloan Health Systems Initiative
Blockchain Virtual World Voting Mechanisms: Are Whale Voters Knights? with Xiang Hui, Luofeng Zhou, and
Catherine
Tucker, data collection
AI and Operations Management: Evidence from Healthcare, with Atiye Cansu Erol and Catherine Tucker, data
cleaning
Computational Measurement of Textual Ambiguity: A Large Language Model Approach to Policy
Interpretation Analysis (for Computer Science outlets), with Sally Dong, Emma Cabale, Luke Thorburn,
Andrew Konya, Michiel Bakker, experiment ongoing
Fellowships, Grants, Honors, and Awards
CHITA Best Student Paper Award (with Catherine Tucker and Amalia Miller),
NBER 2025 Meeting on Racial and Ethnic Health Disparities invited attendee,
MIT Sloan Health Systems Initiative (HSI) Research Fund (PI: Catherine Tucker),
UT Dallas Best Dissertation Award,
WEIS’23 Best Paper Award,
UC Berkeley SLMath Algorithms, Approximation, and Learning in Market and Mechanism Design invited attendee,
Charles C. McKinney Scholarship,
DFW Research Data Center Grant ($10,000),
NBER 2023 Workshop of Digital Economics invited attendee,
NBER 2023 Digital Economics Tutorial invited attendee,
Irving J. Hoch Scholarship,
Office of Graduate Education Research funding,
NSF graduate student travel grant,
Alfred P Sloan Foundation student travel grant,
Betty Gifford Johnson Travel Award,
NBER 2022 Fall Economics of Privacy Tutorial invited attendee
Services
Information Systems Research, MIS Quarterly, Journal of Industrial Economics, American Economic Journal:
Economic
Policy, Journal of Cybersecurity Reviewer,
ASHEcon 2024 discussant, WEIS'24 Session Chair,
ASHEcon 2023 Newsletter writer