| This research examined the reasons for the success of a large, physician-driven health system network (HSN). Performance determinants of success, such as leadership, management systems, information processing, goal alignment, and social practices that comprise a network's management coordination systems were evaluated.;The emergence of HSNs presents new challenges for health care leaders. HSNs operate in intense, dynamic environments and are exceedingly complex organizations. The organizational units, consisting of hospitals, medical groups, and health plans, are diverse and often simultaneously competitive and collaborative. Traditional management control systems frameworks have proven to be less effective for aligning the goals of this interdependent network of organizations.;In this research a normative Management Coordination Systems (MCS) Model that has been found applicable to large, high technology organizations was applied to a highly successful physician-driven HSN to determine limits to its generalizability and to assess its value as an assessment tool for improving HSNs. Discrepancies between the Model and the HSNs practices were explored through the use of written surveys and structured interviews to determine the extent to which the Model should be refined and/or whether the HSN's practices could be improved upon as suggested by the Model. New elements of the Model were identified. Recommendations were made to the HSN to enhance its network potential and preliminary feedback from actions taken was assessed.;The complexity of a large-scale network does not lend itself well to empirical study. In addition, there are unique features to each HSN, impacting generalization from this single case. While there are study limitations, the research furthered understanding of the complexities associated with management coordination of an HSN as it works to adapt to the dynamic health care environment and to achieve alignment among interdependent organizational units. The MCS Model permitted systematic examination of the HSN and its microsystems, two of four levels identified by the Institute of Medicine for redesign of the U.S. health care system. The Model also served as a useful framework to restructure the HSN to operate more effectively as a network, permitting a "system of care" to be delivered to patients. |
