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Brokerage-Centrality Conjugates for Multi-Level Organizational Field Networks: Toward a Blockchain Implementation to Enhance Coordination of Healthcare Delivery

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Networks, Knowledge Brokers, and the Public Policymaking Process

Abstract

A fragmented U.S. healthcare delivery system may reflect a highly brokered communication network controlled by only a few brokers. Such relational inequality in brokerage influences the formation of interorganizational brokerage relations. This chapter presents the theoretical mechanisms that underlie the reasoning of instantiating organizational power dynamics in controlling communication (brokerage) while increasing connectivity (degree centrality); determining opportunities for accessing and exchanging resources across subgroups; and shaping organizational decisions and actions that are transformed collectively into locally centralized or decentralized brokerage structures, called ‘brokerage-centrality conjugates.’ These conjugates make up the interorganizational collaboration network of an organizational field, and is tested and supported by multi-level exponential random graph models. Finally, a blockchain-based network intervention is proposed to enhance interorganizational communication and coordination to improve population health.

Kayo Fujimoto and Peng Wang co-lead this chapter.

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Acknowledgements

This work was supported by the National Institutes of Health (1R01MH100021), Gilead Sciences, Inc. (IN-US-276-D120), and the Sally W. Vernon, Ph.D. Distinguished Professorship in Social Determinants of Health. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health and Gilead Sciences, Inc. We acknowledge Motoki Yanase and the contributions to this study by the YMAP staff in Houston and Chicago.

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Authors and Affiliations

  1. The University of Texas Health Science Center at Houston, Houston, TX, USA

    Kayo Fujimoto, Camden J. Hallmark, Jacky Kuo, Lisa M. Kuhns, John A. Schneider & Peng Wang

  2. Houston, TX, USA

    Connor Smith

  3. University of Chicago, Chicago, IL, USA

    Natascha Del Vecchio & John A. Schneider

  4. The University of Texas at Arlington, Arlington, TX, USA

    Rebecca L. Mauldin

  5. Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Lisa M. Kuhns

  6. Centre for Transformative Innovation, Swinburne University of Technology, Melbourne, Australia

    Peng Wang

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    Matthew S. Weber

  2. School of Communication and Information, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA

    Itzhak Yanovitzky

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Fujimoto, K. et al. (2021). Brokerage-Centrality Conjugates for Multi-Level Organizational Field Networks: Toward a Blockchain Implementation to Enhance Coordination of Healthcare Delivery. In: Weber, M.S., Yanovitzky, I. (eds) Networks, Knowledge Brokers, and the Public Policymaking Process. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-78755-4_11

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