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This paper proposes an organizational change process to prepare physicians and other health professionals for their new roles in patient-centered medical homes (PCMHs). It provides physician-centered tools, models, concepts, and the language to implement transformational patient-centered medical care.

To improve care delivery, quality, and patient engagement, a systems approach to care is required. This paper examines a systems approach to patient care where all inputs that influence patient interactions and participation are considered in the design of health care delivery and follow-up treatment plans. Applying systems thinking, organizational change models, and team-building, we have examined the continuum of this change process from ideation through the diffusion of new methods and behaviors.

PCMHs make compelling business sense. Studies have shown that the PCMH improves patient satisfaction, clinical outcomes and reduces underuse and overuse of medical services. Patient-centered care necessitates transitioning from an adversarial to a collaborative culture. It is a transformation process predicated on strong leadership able to align an organization toward a vision of patient-centered care, creating a collaborative culture committed to health-goal achievement.

This paper proposes that the PCMH is a rigorous team-building transformational organizational change, a radical departure from the current hierarchical, silo-oriented, medical practice model. It requires that participants within and across health care organizations learn new skills and behaviors to achieve the anticipated quality and efficiency improvements. It is an innovative health care organization model of the future whose success is premised on teams supplanting the individual as the building block and unit of health care performance.

This study examines how modular interfaces manifest in multi-provider contexts and how they can improve coordination and customization of services. The aim of the study is to describe interfaces in multi-provider contexts and elaborate on how they support the delivery of integrated patient care.

A qualitative, multiple case study was conducted in two multi-provider contexts in healthcare services: one representing paediatric Down syndrome care in the Netherlands and one representing home care for the elderly in Finland. Data collection involved semi-structured interviews in both contexts.

This study provides insight into several types of interfaces and their role in multi-provider contexts. Several inter- and intra-organizational situations were identified in which the delivery of integrated patient care was jeopardized. This study describes how interfaces can help to alleviate these situations.

This study deepens the understanding of interfaces in service modularity by describing interfaces in multi-provider contexts. The multi-provider contexts studied inspired to incorporate the inter-organizational aspect into the literature on interfaces in service modularity. This study further develops the typology for interfaces in modular services by adding a third dimension to the typology, that is, the orientation of interfaces.

The purpose of the study was to empirically validate the linkages between IoT adoption and how it overarched influenced the patient care service engagement. This contributes to the body of knowledge and helps hospital managers to understand the relationship and relevance of IoT adoption; otherwise healthcare sector are late movers towards technology adoption. This gives a nuanced framework towards establishing empirically validated framework which will motivate healthcare services providers to be motivated to adopt and implement IoT enabled care delivery. The physician patient interaction and alignment during decision making will foster positive word of mouth, superior care service and reduce extra overheads for healthcare providers without compromise or rather with increment in service delivery proposition.

The study theoretically and empirically describes that with the adoption of internet of things (IoT) devices in health care, better services can be provided to patients by using partial least square – structure equation modelling-based robust technique and explains the better understanding of the health-care process with the help of information pervasiveness, physician-patient orientation and improved patient and physician involvement in the decision-making process.

This study shows that wearable IoT device adoption in health-care service delivery opens new opportunities and disrupts the conventional and traditional way of health-care service delivery by empowering the patient to take part in decision-making and enhancing their engagement in health-care service delivery.

The study might influence by generalizability. Perception-based cross-examination knowledge from the patient’s perspective. It is likely that patients who use these devices will grow accustomed to using them and become more capable of using them. Thus, time-series tests have not been used to catch enhanced skills. New patients’ experiences will be altered over time. Regardless, non-response bias and traditional process bias received excessive interest.

The study aims at unravelling how the adoption of IoT enabled practices and usage of IoT devices bolsters the available data points in the context of healthcare especially with respect to patient care delivery. The study conceptualizes and empirically validates how the usage of IoT interface enabled technology enables better patient treatment and caregiver participation. The study puts forth a nuanced understanding regarding how pervasively available ubiquitous care information fosters shared decision making. This study further emphasizes that importance of ensuring a reliable computing environment devoid of privacy and security risks. The study attempts at Emphasizing empirically how the enhanced information pervasiveness catapults the patient-provider interactions, through health data exchange. Highlighting the importance of search feature in cloud storage and recovery mechanisms. The study not only fulfills the overarching linkage between enhanced service engagement with IoT adoption, it provides a mental map and ready to refer framework for hospital and healthcare experts to refer to, which prescribes thar care providers must build new methods aimed at empowerment of patients to participate and take more inclusive role. This unique confluence between patients and physicians will unravel the sync; helping not only avoid costly decision errors, but also improve patient care delivery environment. Patients should be permitted to participate in decision-making,inspire patients to be participatory.

The study efforts to empirically investigate and discover the link between how wearable sensor-based IoT enhances health-care service engagement is underway. Using primary data this linkage validation allows the community and readers at large to gain a nuanced understanding of how superior interaction is enabled by a digital-health-care process with the help of IoT-enabled information pervasiveness, physician-patient orientation and empowered involvement.

The structure of health care financing, the lack of vertical and horizontal integration, and the slow translation of basic research into meaningful health outcomes for the population conspire to make innovation in health service delivery a difficult task. However, health service organizations that can more effectively and systematically understand patient needs – needs that are now poorly understood and often unarticulated – have an intrinsic advantage in delivering high value care. This ‐paper aims to describe a program for translating those needs into health services innovations.

The Mayo Clinic, a large integrated multispecialty medical group based in Rochester, Minnesota developed an in‐house design program, the SPARC Innovation Program, to bring design thinking and business analysis together to develop innovations in care delivery. A project example is described to illustrate how designers, business strategists, health care professionals, and patients create new high‐value health care experiences.

The paper finds that health service organizations need to pay more attention to the patient experience if they are to meet patient needs. The design program described here is one approach that organizations can take if they are serious about deeply understanding patient needs and developing innovations to address them.

While the discipline of design is the core of innovation in many industries, it is not widely known or practiced in health service organizations despite a natural affinity between design and medicine. Understanding and employing the power of design in health services will allow medical institutions to develop more effective health services, enhance patient satisfaction, and meet important human needs.

The purpose of this study is to assess the relationship between patient-centricity, care coordination and delivery of quality care for older people with multiple chronic conditions. Care coordination is defined as a process where physicians, nurses and allied professionals work together to clarify responsibilities, care objectives, treatment plans and discharge plans for delivery of unified care. Patient-centricity is defined as an approach of delivering quality care to patients that focuses on creating a positive experience for them.

A literature review was used to identify measures of care coordination and then partial least square structural equation modeling was used to assess interrelationship among patient-centricity, measures of care coordination and delivery of quality care.

Results reveal that care coordinated pathways consist of IT-enabled coordination, interprofessional teamwork, information sharing and facilitative infrastructure requirements and are influenced by patient-centricity. These are deliberate requisites for delivering of quality care. Results of this study present a validated model of care coordination for older people, which may be further explored to refine the concept of care coordination.

Based on these results, practitioners may develop an overarching strategy to deliver seamless care and to achieve better health outcomes. Measures of care coordination may be used as a performance benchmarking tool and will also help in the process mapping of hospitals.

This paper highlights how patient-centricity may be achieved by focusing on coordinated care processes. This understanding may help in designing processes, which in turn deliver health as a social good in an effective manner.

Results of this study present such a validated model for care coordination, which can be used by researchers.

The supply chain concept aided marketing by highlighting relationships that form a network of firms creating products for consumers. It helped change the focus from individual transactions to a more comprehensive view of the entire system. The value chain concept in marketing extends the supply chain view in an important way: it explicates the value that is created at each stage of the chain. For marketers, it is a vital tool in satisfying consumers – the final part of the value chain. This value chain can be viewed as having two components: the value delivery system and the consumer. This paper explores several approaches to value that are important in the functioning of the value chain. It then delineates three main elements of the value chain and traces them as they apply to services. It then focuses on one of the more complex services, the health care delivery system. It goes on to describe the health care value network and examine the critical factors that affect the success of the health care process. Finally, it delineates several important implications for health care marketers.

Various attempts have been made to understand and resolve the enduring lack of cohesiveness of multidisciplinary teams (MDTs), their dysfunctional service delivery and the feelings of distress among some of the professionals who work in them. Distortions in forensic MDTs have sometimes compromised service delivery and effective risk management. Several public inquiries relating to high‐profile incidents in forensic mental health have noted the role of dysfunctional MDTs. This paper describes the philosophy, structure, functions and achievements of a forensic community MDT in Wellington, New Zealand. It explains a model of care that is adaptable, comprehensive, effective and evidence‐based. It highlights the role of the extended MDT and embedded cultural units from which care professionals work together, share a common philosophy of care and tailor their care to the needs of the individuals or populations they serve.

Purpose – This chapter explores the use of adaptive and disruptive change strategies to create an integrated health care delivery system that is both economically sustainable and patient-centered.

Design/methodology – This case study of Montefiore Medical Center is based on a year of research that included focus-group interviews; individual interviews with executives, frontline staff, and union leaders; site visits; analysis of internal data; and a literature review.

Findings – Montefiore Medical Center is using both adaptive and disruptive strategies to develop an integrated delivery system driven by capitated payments from health insurance companies, a focus on primary care and chronic disease management programs, and community outreach. The growth of these delivery system components in conjunction with Montefiore's Care Management Corporation (to help manage the health plan contracts) has contributed to an affordable cost of care, improved clinical outcomes, and proactive patient and community engagement.

Originality and value – There is a paucity of case studies describing how safety-net hospitals – and health systems in general – can integrate the services they provide to create a positive, seamless, and economical patient experience. The story of Montefiore Medical Center offers an overview of how health care infrastructure and payment methods can be transformed to align financial and clinical incentives and to better serve a patient population that largely depends on government health insurance.

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.

Considering the increasing conceptualization of value creation, this paper aims to empirically examine the influence of pre-encounter value needs of patients on the clinical encounter process and how this impacts on their perceived experiential value, and contributes to the patient’s role in value creation in healthcare service delivery.

A model is proposed to suggest the antecedent and consequences of key elements of the patient–doctor encounter process. Following survey design approach, data collected from 332 outpatients from two clinics in Accra, Ghana, are examined through structural equation modeling using AMOS 23.0.

The findings reveal that patient pre-encounter value needs significantly influence key elements of the patient–doctor encounter process (care delivery approach, level of trust and shared-decision making approach). This in turn affects patient’s perceived experiential value and satisfaction evaluation. The results also suggest that patient characteristics (e.g. educational background and frequency of visit) had no significant effect on the encounter process leading to perceived experiential value; however, patient’s age had significant influence on the encounter process.

This study empirically establishes a need to understand patient’s pre-encounter value needs, which fundamentally influence the patient-doctor encounter process and their perceived experiential value. However, the research only focused on the patient, which could limit the findings considering the multi-actors involved in the service delivery.

Creating value with patients suggests a need for providers to understand patient value needs or goals and adopt an approach to engage in a holistic manner that would result in positive experiences. This would empower and increase confidence of patients in consultations.

Using a quantitative research approach, this research engages in a highly focused investigation of the influence of patient’s pre-encounter value needs on key elements of the patient–doctor encounter process, which has received limited attention in the extant literature. The study also furthers our understanding of the effects of fundamental patient characteristics on encounter process and how this influence actor perceived experiential value.