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With the advent of the internet café, chat sessions, instant messengers, special interest e‐groups and now blogs, people do not need to be physically close together to exchange their ideas. The participants can have shared experiences that are instantaneous and pretty much of the same nature that is usually realized by the traditional collection of special interest people in close proximity. The members of these virtual communities share their knowledge, cooperate with each other to solve problems, and feel responsibility for each other. Internet based technologies have been the great enablers of virtual communities. In the high‐involvement healthcare sector, patients are increasingly seeking online advice and information by participating in virtual communities. The purpose of this paper is to understand the process of consumer value creation in virtual communities.

This paper first adopts Cothrel's framework for the creation of value in virtual communities followed by an application of Kozinets' segmentation model of online consumers to explore the process of consumer value creation by a healthcare virtual community. “Netnography” was used as the research technique for this study. Netnography is an ethnographic research method adapted to the online environment. Discourse analysis is applied to interpret the huge volume of online postings.

The paper identifies four segments of virtual community users – tourists, minglers, devotees, and insiders, and studies their online activities and discussion topics to demonstrate their differential roles as members of healthcare virtual communities.

Most of the earlier works that are focused on virtual communities have been conducted at the conceptual level. In this paper a priori user segments in healthcare virtual communities are empirically profiled. Based on the findings, managerial implications for healthcare virtual communities are formulated.

This paper seeks to understand relationships between prison healthcare and integrated care systems (ICS), including how these affect the delivery of new healthcare interventions. It also aims to understand how closer integration between prison and ICS could improve cross system working between community and prison healthcare teams, and highlights challenges that exist to integration between prison healthcare and ICS.

The study uses evidence from research on the implementation of a pilot study to establish telemedicine secondary care appointments between prisons and an acute trust in one English region (a cross-system intervention). Qualitative interview data were collected from prison (n = 12) and community (n = 8) healthcare staff related to the experience of implementing a cross-system telemedicine initiative. Thematic analysis was undertaken on interview data, guided by an implementation theory and framework.

The research found four main themes related to the closer integration between prison healthcare and ICS: (1) Recognition of prison health as a priority; (2) Finding a way to reconcile networks and finances between community and prison commissioning; (3) Awareness of prison service influence on NHS healthcare planning and delivery; and (4) Shared investment in prison health can lead to benefits.

This is the first article to provide research evidence to support or challenge the integration of specialist health and justice (H&J) commissioning into local population health.

The devastating 2014 Ebola outbreak caused human and economic loss, but it also resulted in remarkable improvement in healthcare leadership. The impact is most evident in the affected West African countries of Guinea, Liberia and Sierra Leone. In this chapter, the Ebola experience is used as a framework to explore the essential elements of healthcare leadership, with particular attention to healthcare crises in under-resourced communities. Overall, healthcare leadership presents unique challenges. In common with leaders of other industries, healthcare leaders must inspire others, create a sense of purpose, make difficult decisions and collaborate with a range of people. But, because their focus is on complex systems that aim to improve people's physical and mental well-being, expectations of healthcare leaders are especially high. Their work can be a matter of life or death. For the leader in an under-resourced area, the challenge and expectations are even higher, particularly in the face of new or emerging health threats. The key to effective healthcare leadership is systems thinking which involves looking at the entire system of care as an integrated whole, rather than discrete parts that operate in isolation. Healthcare leaders must understand that health means mobilizing multisectoral knowledge and resources and applying innovative and multiactor approaches to prevent, detect and address health problems. Since the 2014 Ebola crisis, healthcare leaders are increasingly using a systems approach by looking at the culture of health systems, the impact of diseases locally and globally, and the applicability of health interventions in different environments. In the post-Ebola era, steps to strengthen the healthcare system are described which includes the roles of healthcare leaders. These steps include deployment of field epidemiologists and community health agents, community education and fuller use of the One Health Platform, which allows actors from different sectors (human health, animal health and environmental health) to collaborate. Finally, suggestions for healthcare leadership training are offered.

This study explores nurses' views as to whether they see community pharmacists as “entrepreneurial” and what this might mean for working together in primary care. Pharmacists are expected to fully integrate with their colleagues – particularly nurses – under the New Zealand health policy. Yet, there is scarce literature that examines multidisciplinary teamwork and integration through an entrepreneurial identity lens. This is particularly important since around the world, including New Zealand, community pharmacies are small businesses.

This was an exploratory qualitative study. A total of 18 semi-structured interviews were conducted with nurses from primary care, nursing professional bodies and academics from nursing schools. Interviews were audio recorded and transcribed verbatim. Coding was undertaken through general inductive thematic analysis.

In total three key themes emerged through analysis: the entrepreneurial profile of the community pharmacist, the lack of entrepreneurship across the profession, and the role identity and value that community pharmacists hold, as viewed by nurses. There appeared to be pockets of entrepreneurship in community pharmacy; nurses did not express a blanket label of entrepreneurship across the whole sector. Nurses also discussed several forms of entrepreneurship including commercial-oriented, clinical and social entrepreneurship. The social entrepreneurship identity of community pharmacists sat most comfortably with nurse participants. Overall, nurses appeared to value community pharmacists but felt that they did not fully understand the roles that this profession took on.

This paper contributes to the academic literature by identifying three domains of entrepreneurship relevant to community pharmacy as well as multi-level barriers that will need to be jointly tackled by professional bodies and policy-makers. Improving nurses' and other healthcare professionals' knowledge of community pharmacists' role and expertise is also likely to facilitate better inter-professional integration.

There is scarce literature that attempts to understand how entrepreneurial identity plays out in health organisation and management. This study adds to the knowledge base of factors influencing integration in healthcare.

Despite many calls to strengthen connections between health systems and communities as a way to improve primary healthcare, little is known about how new collaborations can effectively alter service provision. The purpose of this paper is to explore how a health authority, municipal leaders and physicians worked together in the process of transforming primary healthcare.

A longitudinal qualitative case study was conducted to explore the processes of change at the regional level and within seven communities across Northern British Columbia (BC), Canada. Over three years, 239 interviews were conducted with physicians, municipal leaders, health authority clinicians and leaders and other health and social service providers. Interviews and contextual documents were analyzed and interpreted to articulate how ongoing transformation has occurred.

Four overall strategies with nine approaches were apparent. The strategies were partnering for innovation, keeping the focus on people in communities, taking advantage of opportunities for change and encouraging experimentation while managing risk. The strategies have bumped the existing system out of the status quo and are achieving transformation. Key components have been a commitment to a clear end-in-view, a focus on patients, families, and communities, and acting together over time.

This study illuminates how partnering for primary healthcare transformation is messy and complicated but can create a foundation for whole system change.

The purpose of this paper is to examine women homeworkers' access to healthcare services in Thailand. Specifically, it focuses on how the state's universal healthcare service, introduced in the year 2002, has responded/not responded to the needs of poor women homeworkers in Bangkok.

Data collection was done through a structured questionnaire with 415 women homeworkers from 16 districts in Bangkok, Thailand, ten in‐depth interviews and 13 group discussions.

It was found that less than half of the women homeworker respondents accessed the universal healthcare scheme. The obstacles for access include both financial (transportation cost, loss of wage) and time. Also, homeworkers need support from the community/household to access these services. Universal health services itself is not enough to ensure access to healthcare service, especially among poor and minimally educated homeworkers with small children.

The research showed the need to have multiple approaches (state‐provided services and community organizing, as well as awareness among men about their role in care work), in order to ensure universal healthcare coverage.

Universal healthcare services are considered the best way to extend healthcare services to workers in the informal economy. This paper argues that total dependence on state‐provided services does not ensure universal healthcare coverage. There is a need for additional community‐based support mechanisms to ensure access to these services.

The purpose of this paper is to develop a framework investigating patterns of online health communities. In particular, the study draws on coordination theory to identify four community configurations. Their distinct features determine communities’ capacity to internalize and externalize knowledge, which ultimately determines their value creation in a service context.

The authors apply qualitative and quantitative techniques to detect similarities and differences in a sample of 50 online health communities. A categorical principal component analysis combined with cluster analysis reveals four distinct community configurations.

The analysis reveals differences in the degrees of cognitive and affective value creation, the types of community activities, the involved patients, professionals, and other stakeholders; and the levels of data disclosure by community members. Four community configurations emerge: basic information provider, advanced patient knowledge aggregator, systematic networked innovator, and uncomplicated idea sharer.

The findings show that communities can be categorized along two knowledge creation dimensions: knowledge externalization and knowledge internalization. While, previous research remained inconclusive regarding the synergistic or conflicting nature of cognitive and affective value creation, the findings demonstrate that cognitive value creation is an enabler for affective value creation. The emerging configurations offer a classification scheme for online communities and a basis for interpreting findings of future services research in the context of online health communities.

This research combines coordination theory with healthcare, service, and knowledge creation literature to provide a fine-grained picture of the components of online health communities. Thereby, inherent trade-offs and conflicts that characterize the components of coordination theory are investigated.

The implementation of mobile health (mHealth) in developing countries seems to be stuck in a pattern of successive pilot studies that struggle for mainstream implementation. This study addresses the research question: what existing health-related structures, properties and practices are presented by rural areas of developing countries that might inhibit the implementation of mHealth initiatives?

This study was conducted using a socio-material approach, based on an exploratory case study in West Africa. Interviews and participant observation were used to gather data. A thematic analysis identified important social and material agencies, practices and imbrications which may limit the effectiveness of mHealth apps in the region.

Findings show that, while urban healthcare is highly structured, best practice-led, rural healthcare relies on peer-based knowledge sharing, and community support. This has implications for the enacted materiality of mobile technologies. While urban actors see mHealth as a tool for automation and the enforcement of responsible healthcare best practice, rural actors see mHealth as a tool for greater interconnectivity and independent, decentralised care.

This study has two significant limitations. First, the study focussed on a region where technology-enabled guideline-driven treatment is the main mHealth concern. Second, consistent with the exploratory nature of this study, the qualitative methodology and the single-case design, the study makes no claim to statistical generalisability.

To the authors' knowledge, this is the first study to adopt a socio-material view that considers existing structures and practices that may influence the widespread adoption and assimilation of a new mHealth app. This helps identify contextual challenges that are limiting the potential of mHealth to improve outcomes in rural areas of developing countries.

The purpose of this paper is to identify the factors influencing the growth of healthcare virtual communities of practice (VCoPs) through a seven-year longitudinal study conducted using metrics from social-network and semantic analysis. By studying online communication along the three dimensions of social interactions (connectivity, interactivity and language use), the authors aim to provide VCoP managers with valuable insights to improve the success of their communities.

Communications over a period of seven years (April 2008 to April 2015) and between 14,000 members of 16 different healthcare VCoPs coexisting on the same web platform were analysed. Multilevel regression models were used to reveal the main determinants of community growth over time. Independent variables were derived from social network and semantic analysis measures.

Results show that structural and content-based variables predict the growth of the community. Progressively, more people will join a community if its structure is more centralised, leaders are more dynamic (they rotate more) and the language used in the posts is less complex.

The available data set included one Web platform and a limited number of control variables. To consolidate the findings of the present study, the experiment should be replicated on other healthcare VCoPs.

The study provides useful recommendations for setting up and nurturing the growth of professional communities, considering, at the same time, the interaction patterns among the community members, the dynamic evolution of these interactions and the use of language. New analytical tools are presented, together with the use of innovative interaction metrics, that can significantly influence community growth, such as rotating leadership.