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Article
Publication date: 25 February 2019

Debbie Isobel Keeling, Ko de Ruyter, Sahar Mousavi and Angus Laing

Policymakers push online health services delivery, relying on consumers to independently engage with online services. Yet, a growing cluster of vulnerable patients do not…

Abstract

Purpose

Policymakers push online health services delivery, relying on consumers to independently engage with online services. Yet, a growing cluster of vulnerable patients do not engage with or disengage from these innovative services. There is a need to understand how to resolve the tension between the push of online health service provision and unengagement by a contingent of health-care consumers. Thus, this study aims to explore the issue of digital unengagement (DU) (i.e. the active or passive choice to engage or disengage) with online health services to better inform service design aligned to actual consumer need.

Design/methodology/approach

Adopting a survey methodology, a group of 486 health services consumers with a self-declared (acute or chronic) condition were identified. Of this group, 110 consumers were classified as digitally unengaged and invited to write open-ended narratives about their unengagement with online health services. As a robustness check, these drivers were contrasted with the drivers identified by a group of digitally engaged consumers with a self-declared condition (n = 376).

Findings

DU is conceptualized, and four levels of DU drivers are identified. These levels represent families of interrelated drivers that in combination shape DU: subjective incompatibility (misalignment of online services with need, lifestyle and alternative services); enactment vulnerability (personal vulnerabilities around control, comprehension and emotional management of online services); sharing essentiality (centrality of face-to-face co-creation opportunities plus conflicting social dependencies); and strategic scepticism (scepticism of the strategic value of online services). Identified challenges at each level are the mechanisms through which drivers impact on DU. These DU drivers are distinct from those of the digitally engaged group.

Research limitations/implications

Adding to a nascent but growing literature on consumer unengagement, and complementing the engagement literature, the authors conceptualize DU, positioning it as distinct from, not simply a lack of, consumer engagement. The authors explore the drivers of DU to provide insight into how DU occurs. Encapsulating the dynamic nature of DU, these drivers map the building blocks that could help to address the issue of aligning the push of online service provision with the pull from consumers.

Practical implications

This paper offers insights on how to encourage consumers to engage with online health services by uncovering the drivers of DU that, typically, are hidden from service designers and providers impacting provision and uptake.

Social implications

There is a concern that there will be an unintentional disenfranchisement of vulnerable segments of society with a generic policy emphasis on pushing online services. The paper sheds light on the unforeseen personal and social issues that lead to disenfranchisement by giving voice to digitally unengaged consumers with online health services.

Originality/value

Offering a novel view from a hard-to-reach digitally unengaged group, the conceptualization of DU, identified drivers and challenges inform policymakers and practitioners on how to facilitate online health service (re)engagement and prevent marginalization of segments of society.

Details

European Journal of Marketing, vol. 53 no. 9
Type: Research Article
ISSN: 0309-0566

Keywords

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Article
Publication date: 27 November 2017

Debbie Isobel Keeling, Angus Laing and Ko De Ruyter

The purpose of this paper is to focus on the changing nature of healthcare service encounters by studying the phenomenon of triadic engagement incorporating interactions…

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Abstract

Purpose

The purpose of this paper is to focus on the changing nature of healthcare service encounters by studying the phenomenon of triadic engagement incorporating interactions between patients, local and virtual networks and healthcare professionals.

Design/methodology/approach

An 18-month longitudinal ethnographic study documents interactions in naturally occurring healthcare consultations. Professionals (n=13) and patients (n=24) within primary and secondary care units were recruited. Analysis of observations, field notes and interviews provides an integrated picture of triadic engagement.

Findings

Triadic engagement is conceptualised against a two-level framework. First, the structure of triadic consultations is identified in terms of the human voice, virtual voice and networked voice. These are related to: companions’ contributions to discussions and the virtual network impact. Second, evolving roles are mapped to three phases of transformation: enhancement; empowerment; emancipation. Triadic engagement varied across conditions.

Research limitations/implications

These changing roles and structures evidence an increasing emphasis on the responsible consumer and patients/companions to utilise information/support in making health-related decisions. The nature and role of third voices requires clear delineation.

Practical implications

Structures of consultations should be rethought around the diversity of patient/companion behaviours and expectations as patients undertake self-service activities. Implications for policy and practice are: the parallel set of local/virtual informational and service activities; a network orientation to healthcare; tailoring of support resources/guides for professionals and third parties to inform support practices.

Originality/value

Contributions are made to understanding triadic engagement and forwarding the agenda on patient-centred care. Longitudinal illumination of consultations is offered through an exceptional level of access to observe consultations.

Details

Journal of Service Management, vol. 29 no. 3
Type: Research Article
ISSN: 1757-5818

Keywords

Open Access
Article
Publication date: 2 August 2018

Tim Hilken, Jonas Heller, Mathew Chylinski, Debbie Isobel Keeling, Dominik Mahr and Ko de Ruyter

This paper aims to explore the current and future roles of augmented reality (AR) as an enabler of omnichannel experiences across the customer journey. To advance the…

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16489

Abstract

Purpose

This paper aims to explore the current and future roles of augmented reality (AR) as an enabler of omnichannel experiences across the customer journey. To advance the conceptual understanding and managerial exploitation of AR, the paper aims to synthesise current research, illustrating how a variety of current applications merge online and offline experiences, and provides a future research agenda to help advance the state of the art in AR.

Design/methodology/approach

Drawing on situated cognition theorising as a guiding framework, the paper reviews previously published research and currently deployed applications to provide a roadmap for future research efforts on AR-enabled omnichannel experiences across the customer journey.

Findings

AR offers myriad opportunities to provide customers with a seamless omnichannel journey, smoothing current obstacles, through a unique combination of embedded, embodied and extended customer experiences. These three principles constitute the overarching value drivers of AR and offer coherent, theory-driven organising principles for managers and researchers alike.

Originality/value

Current research has yet to provide a relevant, conceptually robust understanding of AR-enabled customer experiences. In light of the rapid development and widespread deployment of the technology, this paper provides an urgently needed framework for guiding the development of AR in an omnichannel context.

Details

Journal of Research in Interactive Marketing, vol. 12 no. 4
Type: Research Article
ISSN: 2040-7122

Keywords

Abstract

Details

European Journal of Marketing, vol. 52 no. 11
Type: Research Article
ISSN: 0309-0566

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