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Service ecosystems are gaining credence among management scholars. However, there is still little agreement about the distinguishing attributes of service ecosystems in both the public and the private sectors. The purpose of this paper is to focus on the health care service system, suggesting a “recipe” for the implementation of a sustainable and innovative health care service ecosystem.

A mixed methodology was used. First, a critical literature review was conducted to lay the conceptual foundations of this study. Then a theory about the institutional, organizational and managerial requisites for the implementation of a health care service ecosystem was developed.

The health care sector is appropriate for the core tenets of the service ecosystem perspective. Tailored interventions aimed at improving the functioning of the health care service ecosystem should be implemented at the micro, meso, macro and mega levels. Patient empowerment, patient-centered care and integrated care are the fundamental ingredients of the recipe for effective health care service ecosystems.

The ecosystem approach provides health policy makers with interesting insights to help shape the health care service system of the future. The paper also contributes to the innovation of managerial practices emphasizing the role of patient involvement in the design and delivery of health care.

This is one of the first attempts to systematize scientific knowledge about service ecosystems in the health care sector. An agenda for further research is suggested, in order to further advance the establishment of an effective and innovative health care service ecosystem.

The purpose of this paper is to investigate how and why some service ecosystems are more resilient and, consequently, more sustainable than others during turbulent times, and how resilience can be cultivated to enable pathways to service ecosystem sustainability.

This work integrates disparate literature from multiple service and sustainability literature streams, iterating through constant comparison with findings from 44 semistructured interviews conducted in the context of primary health care clinic service ecosystems.

The authors offer a novel conceptual framework comprising pillars (shared worldview, individual actor well-being and multiactor interactions), changing practices to cultivate resilience through resilience levers (orchestrators, individual actor effort, actor inclusivity and digitaltech–humanness approach), and pathways to service ecosystem sustainability (volume vs value, volume to value, volume and value). The authors demonstrate that service ecosystems need to change practices, integrating resources differently in response to the turbulent environment, emphasizing the importance of a shared worldview across the ecosystem and assessing different pathways to sustainability.

This paper offers new insights into the important intersection of service marketing, sustainability and health care. The authors provide guidance to practitioners aiming to cultivate resilience in service ecosystems to achieve pathways to sustainability in primary health care clinics. Finally, implications for theory are discussed, and directions to guide future service research offered.

This paper aims to investigate the eHealth ecosystem’s evolution during the coronavirus disease 2019 (COVID-19) pandemic and its effects on the progression of care for patients with chronic cardiovascular disease.

To attain the aim of the study, this study chose to adopt a qualitative method that matches the complexity of the issue. The study was conducted in a real context through 44 face-to-face semi-structured interviews of key informants at different levels of the Italian eHealth service ecosystem, via Microsoft Teams. The interviews were carried out from June 2020 to January 2021. In this research, we adopted an abductive approach that enabled a process where the theoretical framework and the data analysis evolved at the same time.

The study results were used to develop a conceptual framework that considers the key factors enabling and constraining the evolutionary process of the eHealth service ecosystem. In particular, the drivers that emerged from the study were actor role empowerment, actor–network engagement and resource reconfiguration while the inhibitors were inter- and intra-actor misalignment, resource myopia and the platformisation gap. The findings also revealed the pivotal role of the meso level in the development of the eHealth service ecosystem, boosted by the COVID-19 pandemic.

By adopting a service ecosystem perspective, this paper contributes, at both a theoretical and a managerial level, to a better understanding of the dynamics related to the diffusion of eHealth. The study identifies the main issues that researchers, managers and policymakers should address to support the evolution of the eHealth service ecosystem, with particular regard to chronic cardiovascular disease.

The rise of telehealth is evident worldwide, especially now with the COVID-19 pandemic situation, and is providing extensive opportunities for health-care organisations to create added value for different stakeholders. However, even in this extreme situation, the progress of telehealth is quite slow and insufficient. In this context, it is necessary to consider how the application of telehealth services allows co-creating additional value for different stakeholders. Consequently, the purpose of this paper is to explore telehealth services and the added value that they co-create for various stakeholders across publicly and privately oriented health-care ecosystems.

This paper adopted a qualitative research design based on an explorative and comparative approach to study the perceived added value that is co-created during telehealth encounters. The authors deployed a semi-structured interview research design. Interviews were carried out in two settings that have different health-care systems: Lithuania (publicly oriented health care) and the California Bay Area, USA, (privately oriented health care). The research covers telehealth services from the point of view of different stakeholders in the health-care ecosystem.

The paper emphasises that value-in-use is essential in the case of telehealth; however, value-in-exchange is relevant to describe the relationships between public and private insurers and health-care providers. The findings point out that despite the type of health-care system, telehealth added value-in-use was perceived quite similar in both research settings, and differences could be distinguished mainly at the sub-dimensional level. The added value-in-use for patients comprises economic, functional and emotional value; physicians potentially get functional added value-in-use. The authors also highlight that patients and physicians get relational functional and social value-in-use. The added value-in-use for health-care providers consists of economic (in both research settings) and functional value (in Lithuania). The research findings show that there is still an evident lack of health insurance companies ready to recognise telehealth as a valuable service and to reimburse similarly to in cases of in-person visits. Thus, the added value-in-exchange is hardly created and this impedes co-creation of the added value-in-use.

This paper contributes to the field mainly by transferring the business research applied concept of value co-creation into the social-purpose driven health-care industry. The findings are beneficial for the health-care management stream of the literature, which considers health care as a value-based industry. To the best of the authors’ knowledge, this is the first attempt to structure the perceived telehealth added value from the perspectives of different stakeholders and two different health-care ecosystems. This paper also gives a clearer understanding of the role of the value-in-exchange in such complex ecosystems as health care and gives reasons when it could be created in synergy with co-creation of the value-in-use. In this sense, the findings are beneficial from both marketing and innovation theoretical perspectives, as they give a special attention to value creation and co-creation phenomena analysis.

In Japan, health-care systems have long been supported by physicians' long working hours. To solve this problem, there is an urgent need to improve the working environment for physicians while practicing patient-centered medicine and controlling health-care costs. This paper aims to examine the effect of task shifting to nurses and discuss its usefulness from the perspective of health-care value co-creation.

This paper analyzes task shifting to nurses in acute care hospitals in Japan as a solution for the shortage of anesthesiologists. The authors discuss how the value was created from the perspective of the health-care ecosystem, with conceptual consideration of the value co-creation mechanism through patient-centered practices.

The study showed that task shifting initiatives in Japan can improve the motivation of nurses through human resource development while maintaining high quality. The study also suggested that task shifting from physicians to nurses may contribute to improving net income and maintaining the health-care system.

The findings are highly reproducible and can be immediately applied to initiatives at other medical institutions in Japan. Furthermore, it is suggested that these findings might provide some perspective on the realignment of fragmented healthcare in the USA.

It was confirmed in practical terms that micro-level initiatives have an impact on the macro level as well. In addition, the academic presentation of the concept has contributed to the deepening of value research.

Covid has increased the usage of multisided digital platforms. For companies, this has become a business opportunity. Data usage on platforms requires that platform companies co-create services for common customers. In this case, the target is not to make the same value proposition but rather to use the resources such as data, knowledge, technology, or institutions in a complementary manner. Platforms are characterized as a combination of hardware and software including standards, interfaces, and rules making it possible for different ecosystem players to complement and interact in the ecosystem. Current ecosystems include several platforms that do not work without resource integration. The purpose of this study is to increase understanding what do we mean by resource complementarity in service ecosystems.

This study was done via an in-depth qualitative case study in which a health service ecosystem co-creating technological surgery innovation was used as a unit of analysis.

The authors’ findings suggest that key resource capabilities, to enable complementarity in service ecosystems, are motivation, knowledge, skills, data and complementary designed technology components.

The authors’ study increases theoretical understanding of what does one mean by construct of resource complementarity.

From a managerial perspective, it is shown that organizations need to develop adaptive capabilities to utilize internal and external competencies and resources and enable co-creative processes within the service ecosystem.

Very few empirical studies in the marketing literature have focused on multi-sided digital platforms and their resource complementarity in the data-driven healthcare ecosystem settings.

Following the continued development of transformative service research and the prevalence of the service-dominant logic in services marketing literature, increased scholarly interest centers on the co-creation of service actors’ well-being. In light of this significant evolution in service research, this study aims to provide a systematic review and synthesis of the growing, fragmented body of literature on well-being co-creation in services.

The hybrid systematic review approach combines bibliometric and framework-based literature reviews to analyze a sample of 160 article obtained from the Web of Science database. To examine the conceptual structure of the research domain, VOSviewer is used for conducting a bibliometric coupling analysis and a keyword co-occurrence analysis. Next, a content analysis is used to explore how the extant literature addresses the key concepts of service actors’ participation in co-creation, their resource integration and well-being outcomes across the micro-, meso- and macro levels of service ecosystems.

Service actors’ participation and resource integration are key theoretical concepts for understanding well-being co-creation. Yet, a comprehensive overview of well-being co-creation across the different levels of service ecosystems is lacking due to the presence of various application contexts, levels of aggregation, theoretical backgrounds and methodological perspectives. A conceptual framework of well-being co-creation in service ecosystems is developed, highlighting the participation of multilevel service actors and suggesting priorities for further research.

To the best of the author’s knowledge, this paper represents a first effort to systematically review and organize growing literature on well-being co-creation in service ecosystems.

Despite having inadequate resources, highly impoverished patients tend to seek and share health information over social media groups to improve each other’s well-being. This study aims to focus on access to health-care information for such patients and aims to provide an understanding of how online health-care communities (OHCs), as transformative service mediators, can be platforms for patients with chronic and nonchronic health conditions to share their experiences in a base-of-the-pyramid (BOP) context.

A large-scale survey among 658 respondents was conducted in a very low-income country. Structural equation modeling was used to test the hypotheses.

A model of patients’ experience sharing (PES), motivations and consequences for health-care services are introduced and tested. The result supports the PES model for patients with chronic health conditions, showing that utilitarian, hedonic and social value dimensions directly influence PES and indirectly influence patients’ continuance intention with OHCs and patient efforts. However, a mediating effect of PES was found only between the value dimensions and patients’ efforts. A negative moderation effect of medical mistrust was found in the relationship between utilitarian value and PES for both chronic and nonchronic patient groups.

This study is a pioneering attempt to develop and test a PES model in a BOP market.

Emerging transformative service research (TSR) studies adopt a service system lens to conceptualise well-being across the micro, meso and macro levels of aggregation, typically within an organisation. No TSR has yet examined well-being across multiple interconnected organisations at the highest level of aggregation, the meta or service ecosystem level. This study aims to explore how value co-creation and, critically, co-destruction among different actors across interacting organisations enhances or destroys multiple levels of well-being.

This study uses semi-structured, in-depth interviews to collect data from five types of key actors (n = 35): players, team owners, tournament operations managers, casters and viewers, across 29 interconnected organisations in the oceanic esports industry. The interviews were coded using NVivo 12 and thematically analysed.

Resource integration on each level of aggregation within a service ecosystem (micro, meso, macro and meta) can co-create and co-destroy value, which leads to the enhancement and destruction of multiple levels of well-being (individual, collective, service system and service ecosystem). Value co-creation and co-destruction, as well as the resultant well-being outcomes, were interconnected across the different levels within the service ecosystem.

To the best of the authors’ knowledge, this research is the first to incorporate a multi-actor perspective on the well-being consequences of value co-creation and value co-destruction within a service ecosystem as opposed to service system. Thus, this research also contributes to the minimal research which examines the outcomes of value co-destruction, rather than value co-creation, at multiple levels of aggregation.

The purpose of this paper is to examine the role of institutions and institutional complexity in the process through which resources-in-context get their “resourceness.”

To shed light on the process of potential resources gaining their “resourceness,” the authors draw from two streams of literature: the service ecosystems perspective and institutional theory.

The authors combine the process of resources “becoming” with the concept of institutions and conceptualize institutional arrangements, and the unique sets of practices, symbols and organizing principles they carry, as the sense-making frames of the “resourceness” of potential resources. In service ecosystems, numerous partially conflicting institutional arrangements co-exit and provide actors with alternative frames of sense-making and action, enabling the emergence of new instances of “resourceness”.

The paper suggests that “resourceness” is inseparable from the complex institutional context in which it arises. This conceptualization reveals the need for more holistic, systemic and multidisciplinary perspectives on understanding the implications of the process of resources “becoming” on value co creation, innovation and market formation.

As the “resourceness” of potential resources arises due to the influence of institutions, managers need a more profound understanding of the complimentary and inhibiting institutional arrangements and the related practices, symbols and organizing principles that comprise the multidimensional context in which they operate.

This paper is one of the first to focus specifically on the process of resources “becoming,” using a systemic and institutional perspective to grasp the complexity of the phenomenon.