Search results

The purpose of this paper is to understand value cocreation in service ecosystems from a multilevel perspective, uncovering value cocreation factors and outcomes at the micro, meso, and macro levels.

A Grounded Theory approach based on semi-structured interviews is adopted. The sample design was defined to enable the ecosystem analysis at its different levels. At the macro level was the Portuguese Health Information ecosystem. Embedded meso level units of analysis comprised eight health care organizations. A total of 48 interviews with citizens and health care practitioners were conducted at the micro level.

Study results enable a detailed understanding of the nature and dynamics of value cocreation in service ecosystems from a multilevel perspective. First, value cocreation factors are identified (resource access, resource sharing, resource recombination, resource monitoring, and governance/institutions generation). These factors enable actors to integrate resources in multiple dynamic interactions to cocreate value outcomes, which involve both population well-being and ecosystem viability. Study results show that these value cocreation factors and outcomes differ across levels, but they are also embedded and interdependent.

The findings have important implications for organizations that are ecosystem actors (like the Portuguese Ministry of Health) for understanding synergies among value cocreation factors and outcomes at the different levels. This provides orientations to better integrate different actor roles, technology, and information while facilitating ecosystem coordination and co-evolution.

This study responds to the need for a multilevel understanding of value cocreation in service ecosystems. It also illuminates how keystone players in the ecosystem should manage their value propositions to promote resource integration for each actor, fostering resource density and ecosystem viability. It also bridges the high-level conceptual perspective of Service-Dominant logic with specific empirical findings in the very important context of health care.

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.

People with complex health conditions must often navigate landscapes of uncoordinated public, private and voluntary health-care providers to obtain the care they need. Complex health conditions frequently transcend the scope of typical health-care service systems. The purpose of this paper is to explore and characterize such unique assemblages of actors and services as “user-defined ecosystems”.

Building on literature on customer ecosystems, this paper introduces the concept of the user-defined ecosystem (UDE). Using an abductive approach, the authors apply the concept in an interpretive, qualitative study of ten families with special needs children.

This study uncovers complex UDEs, where families actively combine a broad range of services. These ecosystems are unique for each family and extend beyond the scope of designed service ecosystems. Thus, the families are forced to assume an active, coordinating role.

This paper shows how to identify ecosystems from the user’s point of view, based on the selected user unit (such as a family) and the focal value-creating function of the ecosystem for the user.

This paper highlights how service providers can support and adapt to UDEs and, thus, contribute to user value and well-being. This can be used to understand users’ perspectives on service and systems in health and social care.

This study develops the concept of the UDE, which represents a customer-focused perspective on actor ecosystems and contrasts it with a provider-focused and a distributed perspective on ecosystems. This study demonstrates the practical usefulness of the conceptualization and provides a foundation for further research on the user’s perspective on ecosystems.

The COVID-19 pandemic has created a crisis for healthcare systems worldwide. There have been significant challenges to managing public and private health care and related services systems’ capacity to cope with testing, treatment and containment of the virus. Drawing on the foundational research by Frow et al. (2019), the paper explores how adopting a service ecosystem perspective provides insight into the complexity of healthcare systems during times of extreme stress and uncertainty.

A healthcare framework based on a review of the service ecosystem literature is developed, and the COVID-19 crisis in Australia provides an illustrative case.

The study demonstrates how the service ecosystem perspective provides new insight into the dynamics and multilayered nature of a healthcare system during a pandemic. Three propositions are developed that offer directions for future research and managerial applications.

The research provides an understanding of the relevance of managerial flexibility, innovation, learning and knowledge sharing, which offers opportunities leading to greater resilience in the healthcare system. In particular, the research addresses how service providers in the service ecosystem learn from this pandemic to inform future practices.

The service ecosystem perspective for health care offers fresh thinking and an understanding of how a shared worldview, institutional practices and supportive and disruptive factors influence the systems’ overall well-being during a crisis such as COVID-19.

Increasing competition in global markets requires many countries to seek new growth sectors. In addition, the nature of competition is changing. This paper applies the business ecosystem concept and studies San Diego as a spatial health and life sciences ecosystem. The purpose of this paper is to identify issues that should be considered in design of innovation policies and regional industry development.

The research approach is built on a literature review of business ecosystems and spatial innovation. The empirical study is based on semi-structured interviews, observations, and information gathering and verification during field research.

The results include a description of the ecosystem structure and dynamics. This paper demonstrates the bottom-up nature of San Diego’s health and life sciences ecosystem without a dominant lead actor, and presents prerequisites for fostering spatial ecosystems.

A single case may not be able to offer a generalized picture of this topic. However, the study raises several considerations for researchers and decision-makers involved in innovation policy design. Future work should extend the study and involve other spatial and substance contexts to compare findings and to pursue a more generic picture of innovation ecosystems and networks.

This paper demonstrates that applying the concept of business ecosystems to the spatial context provides new insights in terms of dynamic mechanisms and factors contributing to economic growth in a particular location. Understanding how to facilitate the creation of successful spatial ecosystems is in the focal point of innovation policies.

Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.

Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.

Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.

This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.

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.

The entrepreneurial ecosystem (EE) literature is dominated by conceptual studies with insufficient theoretical foundations and empirical evidence on the micro-level. This study aims to explore the largely overlooked question of what the drivers that motivate small and medium-sized enterprises (SMEs) to participate in an ecosystem are.

The study adopts a qualitative exploratory approach. The empirical data consists of 19 semi-structured interviews with top management of SMEs in the health tech ecosystem in Finland. The data were analyzed using a thematic content analysis.

This study reveals a typology of drivers that motivate SMEs to participate in an ecosystem. These include social drivers (networking and cooperation and communication and knowledge sharing), resource drivers (access to resources, formal and informal support and market access) and cognitive drivers (shared goals and common values).

The study contributes to the EE research by highlighting the drivers that motivate health tech SMEs to become members of the local ecosystem. It suggests that managers and entrepreneurs need to be aware of the factors related to social, resource and cognitive drivers to ensure the future success of their business.

The study draws evidence from a micro-level perspective which enriches the understanding of the EE phenomenon. It also explores an increasingly relevant but under-researched field, the health tech ecosystem.

This paper aims to hypothesize that modern health systems are transforming towards what has been called a health ecosystem in complexity‐based health care literature. It has been argued that complexity arises from the interconnectedness, which in this paper is equated with knowledge flows between actors. The paper seeks to discuss the possible implications of a health ecosystem approach to health system management.

The paper is conceptual in nature but the transition towards a health ecosystem is illustrated with an example of a regional health care system in Finland. The case description and related analysis presented are based on qualitative data gathered by interviewing leading office‐holders, by process modeling and by observing management group meetings.

Conceptually, a health ecosystem seems to have potential for the system‐level analysis of the health care system. The discussion concludes that management of knowledge flows should be a strategic management function for individual health organizations as well as for the wider health system.

This study focuses on a Finnish health care system. The operations and structures of health care services and systems vary in different areas and countries.

The practical illustration of the health ecosystem provides a reminder that health care systems are dynamic and largely based on interaction between different actors. The approach provides new strategic insights for the development of health care systems by concentrating on interrelationships and knowledge flows.

The literature has suggested that the ecosystem metaphor offers useful insights for the development of health care systems. Nevertheless, this approach has not been thoroughly studied so far. This paper makes a contribution by presenting a practical illustration of the framework and in light of this discusses the possible implications for health care management.

This study aims to define orchestrator roles and related orchestration capabilities in the entrepreneurial ecosystem (EE) to understand how companies (especially small and medium-sized enterprises and startups) could benefit from the surrounding ecosystem to develop their business.

A qualitative case study of the regional ecosystem built around health technology is researched to get an in-depth understanding of the orchestration roles taken by actors in the ecosystem and, likewise, related bundles of orchestrator role-specific capabilities.

Altogether, eight roles and related orchestration capabilities are defined. First, “opinion leaders,” “business facilitators” and “regulation informants” provide resources for participants. Second, “relationship promoters,” “coordinators” and “commanders” create prerequisites for collaboration. Finally, “integrators” and “complementors” help to create concrete offerings. The roles taken can be simultaneous, and they are in constant change as positions and resources of actors change.

Theoretically, this study contributes to the existing EE and orchestration capability research by studying orchestrator roles and related capabilities in the context of an entrepreneurial health tech ecosystem, a phenomenon that has not received sufficient research attention yet.

Managers will be able to use the lessons learned from this study in understanding, using and developing their capabilities, positions and activities in the network. For policymakers, understanding EE reality and dynamics is useful when developing policies for regional growth, likewise in constructing and developing industrial ecosystems to support entrepreneurship in the region.

The study provides novel in-depth knowledge of orchestration in regional, EEs. It complements the currently dominating conceptual research and brings a micro-level perspective that has mostly been lacking in EE studies.