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The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

Gamification unlocks unprecedented opportunities in healthcare, wellness and lifestyle context. In this scenario, by leveraging on such an approach, information technologies now enabled gamification-based mobile applications primarily employed in health and wellness contexts, focusing on areas such as disease prevention, self-management, medication adherence and telehealth programs. The synergistic integration of gamification-based methodologies in conjunction with the utilization of digital tools, (e.g. as for Internet of Things, mobile applications) for the realm of digital therapeutics (DTx), thus unveiled powerful approaches and paradigms, yielding innovative applications that, through the harnessing of sensors and software-based systems, transform healthcare maintenance, wellness and lifestyle into an engaging pursuit, as a game. This paper explores the factors influencing individuals' intention to autonomously utilize mobile gamification-based apps for self-care and wellness maintenance.

Through explorative research designs an experiment has been conducted among a sample of 376 participants regarding the use of a fictitious gamification-based DTx solution, consisting in a mobile app namely “Health'n’Fit”.

Findings from an experiment conducted with a sample of 460 participants shed light on the possible antecedents and consequents of gamification. Results of the SEM model indicate that customization (CU), trust (TR), mobility (MO) and social value (SV) are the main determinants, although at a different extent of the playful experience; Moreover, gamification positively impacts attitudes and, in turn, perceived usefulness, intention to use and behavioral intentions.

This paper offers a dual-pronged approach that holds practical significance in the realm of healthcare innovation. First, the authors delve into the antecedents shaping individuals' intention to engage with gamification-based DTx, unraveling the factors that influence user adoption. Beyond this, the authors extend their focus to the realm of healthcare service design. By harnessing the potential of gamification and technology, the authors illuminate pathways to conceptualize and create novel healthcare services. This work not only identifies the building blocks of user engagement but also serves as a guide to innovatively craft healthcare solutions that leverage this amalgamation of technology and gamification, contributing to the evolution of modern healthcare paradigms.

In a social context, the paper introduces pioneering technological synergies that merge gamification and DTx to enhance individuals' health and wellness maintenance. By proposing innovative combinations, the authors present novel avenues for promoting healthier lifestyles and behavior change. This not only underscores the potential of technology to positively impact individuals but also highlights the significance of aligning technological advancements with societal well-being. As the research advocates for these innovative solutions, it reinforces the importance of collaborative technological and marketing endeavors, ultimately contributing to the betterment of society as a whole.

This is the first paper exploring the combined effect of gamification and DTx, by shedding light on the peculiarities of both the antecedents of individuals' intention to use such combined technologies.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

The healthcare system in the USA is undergoing unprecedented change and its share of unintended consequences. This paper explores the leadership role of the physician in transforming the present culture of healthcare to restore, refine and preserve its traditional care components.

The literature on change, organizational culture and leadership is leveraged to describe the structural interdependencies and dynamic complexity of the present healthcare system and to suggest how physicians can strengthen the care components of the healthcare culture.

When an organization’s culture does not support internal integration and external adaptation, it is the responsibility of leadership to transform it. Leaders can influence culture to strengthen the care components of the healthcare system. The centrality of professionalism in the delivery of patient services places a moral, societal and ethical responsibility on physicians to lead a revitalization of the care culture.

This paper focuses on cultural issues in healthcare and provides options and guidance for physicians as they attempt to lead and manage the context in which services are delivered.

The Competing Values Framework, the major interdependent domains and five principal mechanisms for leaders to embed and fine tune culture serve as the main tenets for describing the ongoing changes in healthcare and defining the role of the physician as leaders and advocates for the Patient Care Culture.

The paper identifies the antecedents and consequences of integrated supply chain performance (ISCP) in healthcare systems.

Based on a review of the literature constructs of supply chain flexibility (SCF), employee relationships (ERs), organizational orientation (OO) and knowledge exchange (KE) were identified as antecedents of ISCP, and patient centricity (PC) emerged as its consequence. This structural relationship was tested using partial least square structural equation modeling (PLS-SEM).

ERs, SCF, OO and KE positively impacted the performance of an integrated healthcare supply chain. Furthermore, enhanced ISCP in operational processes of the hospital positively influenced patient centeredness and care quality.

Paper contributes by identifying antecedents and consequences of ISCP. Future researchers may explore the inter-relationships among the antecedents of ISCP.

Insights from this study will help practitioners in enhancing hospital operations by integrating processes along the healthcare service supply chain and developing a patient-centric approach.

This paper highlights how PC may be achieved by focusing on a facilitative internal environment. This understanding may help in designing processes that deliver health as a social good in an effective manner.

The empirical evidence from this study can help hospitals integrate their functions, thus, enabling them to deliver quality care.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

The purpose of this paper is to investigate distinctive pathways for product-service system (PSS) development. Moreover, it investigates the contingent effect of the business ecosystem (BE) in terms of being provider-pushed or customer-pulled.

The study adopted a case-based research, performed in the Brazilian and Danish healthcare industries in order to explore the subject.

The results reveal that the capital available for investments influences the pathway. The customer-pulled PSS fast evolved to become result-oriented and connected to a complex resource-dependent network in the BE. The provider-pushed PSS showed a slow evolutionary pathway, limited to product-oriented offerings with low dependence among actors in the BE.

The research offers various managerial implications for PSS providers, policymakers and customers of the healthcare industry.

Expanding networks of data portals and repositories linked to electronic patient record systems, along with advances in information technology, have created both new opportunities in improving public health and new challenges in protecting patient privacy. The purpose of this paper is to review stakeholder perspectives and provide a framework for promoting implementation of current privacy protection improvement recommendations.

This paper summarizes a workshop session discussion stemming from the 2017 Information Technology and Communication in Health (ITCH) biennial international conference in Victoria, British Columbia, Canada. The perspectives within health service research, journalism, informatics and privacy protection were represented.

Problems underlying gaps in privacy protection in the USA and Canada, along with then-current changes recommended by public health leaders as well as Information and Privacy Commissioners, were identified in a session of the 2015 ITCH conference. During the 2017 conference, a workshop outlined the current situation, identifying ongoing challenges and a lack of significant progress. This paper summarizes that 2017 discussion identifying political climate as the major impediment to progress on this issue. It concludes with a framework to guide the path forward.

This paper provides an international perspective to problems, resources and solution pathways with links useful to readers in all countries.

The dynamics of the physician knowledge system in the Southern California Region of Kaiser Permanente are explored. The framing and analysis use concepts from the knowledge management literature and network theory. The criticality of this issue to the establishment of sustainable healthcare relates to the lynchpin nature of embedding evidence-based knowledge in healthcare practice and the simultaneous challenge of combining this with clinical knowledge that derives from practice.

The case study is compiled from longitudinal interviews with over 40 physicians and other stakeholders and an examination of archival information including published articles generated by the learning system.

The socio-technical approach to building this learning system was critical given the expectations of physicians for autonomy in making clinical decisions with respect to their patients. This robust learning system builds on rich professional and organizational networks, is led by physicians, and builds on and extends the foundation of evidence relating to quality and value. The goals of the physician practice and a robust measurement and feedback system provide focus for the learning system.

Accelerating the incorporation of evidence-based practice and increasing the scope and reach of the learning system entails building physician networks, having a robust system for critically examining and extending evidence, and a clear linkage to valued outcomes.

This detailed examination of the dynamics of knowledge absorption extends understanding of the capacity of medical care systems to absorb evidence-based knowledge.

The goal of this article is to provide an overview of healthcare entrepreneurship, both in terms of its current trends and future directions.

The article engages in a systematic review of extant research on healthcare entrepreneurship using the scientific procedures and rationales for systematic literature reviews (SPAR-4-SLR) as the review protocol and bibliometrics or scientometrics analysis as the review method.

Healthcare entrepreneurship research has fared reasonably well in terms of publication productivity and impact, with diverse contributions coming from authors, institutions and countries, as well as a range of monetary and non-monetary support from funders and journals. The (eight) major themes of healthcare entrepreneurship research revolve around innovation and leadership, disruption and technology, entrepreneurship models, education and empowerment, systems and services, orientations and opportunities, choices and freedom and policy and impact.

The article establishes healthcare entrepreneurship as a promising field of academic research and professional practice that leverages the power of entrepreneurship to advance the state of healthcare.

The article offers a seminal state of the art of healthcare entrepreneurship research.