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Book part
Publication date: 12 August 2014

Reconfiguring the Ecosystem for Sustainable Healthcare: Integrating Outside-In and Inside-Out Perspectives

Abraham B. (Rami) Shani and Susan Albers Mohrman

This chapter provides a reflective synopsis of six cases focused on making healthcare sustainable. The nature and value of an ecosystem perspective is explored. The intent…

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Abstract

Purpose

This chapter provides a reflective synopsis of six cases focused on making healthcare sustainable. The nature and value of an ecosystem perspective is explored. The intent is to apply and generate organizational knowledge to understand and guide purposeful design and learning.

Design/methodology

From five countries where healthcare is organized differently, these cases illuminate particular approaches to develop the capabilities for healthcare to deliver greater value to society. Each case is examined through the lens of an appropriate theoretical perspective. This chapter reports the themes that were common in the six case studies.

Findings

New approaches are changing the connections in the healthcare ecosystem, including the flows of: medical knowledge, clinical information, and resources. Common themes include: the importance of networks in the emerging healthcare ecosystem; the role of governance mechanisms and leadership to align the diverse ecosystem components; the engagement of dominant ecosystem actors; the need for adaptive change capabilities, and for multi-stakeholder research collaborations to generate actionable knowledge.

Practical implications

Taking an ecosystem perspective enables healthcare leaders to broaden their conceptualization of the changes that will be required to be sustainable in a changing society.

Social implications

Almost every man, woman and child is affected by the healthcare system. Increasing the sustainability of healthcare is integral to increasing societal sustainability overall.

Originality

Viewing the ecosystem as the appropriate focus of purposeful change departs from a traditional approach that focuses on the effectiveness of each element.

Details

Reconfiguring the Ecosystem for Sustainable Healthcare
Type: Book
DOI: https://doi.org/10.1108/S2045-060520140000004012
ISBN: 978-1-78441-035-3

Keywords

  • Healthcare ecosystem
  • collaborative learning
  • learning mechanisms
  • ecosystem flows
  • networks
  • ecosystem reconfiguration

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Article
Publication date: 4 February 2019

Knowledge transfer in open innovation: A classification framework for healthcare ecosystems

Giustina Secundo, Antonio Toma, Giovanni Schiuma and Giuseppina Passiante

Despite the abundance of research in open innovation, few contributions explore it at inter-organizational level, and particularly with a focus on healthcare ecosystem…

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Abstract

Purpose

Despite the abundance of research in open innovation, few contributions explore it at inter-organizational level, and particularly with a focus on healthcare ecosystem, characterized by a dense network of relationships among public and private organizations (hospitals, companies and universities) as well as other actors that can be labeled as “untraditional” player, i.e. doctors, nurses and patients. The purpose of this paper is to cover this gap and explore how knowledge is transferred and flows among all the healthcare ecosystems’ players in order to support open innovation processes.

Design/methodology/approach

The paper is conceptual in nature and adopts a narrative literature review approach. In particular, insights gathered from open innovation literature at the inter-organizational network level, with a particular attention to healthcare ecosystems, and from the knowledge transfer processes, are analyzed in order to propose an interpretative framework for the understanding of knowledge transfer in open innovation with a focus on healthcare ecosystem.

Findings

The paper proposes an original interpretative framework for knowledge transfer to support open innovation in healthcare ecosystems, composed of four main components: healthcare ecosystem’s players’ categories; knowledge flows among different categories of players along the exploration and exploitation stages of innovation development; players’ motivations for open innovation; and players’ positions in the innovation process. In addition, assuming the intermediary network as the suitable organizational model for healthcare ecosystem, four classification scenarios are identified on the basis of the main players’ influence degree and motivations for open innovation.

Practical implications

The paper offers interpretative lenses for managers and policy makers in understanding the most suitable organizational models able to encourage open innovation in healthcare ecosystems, taking into consideration the players’ motivation and the knowledge transfer processes on the basis of the innovation results.

Originality/value

The paper introduces a novel framework that fills a gap in the innovation management literature, by pointing out the key role of external not R&D players, like patients, involved in knowledge transfer for open innovation processes in healthcare ecosystems.

Details

Business Process Management Journal, vol. 25 no. 1
Type: Research Article
DOI: https://doi.org/10.1108/BPMJ-06-2017-0173
ISSN: 1463-7154

Keywords

  • Open innovation
  • Intermediary networks
  • Healthcare ecosystem
  • Knowledge flow
  • Knowledge transfer

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Book part
Publication date: 12 August 2014

Healthcare: An Ecosystem in Transition

Susan Albers Mohrman and Abraham B. (Rami) Shani

The chapter redefines the focus of the changes required to create sustainable healthcare away from fixing healthcare organizations and toward reconfiguring the constituent…

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Abstract

Purpose

The chapter redefines the focus of the changes required to create sustainable healthcare away from fixing healthcare organizations and toward reconfiguring the constituent elements of the healthcare ecosystem and redefining how they interrelate to yield value more sustainably.

Methodology/approach

Based on a review of recent literature on healthcare reform, we argue that unlike other sectors, healthcare organizations cannot change themselves without changing their connections to the rest of the healthcare ecosystem, including other healthcare organizations, patients, governments, research institutions, vendors, and the citizenry at large. This is because these are not only stakeholders but also integral parts of healthcare processes.

Practical implications

Interventions intended to create more sustainable healthcare must bring together knowledge and perspectives from across the ecosystem, and must converge different sources of information and analysis to generate novel ways of connecting across the ecosystem. Change within a healthcare system cannot achieve the magnitude of transformation needed to become sustainable.

Social implications

If the healthcare ecosystem evolves in the manner described in this chapter, the healthcare ecosystem will no longer center around particular institutions and doctors’ offices but rather be defined by flexible and variable interactions between co-acting elements of the ecosystem.

Originality/value of chapter

The chapter treats the context as the focus of change in order to change the healthcare system. It proposes three kinds of flows: knowledge, clinical, and resource that are already beginning to change and that will eventually result in fundamentally different approaches to healthcare.

Details

Reconfiguring the Ecosystem for Sustainable Healthcare
Type: Book
DOI: https://doi.org/10.1108/S2045-060520140000004005
ISBN: 978-1-78441-035-3

Keywords

  • Healthcare ecosystem
  • sustainable healthcare
  • complex systems
  • reconfiguring the ecosystem
  • networks

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Article
Publication date: 3 December 2019

Service ecosystem well-being: conceptualization and implications for theory and practice

Pennie Frow, Janet R. McColl-Kennedy, Adrian Payne and Rahul Govind

This paper aims to conceptualize and characterize service ecosystems, addressing calls for research on this important and under-researched topic.

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Abstract

Purpose

This paper aims to conceptualize and characterize service ecosystems, addressing calls for research on this important and under-researched topic.

Design/methodology/approach

The authors draw on four meta-theoretical foundations of S-D logic – resource integration, resource density, practices and institutions – providing a new integrated conceptual framework of ecosystem well-being. They then apply this conceptualization in the context of a complex healthcare setting, exploring the characteristics of ecosystem well-being at the meso level.

Findings

This study provides an integrated conceptual framework to explicate the nature and structure of well-being in a complex service ecosystem; identifies six key characteristics of ecosystem well-being; illustrates service ecosystem well-being in a specific healthcare context, zooming in on the meso level of the ecosystem and noting the importance of embedding a shared worldview; provides practical guidance for managers and policy makers about how to manage complex service ecosystems in their quest for improving service outcomes; and offers an insightful research agenda.

Research limitations/implications

This research focuses on service ecosystems with an illustration in one healthcare context, suggesting additional studies that explore other industry contexts.

Practical implications

Practically, the study indicates the imperative for managing across mutually adapting levels of the ecosystem, identifying specific new practices that can improve service outcomes.

Social implications

Examining well-being in the context of a complex service ecosystem is critical for policymakers charged with difficult decisions about balancing the demands of different levels and actors in a systemic world.

Originality/value

The study is the first to conceptualize and characterize well-being in a service ecosystem, providing unique insights and identifying six specific characteristics of well-being.

Details

European Journal of Marketing, vol. 53 no. 12
Type: Research Article
DOI: https://doi.org/10.1108/EJM-07-2018-0465
ISSN: 0309-0566

Keywords

  • Well-being
  • Practices
  • Service ecosystem
  • Institutional arrangements
  • Ecosystem well-being
  • Shared worldview
  • Meso level

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Article
Publication date: 9 October 2017

The role of loyalty programs in healthcare service ecosystems

Vusal Gambarov, Debora Sarno, Xhimi Hysa, Mario Calabrese and Alberto Bilotta

The purpose of this paper is to investigate the role of patient loyalty programs in healthcare environment, generally considered as a way to engage patients and…

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Abstract

Purpose

The purpose of this paper is to investigate the role of patient loyalty programs in healthcare environment, generally considered as a way to engage patients and potentially increase the perception of service quality of healthcare systems, but not systematically analyzed at the state of the art.

Design/methodology/approach

The Service Dominant logic and, in particular, the service ecosystem construct are adopted and integrated with relevant literature references and empirical studies on a sample of patients. Loyalty programs are interpreted as institutions coordinating actors of the healthcare service ecosystem.

Findings

A conceptual model linking loyalty programs to patients and healthcare providers’ co-creation practices, engagement, satisfaction, trust, and perception of service quality is build and explained based on literature and a case study, finding that loyalty programs can strengthen the adaptability and the well-being of a healthcare service ecosystem.

Practical implications

This contribution can have a significant impact on the design of new and the evolution of current healthcare service ecosystem, providing interesting insights to practitioners on the topic of loyalty programs, both for their development and their benefits.

Originality/value

The paper revised previous healthcare service ecosystems and highlights the role of the loyalty program institution at each level and between levels of the ecosystem.

Details

The TQM Journal, vol. 29 no. 6
Type: Research Article
DOI: https://doi.org/10.1108/TQM-02-2017-0019
ISSN: 1754-2731

Keywords

  • Service quality
  • Healthcare
  • Institutions
  • Loyalty programmes
  • Healthcare service ecosystems

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Article
Publication date: 2 July 2018

Institutional types and institutional change in healthcare ecosystems

Oana Maria Pop, Sara Leroi-Werelds, Nadine Roijakkers and Tor W. Andreassen

The purpose of this paper is to propose a typology of institutions enabling or constraining customer centricity and value co-creation in service ecosystems; illustrate the…

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Abstract

Purpose

The purpose of this paper is to propose a typology of institutions enabling or constraining customer centricity and value co-creation in service ecosystems; illustrate the various types of institutions with examples from healthcare; and provide case study evidence on how pharmaceutical companies react to and induce institutional change.

Design/methodology/approach

First, a typology of institutions enabling or constraining customer centricity and value co-creation is proposed and illustrated with examples from healthcare. Next, to clarify how companies deal with these institutions by reacting to or inducing institutional change, two case companies from the pharmaceutical industry are described.

Findings

The research identifies and illustrates nine types of institutions (culture, structure, processes, metrics, language, practices, IP, legislation and general beliefs) grouped by three levels of analysis (micro, meso and macro). Furthermore, the findings of the two case studies indicate that companies react to, but also proactively induce, institutional change.

Research limitations/implications

The investigation is limited to two case studies.

Practical implications

Organizations need to understand the micro-, meso- and macro-level institutions of their service ecosystem; react to institutional changes imposed by other actors; and proactively change institutions by breaking, making or maintaining them.

Social implications

Pharmaceutical companies can improve patient well-being by inducing institutional change.

Originality/value

This research develops a mid-range theory of service ecosystem institutions by developing a typology. This typology is empirically examined in a healthcare context.

Details

Journal of Service Management, vol. 29 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/JOSM-02-2017-0041
ISSN: 1757-5818

Keywords

  • Customer centricity
  • Institutions
  • Service-dominant logic
  • Service ecosystems

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Article
Publication date: 24 August 2020

Managing intellectual capital in healthcare organizations. A conceptual proposal to promote innovation

Hui Huang, Daniele Leone, Andrea Caporuscio and Sascha Kraus

The present article aims at rising stream of literature about intellectual capital in healthcare organizations, by exploring how knowledge-based activities are designed to…

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Abstract

Purpose

The present article aims at rising stream of literature about intellectual capital in healthcare organizations, by exploring how knowledge-based activities are designed to promote innovation and create value. This process concerns not only buyers and sellers of industrial products/services but, more widely, larger networks of healthcare actors which include patients, payers and health institutions.

Design/methodology/approach

To answer the research question, we adopted a conceptual approach aimed at reaching overall comprehension of healthcare innovation mechanisms. We have tracked the pivotal extant studies for catching the roots and dynamics at the base of diffusion of healthcare innovation. This article demonstrates, based on previous literature and theoretical speculations, the contribution that innovative knowledge-based activities (e.g. market access approach) make to intellectual capital in healthcare organizations to promote innovation and create value.

Findings

The results show that three knowledge-based activities of the healthcare ecosystem shape the basis of the proposed conceptual framework. First, a value co-creation strategy to develop capabilities for each health stakeholder is intended as human capital. Second, the market access approach to promote innovation is reported to the relational capital. Third, a digital servitization strategy is referred to the structural capital.

Research limitations/implications

This paper provides implications for the stream of literature about intellectual capital in healthcare organizations. It aims at exploring three knowledge-based activities as value co-creation, market access and digital servitization that respond to different intellectual capital levels components (human, relational, structural).

Originality/value

This article provides a conceptual framework based on the linkage of two fundamental streams of management studies, which correspond to innovation diffusion and intellectual capital management. This offers a more solid conceptualization for managing intellectual capital in healthcare organizations with respect to previous studies and creates value in the ecosystem.

Details

Journal of Intellectual Capital, vol. 22 no. 2
Type: Research Article
DOI: https://doi.org/10.1108/JIC-02-2020-0063
ISSN: 1469-1930

Keywords

  • Intellectual capital
  • Healthcare
  • Market access
  • Innovation process
  • Digital servitization
  • Value co-creation

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Book part
Publication date: 12 August 2014

Reconfiguring the Ecosystem for Sustainable Healthcare: Introduction to the Volume

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Abstract

Details

Reconfiguring the Ecosystem for Sustainable Healthcare
Type: Book
DOI: https://doi.org/10.1108/S2045-060520140000004003
ISBN: 978-1-78441-035-3

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Book part
Publication date: 12 August 2014

Embedding Sustainable-Effectiveness in Decision-Making within an Ecosystem: Lessons from the Health Technology Assessment Program at the Lombardy Region, Italy

Giovanni Radaelli, Emanuele Lettieri, Abraham B. (Rami) Shani, Cristina Masella and Michele Tringali

Healthcare policy-makers are implementing practices based on the logic of cost-opportunity to rationalize investments and resource consumption. The successful…

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Abstract

Purpose

Healthcare policy-makers are implementing practices based on the logic of cost-opportunity to rationalize investments and resource consumption. The successful implementation of these practices depends on policy-makers’ capacity to involve professionals dispersed in the ecosystem, and who are unaccustomed to cooperating. Our case study investigates the institutional work pursued by the Lombardy Region to stimulate a Health Technology Assessment (HTA) program.

Design/methodology/approach

This chapter is based on a longitudinal case study of institutional change linked with a HTA program in the Lombardy Region. The HTA program initiatives were implemented during the 2009–2012 period. The case study is based on triangulating data from archival data, contents of the assessment forms and interviews with regional staff and experts.

Findings

The Lombardy Region implemented two distinct strategies, with mixed results. A strategy that was based on the formalization of the HTA program in a legislative direct through educational efforts did not obtain the commitment of the key actors in the relevant ecosystem. Subsequently, the Region implemented an ‘institutional work’ design strategy that included a combination of political, cultural, technical and structural work. This strategy stimulated local HTA experiments that might be used in the future to legitimize the full diffusion of the new practice in the ecosystem.

Originality/value

This study highlights a viable strategy of change that policy-makers can use to manage processes of institutional change in a professional ecosystem. The ‘institutional work’ strategy can support the establishment of new practices that incorporate the logic of cost-opportunity, which might rationalize the use of resources and improve investment decisions.

Details

Reconfiguring the Ecosystem for Sustainable Healthcare
Type: Book
DOI: https://doi.org/10.1108/S2045-060520140000004010
ISBN: 978-1-78441-035-3

Keywords

  • Sociology of professionals
  • institutional theory
  • institutional change
  • institutional work
  • health technology assessment
  • cost-opportunity logic

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Article
Publication date: 3 August 2012

Enabling healthcare services for the rural and semi‐urban segments in India: when shared value meets the bottom of the pyramid

Mark Esposito, Amit Kapoor and Sandeep Goyal

The access to high quality, a reliable and affordable basic healthcare service is one of the key challenges facing the rural and semi‐urban population lying at base of the…

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Abstract

Purpose

The access to high quality, a reliable and affordable basic healthcare service is one of the key challenges facing the rural and semi‐urban population lying at base of the pyramid (BoP) in India. Realizing this as a social challenge and an economic opportunity (shared value), there has been an emergence of healthcare service providers who have bundled entrepreneurial attitude and passion with available scarce resources to design and implement cost‐effective, reliable and scalable market solutions for the BoP. The purpose of this research paper is to understand the underlying operating principles of these self‐sustainable business models aimed at providing healthcare services to the BoP segment in India.

Design/methodology/approach

The empirical context involves the use of case study research methodology, where the source of data is published case studies and the company websites of four healthcare organizations who have made a socio‐economic difference in the lives of the rural and semi‐urban population lying at the BoP in India.

Findings

The analysis and findings reflect the key operating principles for sustainable healthcare business ventures at the BoP. These include focus on 4A's (accessible, affordable, acceptable and awareness), local engagement, local skills building, learning by experiment, flexible organizational structure, dynamic leadership, technology integration and scalability.

Research limitations/implications

This research study has focused mainly on the published case studies as source of data.

Originality/value

The intent is to understand and bring forth the learning and guiding principles, which act as a catalyst for the future researchers and business ventures engaged in BoP context.

Details

Corporate Governance: The international journal of business in society, vol. 12 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/14720701211267847
ISSN: 1472-0701

Keywords

  • Base of the pyramid
  • Rural healthcare
  • Low income markets
  • Emerging markets
  • Shared value
  • Developing countries
  • Poverty

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