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Digital transformation is one of the key concepts attached to the smart cities’ domain. The requirement to enhance strategically the way that business is delivered around different areas is a critical milestone for the digital transformation agenda and also for business performance management. In this short position chapter, we are focusing on the area of healthcare and we are providing key insights and lessons learned from Saudi Arabia. The main contribution of the chapter is a structured discussion on a digital healthcare strategy in the context of smart cities.

The purpose of this study was to better understand the state of the healthcare facility management (FM) workforce and trends and how it compares to the nonhealthcare industries.

A survey was developed, based on relevant literature, regarding respondents’ gender, race, age, educational attainment and job tenure. The survey was sent electronically via Qualtrics^® system in February 2021 to members of the International Facility Management Association membership; 3,557 individuals completed the survey by April 2021, for a 29% response rate. Only data from 1,407 US respondents working in facility operations were included in this study. Of the 1,407 respondents included in this study, 89 worked in the healthcare industry. The majority of respondents not working in healthcare industry (1,318) were employed in government, education or banking and investment.

The demographics of facility managers in the healthcare industry are similar to the demographics of facility managers in other industries: the majority of the FM workforce is male, middle-aged, white, college educated and employed in-house. While healthcare and nonhealthcare facility managers have similar responsibilities across job levels, compensation for entry-level FM roles in the healthcare industry is significantly lower than for entry-level FM roles in other industries. This low pay in healthcare FM, compared to other industries, may exacerbate ongoing challenges related to talent recruitment and retention and justify pay banding increases to improve attraction of top talent into healthcare FM. Both healthcare and nonhealthcare industries hire new college graduates for entry-level FM jobs, but the healthcare industry is more likely to hire individuals who majored in liberal arts compared to other industries more likely to hire individuals who majored in subjects related to the built environment such as FM and engineering. To compensate for low entry-level pay, healthcare organizations may be focusing recruitment efforts on liberal arts students who have little to no training in the built environment because they have lower pay expectations. Older healthcare facility professionals also have shorter job tenures with their current employers than do older facility professionals in other industries; this trend appears to be recent and not be related to pay or the COVID-19 pandemic. A surge of senior-level FM retirements may be creating advancement opportunities for older entry- and mid-level FM personnel in healthcare; if this situation is a factor, research should be conducted to understand its implications for recruiting and developing healthcare FM talent.

Only data from US respondents who were working in healthcare facility operations at the time of the study were included in the data analysis.

Healthcare organizations can use the study’s findings to help address FM workforce challenges unique to their industry staff recruitment, retention and succession planning.

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the procurement and management of surgical supplies in a prominent public, highly specialized healthcare sector.

This study was conducted in three phases. In Phase 1, the study team interacted with various hospital management stakeholders, including the surgical hospital store, examined the current procurement process and identified challenges. Phase 2 focused on selecting items for a detailed study and collected the qualitative and quantitative details of the store department of the healthcare sector chosen. A detailed study analyzed revenue, output/demand, inventory levels, etc. In Phase 3, a decision-making framework is proposed, and inventory control systems are redesigned and demonstrated for the selected items.

It was observed that the demand for many surgical items had increased significantly over the years due to an increase in disposable/disposable items, while inventories fluctuated widely. Maximum inventory levels varied between 50 and 75%. Storage and availability were important issues for the hospital. It is assumed the hospital adopts the proposed inventory control system. In this case, the benefits can be a saving of 62% of the maximum inventory, 20% of the average stock in the system and optimal use of storage space, improving the performance and productivity of the hospital.

This study can help the healthcare sector administration to develop better systems for the procurement and delivery of common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels, and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study can help the healthcare sector administration develop better systems for procuring and delivering common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study is an early attempt to develop a decision framework and inventory control system from the perspective of healthcare inventory management. The gaps identified in real hospital scenarios are investigated, and theoretically based-inventory management strategies are applied and proposed.

The mental healthcare is experiencing an ever-growing surge in understanding the consumer (e.g., patient) engagement paradox, aiming to vouch for the quality of care. Despite this surge, scant attention has been given in academia to conceptualize and empirically investigate this particular aspect. Thus, drawing on the Stimulus-Organism-Response (S-O-R) paradigm, the study explores how patients engage with healthcare service providers and how they perceive the quality of the healthcare services.

Data were collected from 279 respondents, and the derived conceptual model was tested by using Smart PLS 3.2.7 and PROCESS. To complement the findings of partial least squares (PLS)-based structural equation modeling (SEM), the present study also applied fuzzy set qualitative comparative analysis (fsQCA) to identify the necessary and sufficient conditions to explore substitute conjunctive paths that emerge.

Findings show that patients’ perceived intimacy (PI), cohesion and privacy enhance the quality of mental healthcare service providers. The results also suggest that patients’ PI, cohesion and privacy have indirect effects on the perceived quality of care (PQC) by the service providers through consumer engagement. The fsQCA results derive that the relationship among conditions leading to patients’ perception of the quality of care in regard to mental healthcare service providers is complex and is best reflected as multiple and conjectural causation configurations.

The findings from this research contribute to the advancement of studies on patients’ experiences by empirically examining the unique dynamics of interaction between consumers (patients) and mental healthcare service providers, thereby enriching both the literature on social interactions and the understanding of the consumer–provider relationship.

The results of this study provide practical implications for mental healthcare service providers on how to combine the study variables to enhance the quality of care and satisfy more patients.

A significant research gap has ascertained the inter-relationship between PI, cohesion, privacy, engagement and PQC from the perspective of mental healthcare service providers. This research is one of the primary studies from a managerial and methodological standpoint. The study contributes by combining symmetric and asymmetric statistical tools in service marketing and healthcare research. Furthermore, the application of fsQCA helps to understand the interactions that might not be immediately obvious through traditional symmetric methods.

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.

Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.

In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.

Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.

This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.

The holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.

This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.

Business models (BMs) are becoming increasingly crucial for value creation in the healthcare sector. The study explores the conceptualization and application of BM concepts within the healthcare sector and investigates their evolution in emerging economies (EEs) and developed economies (DEs). This study aims to uncover these two contexts' shared characteristics and unique variances through a comparative analysis.

The paper systematically investigates and consolidates the literature on healthcare by employing the antecedents, decisions and outcomes (ADO) framework and finally examines 71 shortlisted articles published between 2003 and 2022.

The recognition of the BM within healthcare is increasing, both in EEs and DEs. EEs prioritize value creation and capture through cost efficiency, while DEs focus on innovation. Key theories employed include a resource-based view, the network theory and the theory of innovation. Case studies are commonly used as a methodology. Further research is needed to explore the decisions and outcomes of BMs.

The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

Beyond comparing and highlighting gaps in BMs between EEs and DEs, benchmarking DE's healthcare business models (HBMs) helps healthcare organizations in EEs align their practices, mitigate risks and establish efficient healthcare systems tailored to their specific contexts. The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

The study analyzes HBMs using an SLR framework perspective and provides practical implications for academicians and practitioners to enhance their decision-making.

Healthcare property has become an important alternate property sector in recent years for many international institutional investors. The purpose of this paper is to assess the risk-adjusted performance, portfolio diversification benefits and performance dynamics of French healthcare property in a French property portfolio and mixed-asset portfolio over 1999–2020. French healthcare property is seen to have different performance dynamics to the traditional French property sectors of office, retail and industrial property. Drivers and risk factors for the ongoing development of the direct healthcare property sector in France are also identified, as well as the strategic property investment implications for institutional investors.

Using annual total returns, the risk-adjusted performance, portfolio diversification benefits and performance dynamics of French direct healthcare property over 1999–2020 are assessed. Asset allocation diagrams are used to assess the role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio. The role of specific drivers for French healthcare property performance is also assessed. Robustness checks are also done to assess the potential impact of COVID-19 on the performance of French healthcare property.

French healthcare property is shown to have different performance dynamics to the traditional French property sectors of office, retail and industrial property. French direct healthcare property delivered strong risk-adjusted returns compared to French stocks, listed healthcare and listed property over 1999–2020, only exceeded by direct property. Portfolio diversification benefits in the fuller mixed-asset portfolio context were also evident, but to a much lesser extent in a narrower property portfolio context. Importantly, this sees French direct healthcare property as strongly contributing to the French property and mixed-asset portfolios across the entire portfolio risk spectrum and validating the property industry perspective of healthcare property being low risk and providing diversification benefits in a mixed-asset portfolio. However, this was to some degree to the loss or substitution of traditional direct property exposure via this replacement effect. French direct healthcare property and listed healthcare are clearly shown to be different channels in delivering different aspects of French healthcare performance to investors. Drivers of French healthcare property performance are also shown to be both economic and healthcare-specific factors. The performance of French healthcare property is also shown to be different to that seen for healthcare property in the UK and Australia. During COVID-19, French healthcare property was able to show more resilience than French office and retail property.

Healthcare property is an alternate property sector that has become increasingly important in recent years. The results highlight the important role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio, with French healthcare property having different investment dynamics to the other traditional French property sectors. The strong risk-adjusted performance of French direct healthcare property compared to French stocks, listed healthcare and listed property sees French direct healthcare property contributing to the mixed-asset portfolio across the entire portfolio risk spectrum. French healthcare property’s resilience during COVID-19 was also an attractive investment feature. This is particularly important, as many institutional investors now see healthcare property as an important property sector in their overall portfolio; particularly with the ageing population dynamics in most countries and the need for effective social infrastructure. The importance of French direct healthcare property sees direct healthcare property exposure accessible to investors as an important alternate real estate sector for their portfolios going forward via both non-listed healthcare property funds and the further future establishment of more healthcare REITs to accommodate both large and small institutional investors respectively. The resilience of French healthcare property during COVID-19 is also an attractive feature for future-proofing an investor’s portfolio.

This paper is the first published empirical research analysis of the risk-adjusted performance, diversification benefits and performance dynamics of French direct healthcare property, and the role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio. This research enables empirically validated, more informed and practical property investment decision-making regarding the strategic role of French direct healthcare property in a portfolio; particularly where the strategic role of direct healthcare property in France is seen to be different to that in the UK and Australia via portfolio replacement effects. Clear evidence is also seen of the drivers of French healthcare property performance being strongly influenced by healthcare-specific factors, as well as economic factors.

Innovation management in the healthcare sector has undergone significant evolutions over the last decades. These evolutions have been investigated from a variety of perspectives: clusters, ecosystems of innovation, digital ecosystems and regional ecosystems, but the dynamics of networks have seldom been analyzed under the lenses of entrepreneurial ecosystems (EEs). As identified by Cao and Shi (2020), the literature is silent about the organization of resource allocation systems for network orchestration in EEs. This article investigates these elements in the healthcare sector. It discusses the strategic role played by entrepreneurial support organizations (ESOs) in resource allocation and elaborates on the distinction between sponsored and nonsponsored ESOs in EEs. ESOs are active in network orchestration. The literature explains that ESOs lift organizational, institutional and cultural barriers, and support entrepreneurs' access to cognitive and technological resources. However, allocation models are not yet discussed. Therefore, our research questions are as follows: What is the resource allocation model in healthcare-related EEs? What is the role played by sponsored and nonsponsored ESOs as regards resource allocation to support the emergence and development of EEs in the healthcare sector?

The article offers an explanatory, exploratory, and theory-building investigation. The research design offers an abductive research protocol and multi-level analysis of seven (sponsored and nonsponsored) ESOs active in French healthcare ecosystems. Field research elaborates on semi-structured interviews collected between 2016 and 2022.

This article shows explicit complementarities between top-down and bottom-up resource allocation approaches supported by ESOs in the healthcare sector. Despite explicit originalities in each approach, no network orchestration model prevails. Multi-polar coordination is the rule. Entrepreneurs' access to critical technological and cognitive resources is based on resource allocation modalities that differ for sponsored versus nonsponsored ESOs. Emerging from field research, this research also shows that sponsored and nonsponsored ESOs manage their roles in different ways because they confront original issues about organizational legitimacy.

Beyond the results listed above, the main originalities of the paper relate to the instantiation of multi-level analysis operated during field research and to the confrontation between sponsored versus nonsponsored ESOs in the domain of healthcare-related innovation management. This research shows that ESOs have practical relevance because they build original routes for resource allocation and network orchestration in EEs. Each ESO category (sponsored versus nonsponsored) provides original support for resource allocation. The ESO's legitimacy is inferred either from the sponsor or the services delivered to end-users. This research leads to propositions for future research and recommendations for practitioners: ESO managers, entrepreneurs, and policymakers.