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1 – 10 of 506Cristina Mele, Tiziana Russo-Spena, MariaLuisa Marzullo and Andrea Ruggiero
How to improve healthcare for the ageing population is attracting academia attention. Emerging technologies (i.e. robots and intelligent agents) look relevant. This paper aims to…
Abstract
Purpose
How to improve healthcare for the ageing population is attracting academia attention. Emerging technologies (i.e. robots and intelligent agents) look relevant. This paper aims to analyze the role of cognitive assistants as boundary objects in value co-creation practices. We include the perceptions of the main actors – patients, (in)formal caregivers, healthcare professionals – for a fuller network perspective to understand the potential overlap between boundary work and value co-creation practices.
Design/methodology/approach
We adopted a grounded approach to gain a contextual understanding design to effectively interpret context and meanings related to human–robot interactions. The study context concerns 21 health solutions that had embedded the Watson cognitive platform and its adoption by the youngest cohort (50–64-year-olds) of the ageing population.
Findings
The cognitive assistant acts as a boundary object by bridging actors, resources and activities. It enacts the boundary work of actors (both ageing and professional, caregivers, families) consisting of four main actions (automated dialoguing, augmented sharing, connected learning and multilayered trusting) that elicit two ageing value co-creation practices: empowering ageing actors in medical care and engaging ageing actors in a healthy lifestyle.
Originality/value
We frame the role of cognitive assistants as boundary objects enabling the boundary work of ageing actors for value co-creation. A cognitive assistant is an “object of activity” that mediates in actors' boundary work by offering novel resource interfaces and widening resource access and resourceness. The boundary work of ageing actors lies in a smarter resource integration that yields broader applications for augmented agency.
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Maria Vincenza Ciasullo, Weng Marc Lim, Mohammad Fakhar Manesh and Rocco Palumbo
Healthcare policies around the globe are aimed at achieving patient-centeredness. The patient is understood as a prosumer of healthcare, wherein healthcare service co-production…
Abstract
Purpose
Healthcare policies around the globe are aimed at achieving patient-centeredness. The patient is understood as a prosumer of healthcare, wherein healthcare service co-production and value co-creation take center stage. The article endeavors to unpack the state of the literature on the innovations promoting the transition toward patient-centeredness, informing policy and management interventions fostering the reconceptualization of the patient as a prosumer of healthcare services.
Design/methodology/approach
A hybrid review methodology consisting of a bibliometric-interpretive review following the Scientific Procedures and Rationales for Systematic Literature Reviews (SPAR-4-SLR) protocol is used. The bibliometric component enabled us to objectively map the extant scientific knowledge into research streams, whereas the interpretive component facilitated the critical analysis of research streams.
Findings
Patient-centeredness relies on a bundle of innovations that are enacted through a cycle of patients' activation, empowerment, involvement and engagement, wherein the omission of any steps arrests the transition toward service co-production and value co-creation. Institutional, organizational and cognitive barriers should be overcome to boost the transition of patients from consumers to prosumers in a patient-centered model of healthcare.
Originality/value
The article delivers the state of the art of the scientific literature in the field of innovations aimed at sustaining the transition toward patient-centeredness and provides some food for thoughts to scholars and practitioners who wish to push forward service co-production and value co-creation in healthcare.
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Sherali Zeadally, Farhan Siddiqui, Zubair Baig and Ahmed Ibrahim
The aim of this paper is to identify some of the challenges that need to be addressed to accelerate the deployment and adoption of smart health technologies for ubiquitous…
Abstract
Purpose
The aim of this paper is to identify some of the challenges that need to be addressed to accelerate the deployment and adoption of smart health technologies for ubiquitous healthcare access. The paper also explores how internet of things (IoT) and big data technologies can be combined with smart health to provide better healthcare solutions.
Design/methodology/approach
The authors reviewed the literature to identify the challenges which have slowed down the deployment and adoption of smart health.
Findings
The authors discussed how IoT and big data technologies can be integrated with smart health to address some of the challenges to improve health-care availability, access and costs.
Originality/value
The results of this paper will help health-care designers, professionals and researchers design better health-care information systems.
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Heather L. Rogers, Susana Pablo Hernando, Silvia Núñez - Fernández, Alvaro Sanchez, Carlos Martos, Maribel Moreno and Gonzalo Grandes
This study aims to elucidate the health care organization, management and policy barriers and facilitators associated with implementation of an evidence-based health promotion…
Abstract
Purpose
This study aims to elucidate the health care organization, management and policy barriers and facilitators associated with implementation of an evidence-based health promotion intervention in primary care centers in the Basque Country, Spain.
Design/methodology/approach
Seven focus groups were conducted with 49 health professionals from six primary care centers participating in the Prescribing Healthy Life program. Text was analyzed using the Consolidated Framework for Implementation Research (CFIR) focusing on those constructs related to health care organization, management and policy.
Findings
The health promotion intervention was found to be compatible with the values of primary care professionals. However, professionals at all centers reported barriers to implementation related to: (1) external policy and incentives, (2) compatibility with existing workflow and (3) available resources to carry out the program. Specific barriers in these areas related to lack of financial and political support, consultation time constraints and difficulty managing competing day-to-day demands. Other barriers and facilitators were related to the constructs networks and communication, culture, relative priority and leadership engagement. A set of six specific barrier-facilitator pairs emerged.
Originality/value
Implementation science and, specifically, the CFIR constructs were used as a guide. Barriers and facilitators related to the implementation of a health promotion program in primary care were identified. Healthcare managers and policy makers can modify these factors to foster a more propitious implementation environment. These factors should be appropriately monitored, both in pre-implementation phases and during the implementation process, in order to ensure effective integration of health promotion into the primary care setting.
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Vincent Peters, Mervi Vähätalo, Bert Meijboom, Alice Barendregt, Levinus Bok and Esther de Vries
This study examines how modular interfaces manifest in multi-provider contexts and how they can improve coordination and customization of services. The aim of the study is to…
Abstract
Purpose
This study examines how modular interfaces manifest in multi-provider contexts and how they can improve coordination and customization of services. The aim of the study is to describe interfaces in multi-provider contexts and elaborate on how they support the delivery of integrated patient care.
Design/methodology/approach
A qualitative, multiple case study was conducted in two multi-provider contexts in healthcare services: one representing paediatric Down syndrome care in the Netherlands and one representing home care for the elderly in Finland. Data collection involved semi-structured interviews in both contexts.
Findings
This study provides insight into several types of interfaces and their role in multi-provider contexts. Several inter- and intra-organizational situations were identified in which the delivery of integrated patient care was jeopardized. This study describes how interfaces can help to alleviate these situations.
Originality/value
This study deepens the understanding of interfaces in service modularity by describing interfaces in multi-provider contexts. The multi-provider contexts studied inspired to incorporate the inter-organizational aspect into the literature on interfaces in service modularity. This study further develops the typology for interfaces in modular services by adding a third dimension to the typology, that is, the orientation of interfaces.
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Floriana Fusco, Marta Marsilio and Chiara Guglielmetti
Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have…
Abstract
Purpose
Understanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have pointed out the benefits of cross-fertilization between the various research fields, the literature on this topic is still scattered and poorly integrated. This study aims to summarize and integrate multiple strands of extant knowledge CC by identifying the outcomes of health CC and the determinants of these outcomes and their relationships.
Design/methodology/approach
A structured literature review was conducted per PRISMA guidelines. A total of 4,189 records were retrieved from the six databases; 1,983 articles were screened, with 161 included in the qualitative thematic analysis.
Findings
This study advances a comprehensive framework for healthcare CC based on a thorough analysis of the outcomes and their determinants, that is, antecedents, management activities and institutional context. Extant research rarely evaluates outcomes from a multidimensional and systemic perspective. Less attention has been paid to the relationship among the CC process elements.
Research limitations/implications
This study offers an agenda to guide future studies on healthcare CC. Highlighting some areas of integration among different disciplines further advances service literature.
Practical implications
The framework offers an operational guide to better shape managerial endeavors to facilitate CC, provide direction and assess multiple outcomes.
Originality/value
This is the first extensive attempt to synthesize and integrate multidisciplinary knowledge on CC outcomes in healthcare settings by adopting a systematic perspective on the overall process.
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Veronica Ungaro, Laura Di Pietro, Roberta Guglielmetti Mugion and Maria Francesca Renzi
The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting…
Abstract
Purpose
The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.
Design/methodology/approach
Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.
Findings
The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.
Originality/value
This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.
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Antti Peltokorpi, Juri Matinheikki, Jere Lehtinen and Risto Rajala
To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency…
Abstract
Purpose
To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency problems and tilts the incentives of diverse actors toward more systematic outcomes.
Design/methodology/approach
A two stage multimethod case study of occupational health services. A qualitative stage aimed to understand the reasons, mechanisms, and outcomes of payor–provider integration. A quantitative stage evaluated the performance of the integrated hospital against fee-for-service partner hospitals with a sample of 2,726 patients.
Findings
Payor–provider integration mitigates agency problems on multiple levels of the service system by complementing formal governance mechanisms with informal mechanisms. Compared to partner hospitals, the integrated hospital yielded 9% lower the total costs of occupational injuries achieved primarily by emphasizing conservative care and faster recovery.
Research limitations/implications
Focuses on occupational health services in Finland. Provides initial evidence of the effects of payor–provider integration on the operational performance.
Practical implications
Vertical integration may provide systematic outcomes but requires mindful implementation of multiple mechanisms. Rigorous change management initiative is advised.
Social implications
For patients, the research shows payor–provider integration of health services can be implemented in a manner that it reduces care costs while not compromising care quality and customer satisfaction.
Originality/value
This study provides a rare longitudinal analysis of payor–provider integration in health-care operations management. The study adds to the knowledge of operational performance improvement of health services.
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Roberta Sebastiani and Alessia Anzivino
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Originality/value
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.
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James A. Shaw, Pia Kontos, Wendy Martin and Christina Victor
The purpose of this paper is to use theories of institutional logics and institutional entrepreneurship to examine how and why macro-, meso-, and micro-level influences…
Abstract
Purpose
The purpose of this paper is to use theories of institutional logics and institutional entrepreneurship to examine how and why macro-, meso-, and micro-level influences inter-relate in the implementation of integrated transitional care out of hospital in the English National Health Service.
Design/methodology/approach
The authors conducted an ethnographic case study of a hospital and surrounding services within a large urban centre in England. Specific methods included qualitative interviews with patients/caregivers, health/social care providers, and organizational leaders; observations of hospital transition planning meetings, community “hub” meetings, and other instances of transition planning; reviews of patient records; and analysis of key policy documents. Analysis was iterative and informed by theory on institutional logics and institutional entrepreneurship.
Findings
Organizational leaders at the meso-level of health and social care promoted a partnership logic of integrated care in response to conflicting institutional ideas found within a key macro-level policy enacted in 2003 (The Community Care (Delayed Discharges) Act). Through institutional entrepreneurship at the micro-level, the partnership logic became manifest in the form of relationship work among health and social care providers; they sought to build strong interpersonal relationships to enact more integrated transitional care.
Originality/value
This study has three key implications. First, efforts to promote integrated care should strategically include institutional entrepreneurs at the organizational and clinical levels. Second, integrated care initiatives should emphasize relationship-building among health and social care providers. Finally, theoretical development on institutional logics should further examine the role of interpersonal relationships in facilitating the “spread” of logics between macro-, meso-, and micro-level influences on inter-organizational change.
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