Service innovations breaking institutionalized rules of health care

Abstract

Purpose Although the digital era has given rise to major transformations in many industries, health care has been remarkably resistant to radical innovations coming outside the field. The purpose of this paper is to explore and explain how new ventures aim to break institutional arrangements (i.e. regulations, normative rules, and cultural-cognitive beliefs) protecting the field by introducing digitally enabled service innovations into health care markets. Design/methodology/approach The study is qualitative and interpretative in nature and utilizes case study as a research strategy. The paper is based on data that were collected through narrative interviews and document analysis from seven new ventures participating in a start-up accelerator program. Findings Results indicate that service innovations that require a change in the institutional structures of the health care system are enacted through three highly iterative key processes: institutional sensemaking that creates an understanding of prevailing institutional arrangements and that constructs meaning for institutional change efforts, theorization of change through linguistic device, and modifications of institutions by building legitimacy and mobilizing external constituencies. Practical implications The findings provide practical insights into how new ventures struggle, navigate, and negotiate on specific alternatives related to institutional change while pursuing the introduction of innovations to market. Originality/value This research extends the institutional perspective on service innovation by zooming into micro-level processes of institutional change driven by new ventures. The study develops the theory of institutional entrepreneurship by highlighting cognitive processes of change, and suggests incorporating “institutional thinking” more tightly into the study and management of service innovation.

Institutionalization Process of Service Innovation: Overcoming Competing Institutional Logics in Service Ecosystems

“…At the same time, however, an innovation typically causes change and disruption in the prevailing system, and new practices and structures may be needed before the value can be realized (Koskela-Huotari et al 2016). For example, many innovations in the health care industry aim at reducing health care costs, but the prevailing institutions such as administrative, technical, or legislative infrastructure and systems do not support or adapt for the necessary change, or even protect the health care regime against radical innovations (Wallin and Fuglsang 2017). Reflecting such notions, argue that institutionalization, i.e.…”

“…As institutional logics shape individual and organizational actions (Thornton and Ocasio 2008), it is fruitful to examine how diverse actors with differing institutional logics achieve directions for joint actions, and the key obstacles therein. Development of convergent institutional logics has been identified a critical step for innovation to diffuse to markets, and gain legitimacy across relevant stakeholders (Wallin and Fuglsang 2017). This understanding is pivotal for gaining a broader view of service innovation that is interdisciplinary in nature, involving changes in technological, business, and human practices (Spohrer and Maglio 2008).…”

Mapping Value Co-creation Literature in the Technology and Innovation Management Field: A Bibliographic Coupling Analysis

“…We refer to the light pink cluster as “Service innovation/value innovation” because most of the documents revolve around these topics ( Mele et al, 2014 ; Lusch and Nambisan, 2015 ; Koskela-Huotari et al, 2016 ; Chen, 2017 ; Wallin and Fuglsang, 2017 ; Di Pietro et al, 2018 ; Randhawa et al, 2018 ). Russo-Spena and Mele (2012) approach innovation as a co-creation process from a practice-based vision and develop the five “Co-s” model.…”

Digital transformation shaping structural pillars for academic entrepreneurship: A framework proposal and research agenda

“…Pillar 4 resulted from various articles (Luckman, 2008 ; Mancha & Shankaranarayanan, 2020 ; Monllor & Soto-Simeone, 2019 ; Wallin & Fuglsang, 2017 ) showing how individuals with digital perception can break with institutional agreements (Wallin & Fuglsang, 2017 ). Indeed, digital literacy (Luckman, 2008 ) together with exposure to digital technology, can develop business self-efficacy in individuals (Monllor & Soto-Simeone, 2019 ), as well as developing entrepreneurial intention (Mancha & Shankaranarayanan, 2020 ), allowing the conclusion that Individual Characteristics are one of the pillars supporting R2.…”