The long and winding road of eHealth. The service ecosystem perspective

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.

Proceedings of the 17th International Research Symposium on Service Excellence in Management - QUIS17

“…According to extant literature, the preliminary findings show that actors' engagement, resource integration, and reconfiguration are coordinated by institutions and institutional arrangements (Sebastiani and Anzivino, 2021;Edvardsson et al, 2014) and the platformization role of the meso level as an integrator.…”

“…Meso level appears as a virtual platform in which interactions between different actors take place and in which also tensions arise and are overcome (Sebastiani and Anzivino, 2021;Jaakkola et al, 2019).…”

“…During COVID-19 pandemic, hospitals and clinics had to find new and practical solutions to address the impacts on individual and collective well-being due also to the increased diffusion of chronic diseases (Sebastiani and Anzivino, 2021). Technological devices might be increasingly leveraged to coordinate the process of integrating resources and co-creating transformative value Danaher and Gallan, 2016;Anderson et al, 2018).…”

International eHealth ecosystems and the quest for the winning value proposition: findings from a survey study

“…These challenges can have a technical nature, like managing complex and huge amounts of data, ensuring scalability, facilitating interoperability, optimizing security & privacy, and designing for high usability ( Asthana et al , 2019 ; Farahani et al , 2018 ; Nijeweme-d’Hollosy et al , 2015 ). On the other hand, barriers are also present on the organizational and human level ( Fiorini et al , 2022 ; Sebastiani & Anzivino, 2021a ). Sebastiani and Anzivino (2021a) studied key inhibitors and enablers on these levels for an Italian eHealth ecosystem that supports care for patients with chronic cardiovascular problems during the COVID-19 pandemic.…”

“…On the other hand, barriers are also present on the organizational and human level ( Fiorini et al , 2022 ; Sebastiani & Anzivino, 2021a ). Sebastiani and Anzivino (2021a) studied key inhibitors and enablers on these levels for an Italian eHealth ecosystem that supports care for patients with chronic cardiovascular problems during the COVID-19 pandemic. The main inhibitors they found were inter- and intra-actor misalignments (a lack of mutual understanding and the lack of a common worldview among the main actors involved), resource myopia (a lack of understanding the full potential of the tools that are implemented in an ecosystem), and the platformisation gap (the lack of a virtual platform through which actors can interact).…”