User-defined ecosystems in health and social care

Abstract

Purpose People with complex health conditions must often navigate landscapes of uncoordinated public, private and voluntary health-care providers to obtain the care they need. Complex health conditions frequently transcend the scope of typical health-care service systems. The purpose of this paper is to explore and characterize such unique assemblages of actors and services as “user-defined ecosystems”. Design/methodology/approach Building on literature on customer ecosystems, this paper introduces the concept of the user-defined ecosystem (UDE). Using an abductive approach, the authors apply the concept in an interpretive, qualitative study of ten families with special needs children. Findings This study uncovers complex UDEs, where families actively combine a broad range of services. These ecosystems are unique for each family and extend beyond the scope of designed service ecosystems. Thus, the families are forced to assume an active, coordinating role. Research limitations/implications This paper shows how to identify ecosystems from the user’s point of view, based on the selected user unit (such as a family) and the focal value-creating function of the ecosystem for the user. Social implications This paper highlights how service providers can support and adapt to UDEs and, thus, contribute to user value and well-being. This can be used to understand users’ perspectives on service and systems in health and social care. Originality/value This study develops the concept of the UDE, which represents a customer-focused perspective on actor ecosystems and contrasts it with a provider-focused and a distributed perspective on ecosystems. This study demonstrates the practical usefulness of the conceptualization and provides a foundation for further research on the user’s perspective on ecosystems.

Well-being co-creation in service ecosystems: a systematic literature review

“…Similar to Mickelsson et al (2022), we also note the need to identify how user-defined service ecosystems form; they stem from customers’ perceptions and can encompass different actors, resources and relationships. Additionally, by shifting focus, further research might examine well-being co-creation from other micro level service actors’ viewpoints (e.g.…”

Organizational practices to co-create value with family members engaged in service journeys of their loved ones

“…Indeed, dyadic interactions between customers and service providers along a service journey are often influenced by their social network, by which the role of family members cannot be ignored (Abboud et al ., 2021). As a matter of fact, family members often play important roles along service journeys of customers experiencing vulnerabilities like chronic diseases (McColl-Kennedy et al ., 2012; Mickelsson et al ., 2022). Along those journeys, we contend that family members can fulfill the roles of “partial employees” and “secondary customers”, which are detailed in the next paragraphs.…”

“…Yet, organizations can also co-create value with family members by allowing them to disengage from the service journey of their loved one, for instance because adopting an informal carer role is exhausting (Leino, 2017; Leino et al ., 2021). Indeed, prior work indicates that family members may experience vulnerabilities when being involved in the service journey of their loved ones (Leino et al ., 2021; Mickelsson et al ., 2022; Pavia and Mason, 2014; Raciti et al ., 2022). In those situations, family members may perceive value when organizations take care of them as “secondary customers” of their services (e.g.…”

Wellbeing implications of BoP marketing: a service ecosystem approach

“…In the context use of technology for well-being, Khaksar et al (2017) revealed that social assistive technologies contribute to the well-being of aged customers. In a recent study, Mickelsson et al (2022) explored the role of information technology in navigating the treatment of patients by focusing on a user-defined ecosystem. Previte and Robertson (2019) and Pandey et al (2022) attempted to summarize literature about transformative service exchange for well-being, using technology.…”

“…Service ecosystem, TSR and well-being have been primarily studied within the ambits of health care (i.e. Beirão et al , 2017; Mickelsson et al , 2022). Based on our review of extant literature, it may be inferred that hardly any study, thus, far has explored how the technology-enabled service ecosystem promotes well-being in the BoP context.…”