Value Co-creation in the Health Service Ecosystems: The Enabling Role of Institutional Arrangements

Abstract

The health care service system is currently undergoing a profound revolution that has put the patient at the core of health outcome co-creation. Patient-centered care could be associated with Service Dominant Logic that looks at co-creation process as a dynamic resources' integration between actors. From this standpoint, the need for a broader vision of value creation process towards a service ecosystem perspective is emerging. This paper includes an overview of the scientific literature and reports on a narrative case study analysis concerning the "International Consortium for Health Outcomes Measurement" in an attempt to nourish the debate on the different ways that multiple actors can collaboratively shape a health service ecosystem. Findings reveal that co-creation practices, involving multiple actors who belong to different ecosystem levels, led to mutual adjustments and to on-going shared changes. These processes directly influenced health outcome creation, which is reframed in light of patients' needs, expectations, and experiences. Therefore, patients are assuming the role of health outcome "co-creator", interacting with all other ecosystems actors (e.g. physicians, institutions, NGO s , health managers, ICTs providers etc.). This study represents a first and preliminary attempt to investigate a real example of dynamic resources' exchange, based on the contribution of multiple interacting actors and on the role of interdepend and interacting institutions in value practices.

Online Value Co-Creation in the Healthcare Service Ecosystem: A Review

“…As social technologies such as online communities embedded in ecosystems, it is essential to understand how technology enables ecosystem emergence and provide opportunities for ecosystem actors. In a complex domain such as healthcare, the service ecosystem view suggest a comprehensive understanding of value co-creation between the actors (Ciasullo et al 2017). The ecosystem's view leads to a great understanding of the necessity for resources' combinations, which is a fundamental aspect of value co-creation (Pappa et al 2017).…”

“…Besides, the perspective in which healthcare organisations are able to participate indirectly in value co-creation might be an area of investigation (Hardyman et al 2015). Furthermore, while in a complex domain such as healthcare, the service ecosystem view suggest a comprehensive understanding of value co-creation between the actors (Ciasullo et al 2017), not many authors have focused on meso, macro and mega level. For instance, Hardyman et al (2015 have investigated the interactions between healthcare organisations, local health agencies, and social services in the meso level.…”

“…OHCs enable users to access, share, and recombine the resources in order to create online value in the healthcare ecosystem. As 8 studies out of 22 articles opined that for beneficial outcomes of value cocreation process, resources require to be combined with other resources (Beirão et al 2017;Chung 2013;Ciasullo et al 2017;Ciasullo et al 2016;Hammervoll 2014;Osei-Frimpong et al 2015;Palumbo et al 2017;van der Eijk et al 2013). As an example of online resource sharing, the patient assisted with this new knowledge can share and discuss with other patients on an OHC.…”

“…It assists ecosystem managers to make sure that resource integration is facilitated to foster benefits for all actors for engaging in value co-creation activities (Beirão et al 2017). Co-creation practice created by various actors, belonging to different service ecosystems levels (micro, meso, and macro), show a mutual adjustment and contribute to ongoing shared changes (Ciasullo et al 2017). In a service ecosystem, the process of value co-creation is impacted by actors' abilities to access, adapt, and integrate resources that are severely shaped by the social context such as relationship and resources (Akaka et al 2013;Pinho et al 2014).…”

“…Actors in such an ecosystem are engaged to share their resources, responding to value propositions which offer the possibility for positive outcomes (Frow et al 2016). In line with this, the outcome of health co-creation takes place not only in light of patients' demands, requirements, expectations, and experiences but also "with" the patient, who plays the main partner of healthcare professionals and a fundamental value co-creator (Ciasullo et al 2017). Likewise, with the rapid growth of social media technology, online communities have been provided as ideal platforms for fostering cocreation between the different actors in healthcare service ecosystem (Amann 2017;Nambisan and Nambisan 2009).…”