Empowering health care consumers in the era of Internet of Things

The Internet of Things (IoT) is emerging as a significant development in information technology that aims to link the digital world with the real world to improve human life. IoT refers to digital tools collecting data and providing hyper-personalized information to its users. With the rapid integration of the IoT in the healthcare sector (HIoT), it has been presumed that HIoT devices have an empowering effect on patients; however, this has yet to be investigated. Furthermore, the literature reveals a lack of consistency regarding the definition of patient empowerment. This study aims to fill these gaps and investigates whether HIoT systems increase user empowerment for individuals suffering from chronic illnesses. It also examines how empowerment is defined for HIoT users. To answer these two research questions, we conducted a qualitative research study consisting of 20 semi-structured, in-depth interviews carried out with individuals suffering from Type 1 diabetes (T1D). The interviews were transcribed and content analysis was conducted on the data. The study enabled us to examine whether and how the HIoT triggered empowerment for patients suffering from T1D. Findings reveal four main dimensions of empowerment for HIoT users: (1) self-efficacy, (2) patient control, (3) knowledge development and (4) participation in the decision-making process along with the doctor. Results also highlight that participants feel empowered by personal acceptance of living with their health condition and social support. In addition, the analysis led to the identification of the barriers which need to be overcome to ensure that HloT systems improve patient empowerment.     

Hospital Positioning and Integrated Hospital Marketing Communications: State-of-the-Art Review,Conceptual Framework,and Research Agenda

In the light of patient empowerment and channel fragmentation, hospitals struggle to target patients in their new role as active, knowledgeable consumers. As market differentiation via traditional marketing mix variables such as price is hardly achievable in healthcare, superior communication grounded on sound positioning is a more promising lever for competitive advantage. Yet, research on marketing-driven communication from provider to patient lacks synthesis and critical reflection. Drawing upon evidence from previous research, this article unites 62 articles from medical and social sciences covering aspects of hospital marketing communications. Derived from qualitative content analysis, findings on the effectiveness of specific communication channels and contents are portrayed. This article further uncovers the characteristics of four evolving archetypes for hospital positioning and illustrates the implementation of integrated hospital marketing communication strategy. The elaborated conceptual framework can be used as a managerial tool for tailoring hospital communications. The article closes by highlighting future research directives.     

The effect of customer empowerment on adherence to expert advice

Customers often receive expert advice related to their health, finances, taxes or legal procedures, to name just a few. A noble stance taken by some is that experts should empower customers to make their own decisions. In this article, we distinguish informational from decisional empowerment and study whether empowerment leads customers to adhere more or less to expert advice. We empirically test our model by using a unique dataset involving 11,735 respondents in 17 countries on four continents. In the context of consumer adherence to doctors' therapy advice (patient non-adherence to doctor advice may cost about $564 billion globally to the pharmaceutical industry every year), we find that decisional empowerment lowers adherence to expert advice. The effect of informational empowerment varies predictably across cultures and is only universally beneficial when initiated by the customer. These findings have important implications for professional service providers.     

市场竞争性和我国的医疗体制改革——经济学视角下的医疗体制改革模式

市场的竞争性不仅取决于市场结构,还取决于价格信息在消费者之间的传播速度。由于医疗服务的价格信息在患者之间的传播是一个缓慢的时间过程,所以医疗服务市场看似有竞争而实际上竞争程度远比一般商品和服务市场低得多。在说明医疗服务市场的高价格水平形成机制的同时,指出政府只要能够改变医疗服务价格信息的传播机制,就能够建立一个以市场机制为基础的高效率的医疗卫生体制。     

Employee emotional response toward healthcare organization’s service recovery efforts and its influences on service recovery performance

Previous studies on service recovery performance of frontline employees have focused primarily on the direct relationship with the organizational efforts for service recovery. However, based on the reformulation of attitude theory (appraisal-emotional response-behaviour), we believe that the emotional responses (work engagement and burnout) toward organizational efforts for service recovery of frontline employees mediate the relationship. Thus, the purpose of this study is to examine how healthcare frontline employees show their emotional response toward the organizational efforts for service recovery and it influence on actual recovery performance. This study uses two conflicting emotional responses, burnout and work engagement, to examine how employees react toward organizational efforts, helping better understand employees?? evaluations of the efforts. Research model and hypothesis were tested using a sample of frontline employees who perform none-clinical activities in hospitals. The results showed that teamwork and empowerment have positive effects on work engagement. In addition, customer complaint management, empowerment, and teamwork influenced negatively on burnout. Lastly, work engagement and burnout showed statistically significant impact of service recovery performance of frontline employees. Among the organizational efforts for service recovery, teamwork was the most important factor in improving frontline employees?? work engagement and lessened their burnout, respectively. Interestingly, customer service training had a negative effect on burnout. Besides, by comparing our research model to two alternative models, we confirmed the validity of the research model.     

消费者增权理论与我国消费者权益保护法的完善

消费者增权理论是近年来西方社会科学领域关注的热点问题之一,在消费者增权理论中,信息供给型增权和制度供给型增权是两种主要模式。我国现阶段的消费模式和消费者权益保护实践表明,制度供给型消费者增权可以更好地保护消费者利益。所以,从消费者增权理论出发,完善消费者权益保护法律体系,是增进消费者利益保护和实现消费和谐的重要举措。     

The influence of hospitable design and service on patient responses

ABSTRACT

A study of 216 respondents examined a medical center environment’s influence on patient responses. A stimulus–organism–response (S-O-R) model was adapted to the theory that more hospitable healthcare servicescape elements will affect patients’ overall satisfaction with healthcare experience, loyalty intentions, and willingness to pay out-of-pocket expenses for healthcare services. Servicescape elements included atmospherics of the healthcare environment, service delivery by healthcare staff, physical design of the healthcare environment, and wayfinding. Results of structural equation modeling confirmed that the four servicescape elements – had a significant impact on patients’ overall satisfaction with the healthcare experience. Furthermore, overall satisfaction with the healthcare experience predicted patients’ loyalty intentions and willingness to pay out-of-pocket expenses for healthcare services. The study makes a significant contribution to the empirical modeling of patients’ behavioral responses to hospitable healthcare environments.     

Relocating empowerment as a management concept for Asia

Management theories, especially those in the area of human resource management, are predominantly Western-centric in origin and in the empirical testing that underpins them. The purpose of this paper is to explore perceptions of one such theory, employee empowerment, in an Asian context. Information gathered from an open ended questionnaire and focus groups provide an in-depth examination of hotel managers' perceptions and practice of empowerment in the workplace. This study provides tentative indicators of significant culturally-driven differences in the understanding and application of employee empowerment (in terms of both research and practice) between Western and Asian contexts. The results of this study indicate that empowerment in Asian cultures relates much more to the individual and his/her merits, in contrast to organizationally-driven empowerment in Western countries. The findings also indicate that empowerment by hotel managers is related to the level of personal trust the manager has in an employee.     

One-click at a time: Empowering mothers for their adolescent children's educational expenditures through social media usage

Mothers play a significant role in deciding their adolescents' educational expenditures. They increasingly rely on the Internet for information search and building online support networks to enhance their confidence. Thus, we use the psychological empowerment theory in this study to examine the association between social media use and educational expenditures. Through two studies, we show how a mother's use of social media (active/passive use) significantly impacts adolescent children's educational expenses via dimensions of psychological empowerment. We further demonstrate that the two dimensions of psychological empowerment differentially drive this relationship: intrapersonal (relying on the self) and Interactional (leveraging the community) empowerment. We discover that active (passive) social media use increases mother' intrapersonal (interactional) empowerment. We also find that cross-cultural differences play a role in psychological empowerment's effect on educational expenditures, where intrapersonal empowerment is vital in the United States, and interactional empowerment is more relevant in India. Our key contributions to literature are three-fold: we establish the relationship between a mother's social media use and educational expenditures for their adolescent children, identify predictors of different dimensions of psychological empowerment, and present evidence for cross-cultural differences in the empowering role of social media.     

Transparency and empowerment in an investment environment

In a laboratory-controlled environment we provide experimental evidence on the effects of transparency (complete over incomplete information) and empowerment on trust and trustworthiness. We implement a simple version of the standard two-person investment game in a repeated game context with multiple treatments under two information environments. We find that when principals are empowered by being able to penalize agents who may not act in a way the principal believes is in the principal's best interest, the level of trust and investment increases over that which is realized in the absence of empowerment regardless of the degree of transparency. In transparent environments the effect of empowerment is about the same regardless of whether empowerment is introduced or removed. However, in opaque environments, the loss of empowerment has a substantially greater negative effect on trust than the positive effect associated with the introduction of empowerment.     

Patient care,satisfaction and service quality in health care

It is becoming increasingly important in the healthcare setting to treat patients as consumers and measure their satisfaction with medical services rendered. As such, patient satisfaction should be considered an important output of a country's healthcare system, basically reflecting the stage of its development. The conducted study tested students’ satisfaction with the quality of service provided by student polyclinics. In particular, the study has analysed the impacts of personal relationships, promptness and tangibility on student satisfaction. The findings imply that all three factors significantly affect patient satisfaction, with personal relationships having the strongest impact. Such results suggest that healthcare providers should encourage their doctors to devote more time to their patients and show genuine concern for patients’ problems if they wish to improve overall satisfaction of their patients with the delivered services.     

Rhetoric versus Reality: Exploring Consumer Empowerment in a Maternity Setting

This study explores consumer empowerment in a maternity setting in the Republic of Ireland. Our results indicate that empowerment is a complex phenomenon influenced by many variables. While the current health services literature is focusing on active consumers of health services, our study shows that not all pregnant women have the same needs for and attitudes toward empowerment: some women do indeed seek to be overtly empowered in the maternity setting and equate empowerment with a high level of control over the service provision; others pursue a more passive role but may still experience such a role as empowering. A theoretical discussion focusing on the complexities of empowerment and issues of power and authoritative knowledge in cultural systems concludes this paper.     

Moderating effects of consumer empowerment on the relationship between involvement in eco‐friendly food and eco‐friendly food behaviour

This study investigates the moderating effect of consumer empowerment on the relationship between involvement in and purchase behaviour towards eco‐friendly food. It uses the generalized linear model, with data from the 2017 Research on Food Consumption. The results showed that gender is related only to involvement in eco‐friendly food and this involvement is higher for women than for men. Moreover, involvement in eco‐friendly food, purchase empowerment, engagement empowerment and frequency of buying eco‐friendly food increase as age increases, with the highest increases observed at ages 40–49 and 50–59; the score for those older than these age groups was much lower, resembling an inverted U shape. Groups with high education and income levels presented high scores for involvement in eco‐friendly food, purchase empowerment, engagement empowerment and frequency of buying eco‐friendly food. Regarding the effects of involvement in eco‐friendly food, purchase empowerment and engagement empowerment on the frequency of buying eco‐friendly food, the main effects of involvement in eco‐friendly food and purchase empowerment as well as the interactive effects between involvement in eco‐friendly food and engagement empowerment were statistically significant.     

Effects of transactional leadership,psychological empowerment and empowerment climate on creative performance of subordinates: A cross-level study

This research surveyed 101 teams, involving 497 team members and 101 team leaders, in a large multinational company in China. A hierarchical linear model is used to examine the hypothesized mediated moderation model. It is found that: (1) individual psychological empowerment is positively related to creative performance; (2) the relationship between transactional leadership and subordinates’ creative performance is moderated by team empowerment climate; (3) individual transactional leadership behavior is positively related to subordinates’ creative performance in teams with higher empowerment climate, but negatively related to subordinates’ creative performance in lower empowerment climate; and (4) the relationship between transactional leadership, team empowerment climate and creative performance is partially mediated by subordinates’ psychological empowerment perception. Theoretical contributions and practical implications are also discussed.     

Comparing Innovation Capability of Small and Medium‐Sized Enterprises: Examining the Effects of Organizational Culture and Empowerment

This study analyzes the impact of organizational culture and empowerment on innovation capability, and examines the peculiarities of these effects. The study's hypotheses are tested by applying both individual and firm‐level analyses to survey data collected from 743 employees from 93 small and medium‐sized firms located in Turkey. For medium‐sized enterprises on both the individual and firm level of analysis, results suggest that collectivism and uncertainty avoidance are positively associated with empowerment, whereas power distance is negatively related to empowerment. Assertiveness focus has no relations with empowerment and innovation capability, yet among cultural dimensions, only uncertainty avoidance is related to innovation capability. For small‐sized enterprises, findings suggest that both power distance and uncertainty avoidance are linked to both empowerment and innovation capability on the individual level, whereas two new paths between collectivism and innovation capability and between assertiveness focus and empowerment are found on the firm level. Also, empowerment is found to be positively related to innovation capability for both small and medium‐sized enterprises (SMEs) on both the individual and firm level. In terms of managerial practice, our study helps clarify the key role played by cultural dimensions in the process of shaping an empowering and innovative work environment. Findings also reveal that managers should focus on participative managerial practices (e.g., empowerment) to promote innovation capability of SMEs.     

How policy is shaping the macro healthcare delivery supply chain: The emergence of a new tier of retail medical clinics

The healthcare industry continues to face substantial pressure to simultaneously improve costs and patient centricity. Much of the focus to date has concerned policy interventions capable of improving these performance measures for traditional healthcare providers, such as hospitals. But recently, nontraditional healthcare providers like Walmart Health and Amazon have made forays into the industry by establishing retail medical clinics (RMCs). These efforts constitute a redistribution of how services are organized across the macro healthcare delivery supply chain. While RMCs stand to bring innovative models of service delivery to patients, the policy environment can both enable and inhibit their involvement in the industry. We develop a framework that explains how structural and conduct regulations have historically influenced demand for and supply of healthcare services. We then describe how these regulatory factors can support nontraditional healthcare providers as they launch innovative service delivery models aimed at efficiency and customer centricity.     

Entrepreneurship Education in a Poverty Context: An Empowerment Perspective

Empowerment is an important but understudied phenomenonExperiential Learning in entrepreneurship education. We integrate literatures on empowerment theory and experiential learning to propose a conceptual model of empowerment‐based entrepreneurship education. The concept of entrepreneurial empowerment is introduced as a cognitive state characterized by meaning, competence, self‐determination, and impact toward entrepreneurial activities. The model proposes that empowerment has a mediating role in the relationship between experiential learning approaches in a poverty context and the acquisition of learning outcomes. The model is illustrated using an entrepreneurship and adversity program that supports local low‐income individuals in starting and growing their ventures.     

Stakeholder engagement through empowerment: The case of coffee farmers

While most studies on stakeholder engagement focus on high‐power stakeholders (typically, employees), limited attention has been devoted to the engagement of low‐power stakeholders. These have been defined as vulnerable stakeholders for their low capacity to influence corporations. Our research is framed around the engagement of low‐power stakeholders in the coffee industry who are, paradoxically, critical resource providers for the major roasters. Through the case study of Lavazza—the leading Italian roaster—we investigate empowerment actions addressed to smallholder farmers located in Brazil, India, East Africa, Haiti, and the Dominican Republic. We contribute to the theoretical discussion around engagement and empowerment by developing a framework linking together areas of empowerment (defined in the literature) and specific empowerment actions (emerging from our interviews). Our insights shed light on how organizations can design empowerment strategies leading to more effective stakeholder engagement and how empowerment actions can contribute to turn low‐power stakeholders into active business partners. We demonstrate that moving from a traditional competitive view of corporate–stakeholder relationships to a stakeholder theory view based on a logic of cooperative partnerships reinforces the idea that stakeholder engagement and empowerment are both entangled with the value creation process.     

The promises and constraints of consumer-directed healthcare

Consumer-directed healthcare promises to reduce costs and increase quality by expanding provider choice for prospective patients. High-deductible insurance, employer- or government-subsidized health savings accounts, transparent pricing, and accurate information on clinical performance help generate millions of patients shopping for healthcare. As in any other well-behaved market, when patients shop, there is a link between financial reward and value for the individual patient. Absence of price competition, agency problems, and high barriers to entry in local markets are market failures that currently break this link in U.S. healthcare. Consumer-directed health plans are already popular among many employers and have established a momentum that indirectly shapes discussion of reform by the Obama administration. Complexity of reporting clinical results, dependence of treatment success on at-home patient behavior, and scientific ignorance among consumers threaten delivery of results promised by theory. Successful implementation requires regulator attention to sophisticated data reporting that adjusts for clinical risk, avoidance of patient-focused marketing that leads to over-consumption, and adequate subsidy of health savings accounts. In the end, implementation shifts the locus of healthcare system control from cost-shifting negotiations between employers, providers, and payers to new-found purchasing power of prospective patients.     

Consumer Control and Empowerment: A Primer

This paper introduces consumer empowerment as a promising research area. Going beyond lay wisdom that more control is always better, we outline several hypotheses concerning (a) the factors that influence the perception of empowerment, and (b) the consequences of greater control and the subjective experience of empowerment on consumer satisfaction and confidence.