How blockchain will transform the healthcare ecosystem

Blockchain has the potential to fundamentally transform the healthcare ecosystem, impacting all healthcare participants. In this article, we study the potential impact of blockchains on patient-centered care delivery by looking at the ecosystem of blockchain-based solutions being developed for key stakeholders: patients, pharmaceutical firms, hospital systems, and insurance providers. Building from our interviews with senior managers, our actual experience in the healthcare industry, and our academic research, we outline how blockchain will transform healthcare, and we provide guidance as to how those in healthcare need to start thinking about engaging with blockchain technology.     

Market-testing Healthcare: Managed Care, Market Evolution and the Search for Regulatory Principles

The growing costs of healthcare as a percentage of GDP in the industrial countries are causing considerable problems for these economies, but any attempt to change the existing healthcare system in any given country is usually accompanied by hefty political debate. A system needs to be found that rations healthcare efficiently and effectively, and which is also politically acceptable. The following article examines recent changes in the healthcare systems in the UK and USA and discusses the extent to which they meet these criteria.     

Ageing-related services as a key element for social cohesion

The aim of this article is to carry out an empirical analysis of certain factors related to dependence in Spain and additionally to study the intensity of the use of health resources by dependents. Age appears to be the main socio-demographic factor related to dependence, which confirms the need for measures to deal with the demographic changes taking place. Thus, providing services to cover long-term care could become an important instrument for social cohesion. Multivariate analysis does not reveal a strong link between the use of healthcare services and dependence that would justify the joint management of the two systems. This means that self-regulating management of dependence and healthcare systems may be adequate except in the case of severe dependency.     

Category Captain Management: a new approach for healthcare suppliers to partner with their hospital customers

Hospitals represent a substantial market for pharmaceutical and medical device companies. The typical approach by healthcare manufacturers and suppliers to hospitals is to send representatives or detailers to hospitals and meet with representatives of hospital formularies and purchasing officials. Classic channels systems, and specifically, Category Captain Management ("CCM") may provide more of a sustainable competitive advantage than traditional hospital detailing. The purpose of this article is to discuss how CCM might apply as an approach for healthcare suppliers to truly partner with their hospital customers.     

Applications of business analytics in healthcare

The American healthcare system is at a crossroads, and analytics, as an organizational skill, figures to play a pivotal role in its future. As more healthcare systems capture information electronically and begin to collect more novel forms of data, such as human DNA, how will we leverage these resources and use them to improve human health at a manageable cost? In this article, we argue that analytics will play a fundamental role in the transformation of the American healthcare system. However, there are numerous challenges to the application and use of analytics: the lack of data standards, barriers to the collection of high-quality data, and a shortage of qualified personnel to conduct such analyses. There are also multiple managerial issues, such as how to get end users of electronic data to employ it consistently to improve healthcare delivery and how to manage the public reporting and sharing of data. In this article, we explore applications of analytics in healthcare, barriers and facilitators to its widespread adoption, and ways in which analytics can help us achieve the goals of the modern healthcare system: high-quality, responsive, affordable, and efficient care.     

Muddling through cybersecurity: Insights from the U.S. healthcare industry

The U.S. healthcare sector is inadequately prepared to deal with the reality of cyber threats. The increasing use of smart medical equipment and mobile devices is making healthcare organizations more susceptible to ransomware and other types of malware. The size and complexity of operations, coupled with the presence of numerous legacy and incompatible systems, make it difficult to implement effective cybersecurity measures. The daunting nature of the problem often results in an if-it-ain’t-broke-don’t-fix-it stance among senior healthcare leaders. The preponderance of healthcare-related laws, compliance regulations, and security guidance frameworks serve to complicate the cybersecurity challenge further and too often results in senior leadership assuming a state of blissful ignorance. This study sheds light on the key factors contributing to the chaotic state of affairs and presents a roadmap to a more deliberate and proactive approach to cybersecurity risk management.     

Healthcare and hospitality: intangible dynamics for evaluating industry sectors

In order to assess potentially profitable exchanges across the healthcare and hospitality industries, this paper reviews intangibles theory, ranging from big data through knowledge assets (explicit and tacit) to intelligence, establishing the potential value from each and best practices for managing. Metrics are offered for the assessment of firms and industries according to these intangibles. Based on the metrics, intangible practices can be identified in all the industry sectors across healthcare as well as from hospitality sectors. Similarities are identified between hospitality and specific healthcare sectors (retail pharmacies have most in common with hospitality firms, both possessing strong data and explicit knowledge capabilities). Implications for strategy, competition, and intangibles management systems can also be drawn (chiefly process and customer relationship data and knowledge leading to operational and marketing excellence).     

The normalization of deviance in healthcare delivery

Many serious medical adversities result from violations of recognized standards of practice. Over time, even egregious violations of standards of practice may become “normalized” in healthcare delivery systems. This article describes what leads to this normalization and explains why flagrant practice deviations can persist for years, despite the importance of the standards at issue. This article also provides recommendations to aid healthcare organizations in identifying and managing unsafe practice deviations before they become normalized and pose genuine risks to patient safety, quality care, and employee morale.     

Medical error reduction: the effect of employee satisfaction with organizational support

The problem of medical errors as a factor of service quality has become critically important for healthcare providers. The research model in this paper describes how employee satisfaction with organizational support (ESWOS) and organizational systems supported by an organizational culture impact medical error reduction. The proposed research model was tested using structural equation modelling for hypotheses, based on data collected from 186 respondents in four selected hospitals. The results of the study strongly support that medical error reduction is associated with ESWOS. Also, organizational culture which supports ESWOS and organizational systems as preventive and corrective systems is important for reducing medical errors.     

Driving health IT implementation success: Insights from The Christ Hospital

The application of information technology to healthcare promises significant benefits, particularly with regard to innovations in improving both clinical and administrative processes. However, to date, few studies have been devoted to understanding the process of implementing a hospital's clinical and business systems and the drivers of success. In this article, we describe a major HIT implementation undertaken by The Christ Hospital (TCH). Specifically, we report on TCH's efforts to separate from a well-established, multi-facility healthcare delivery network and move toward providing world-class patient care on its own. Here, we examine how different stakeholder perspectives, rather than causing conflict, were capitalized on via a collaboration-intensive process. These stakeholders included administrators, physicians, nurses, and other hospital staff, as well as external vendors and TCH's consulting partner. This project is unique due to the speed and spirit of collaboration with which it was accomplished. Our findings have a number of generalizable lessons for practice and implications for research.     

HEALTHQUAL: a multi-item scale for assessing healthcare service quality

The purpose of this study is to examine the measurement dimensions of healthcare service quality proposed in previous studies, quality awards, and service quality accreditation and/or certification systems in the international community. Based on this review, a comprehensive set of healthcare service quality (HEALTHQUAL) measurement items is derived focusing on care processes and results. Thus, the study investigated priorities among the nine measurement items identified through 368 patients and 389 public respondents in South Korea. The results show that the degree of care improvements (26.55 %) was rated as the most important and the second was tangibles (19.82 %) by both groups. The proposed measurement items for HEALTHQUAL were tested using data collected from 385 patients and 251 public respondents at a hospital with more than 500 beds in South Korea. The proposed HEALTHQUAL model consisted of the following five components: empathy, tangibles, safety, efficiency, and degree of improvements of care service.     

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.     

Reliability evaluation of healthcare services by assessing the technical efficiency

Classical reliability analysis techniques of manufacturing and defence industries are not a perfect fit for the assessment of the reliability of services. This is partly due to the lack of proper and valid reliability testing procedures in service systems and complications faced in identifying critical service parameters. Since most prominent performance indicators of a system can be associated with the maximum overall reliability it achieves, then factors that degrade the reliability can be identified with respect to its superior peers. This study utilizes the data envelopment analysis for the evaluation of reliability in service systems with a focus on healthcare. This approach comparably evaluates the performance of a service provider over a period of time by means of failure rates and identifies the factors affecting unreliable time phases. Application of the proposed method is illustrated with a private Turkish hospital along with an example of failure mode and effect analysis for inpatient treatment.     

Performance impacts of interorganizational cooperation: a transaction cost perspective

This study builds on the transaction cost theory to examine the performance effects of interorganizational cooperation and develops an understanding of how different forms of cooperative relationships affect organizational performance within a major service sector, namely the healthcare industry. The authors study, in particular, two cooperative forms applied to hospitals: hospital-based health networks and health systems. An empirical investigation of 382 hospitals in Taiwan shows that interorganizational cooperation exerts positive effects on hospital performance. In addition, health systems have greater positive effects on hospital efficiency than health networks. Furthermore, this study finds that the positive impact of participation in health systems is especially significant for private hospitals, local community hospitals, and hospitals in highly competitive regions. The findings reveal that performance impacts of interorganizational cooperation are contingent on the cooperative arrangements in the healthcare industry.     

Scenario-based design of cooperative systems

Over the past few years, scenario-based design has attained a growing interest as a way to incorporate a focus on the future use of an application into the construction of software. Scenarios have, however, mostly been used in the design of user-interfaces and hence focused on single-user situations. Based on experiences from applying scenarios in the re-design of an Hospital Information System in the Danish healthcare sector, this paper describes how collaborative scenarios can be used in the design of cooperative computer systems and what such col-laborative scenarios should contain. The paper concludes that such scenarios were useful in bridging the gab between understanding collaborative work practices and designing collaborative computer systems.     

我国城乡基本公共服务非均等化研究

城乡基本公共服务非均等化问题是当前我国面临的严峻问题,实现城乡基本公共服务的均等化有利于维护社会公平、服务型政府的构建以及社会的和谐与稳定。当前,我国城乡在基础设施、基础教育、社会保障、医疗卫生等方面存在明显的差距,体制的不完善以及政府治理理念的错位是导致非均等化的主要原因。因此,需要通过改革和完善相关体制,转变政府治理理念等措施,推进我国城乡基本公共服务的均等化。     

Impact of operational innovations on customer loyalty in the healthcare sector

This study investigates the effects of operational innovations, such as application of advanced information technology (IT) systems and supported knowledge and skills (SKSs), on care quality and customer loyalty in the healthcare industry. A research model is proposed based on previous studies and examined the relationships among the constructs using the structural equation modeling approach. Research data were collected through a survey of patients and employees of participating hospitals in Korea, with a patient and an employee as one set. The results of the study indicate that operational innovations result in improved customer closeness, which is associated with IT systems usage and SKSs for delivery of quality care, which have a positive impact on patient satisfaction and customer loyalty. Thus, hospital managers should encourage employees to generate new ideas for work efficiency, care quality, customer loyalty, and organizational performance.     

Consumer Sovereignty in Healthcare: Fact or Fiction?

We pose the question: Is consumer sovereignty in the healthcare market fact or fiction? Consumer sovereignty in healthcare implies that society benefits at large when healthcare organizations compete to develop high quality healthcare products while reducing the cost of doing business (reflected in low prices), and when consumers choose wisely among healthcare products by purchasing those high quality products at low prices. We develop a theoretical model that encourages systematic empirical research to investigate whether consumer sovereignty in healthcare is fact or fiction. In doing so, we develop a series of theoretical propositions that may demonstrate that consumer sovereignty is more fiction than fact. Specifically, healthcare consumers lack the ability, motivation, and opportunity to choose healthcare products that are high in quality and low in price. Similarly, healthcare firms lack the ability, motivation, and opportunity to compete in ways to develop and market higher quality products at lower prices.     

An application of health-portals to improve electronic listening

Electronic listening (eListening) is an innovation that potentially provides patients and other users with the right answer in the right place at the right time. Thus, eListening can potentially improve service flexibility, adaptability and quality. The main purpose of this paper is to investigate the extent to which new web-based service delivery channels, which we refer to as health-portals (he-portals), facilitate eListening in the Spanish public healthcare sector. In this paper, we investigate the relative importance and significance of hospital size and three different types of information and communications technologies (Internet, groupware and collective systems) on the use of eListening through an empirical investigation of 300 Spanish public he-portals. Our main conclusion is that the implementation of Internet systems alone does not guarantee the development of effective eListening. In addition, we demonstrate that hospital size does not affect the level of eListening achieved by hospitals.