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.     

The vulnerable healthcare consumer: an interpretive synthesis of the patient experience literature

The increased policy emphasis on the ‘patient experience’ places the health consumer in centre stage as the driver for healthcare delivery. This poses challenges for service providers to meet the needs of more vulnerable groups, notably those with disabilities, who are often more likely to be both in greater need of services and, at the same time, less able to access them. This paper reports an interpretive synthesis of qualitative research studies in the UK and US on the experience of vulnerable patient groups using a broad range of health services. An interpretive review method was adopted to capture the complexity of the data. Eighteen papers were identified as meeting the inclusion criteria for the review. Seven key themes were identified: life experience, service design, point of delivery, accessibility, availability, specialist education/training and consumer typology. Although policy makers and providers often refer to the need for greater consumerism in the development of health services, our review suggests that it may be appropriate to consider a model of ‘mediated consumerism’ for some groups of service users. While some concerns are common to both mainstream and vulnerable consumers, others such as accessibility of services, and the resulting experience of health care, are particular to specific vulnerable groups. Accessing the experiences of these more vulnerable groups therefore warrants close attention in the development of both policy and practice in health service delivery.     

The Impact of the Internet on Professional Relationships: The Case of Health Care

This paper considers the impact of the internet on professional services, specifically healthcare services which have been characterised as asymmetrical in information and power distribution. For complex professional services the internet is primarily an information resource offering perceived parity with professionals. Based on interviews with healthcare professionals and website managers, this paper considers how professionals perceive the internet to be changing patterns of professional–consumer interaction and the nature of professional–consumer relationships. Manifest at service encounter level and health policy level, professionals perceived the evolving parameters of the consumer role to be generating a requirement for a fundamental revision of models of service delivery and professional roles.     

Competitive advantage through service differentiation by manufacturing companies

This paper examines the relationship among the complexity of customer needs, customer centricity, innovativeness, service differentiation, and business performance within the context of companies that have made a service transition from pure goods providers to service providers. A survey of 332 manufacturing companies provides the basis for the empirical investigation. One key finding is that a strong emphasis on service differentiation can lead to a manufacturing firm's strategies for customer centricity being less sensitive to increasingly complex customer needs, which can increase a firm's payoff for customer centricity. In contrast, the payoff from innovativeness appears to be higher if the firm focuses its resources on either product or service innovation; that is, a dual focus does not work well. This paper discusses the implications of these findings for researchers and managers.     

Process Coordination Within a Health Care Service Supply Network

There are two manifestations of supply chains in health care. One involves the supply of equipment and materials used in health care delivery. The other supply chain involves the delivery of health care itself, wherein patients supply their physical conditions and service suppliers deliver health care services. This article considers the latter supply chain, analyzing a case study in which patients have comorbidities and thus require the services of a network of multiple health care providers. In the case study, we examine three schemes for coordination of care. In the first scheme, the patient herself is expected to manage the coordination. In the second scheme, physicians are expected to coordinate the care. In the third scheme, a third‐party coordinator manages care across network members. We examine these three possible coordination alternatives using a technique known as Process‐Chain‐Network (PCN) Analysis. PCN Analysis helps us document how coordination schemes are implemented and where they may fail. Our analysis of the case study leads us to the development of ex post theory about who should initiate coordination and how it should take place under conditions of comorbidities. Empirical data coming from the case study support the theory. We describe possible applications of the theory inside and outside of health care, and show how the PCN approach can guide process innovation.     

Service providers’ sustainable service innovation: service-dominant logic

This study examined the service innovation in different service providers with multiple case-study approach. From the perspective of service-dominant logic, four service innovation development models can be distinguished in Technology Development Program companies in Taiwan, including service system integrator and niche market, innovative service solution provider and niche market, innovative service solution provider and mass market, and service system integrator and mass market. Service providers develop ICT platforms, customer relationship management systems, community commerce services, and multi-channel services that are appropriate for a specific industry. On the one hand, active improvement of ICT service system integration extends company capabilities toward external cooperative partners through the provision of integrated product services and comprehensive solutions. On the other hand, innovative service solutions optimize consumer experience and customer relationship management and improve business effectiveness and reduce operations costs due to an important role assigned to services and experience in product sales.     

A New Framework for Service Supply Chains

Despite the extensive amount of academic work devoted to supply chain management, today the structure of service supply chains still remains unexplored. The aim of this paper is to verify and explain this gap with regard to the unique nature of the services industry and the applicability of existing supply chain management literature to service businesses. This paper develops a new model for service supply chains and applies it to the healthcare industry. The results of this study are relevant both to practitioners in the services industry and to researchers conducting further studies in the field.     

Investigating pharmaceutical logistics service quality with refined Kano's model

This study applies the refined Kano model and importance-satisfaction model to investigate medical institutions' satisfaction with and perceptions of importance of domestic pharmaceutical logistics services. Survey data involving 104 respondents from medical institutions are analyzed with importance-satisfaction and the refined Kano model. The results demonstrate that the refined Kano model will generate different classification of quality attributes for the pharmaceutical logistics industry, and medical institutions with different characteristics really have varying responses to quality attributes of pharmaceutical logistics services. The present research contributes to the literature by demonstrating that provision of high-value-added and crucial quality attributes by service providers can give them an edge in the market. In addition, when service providers understand their customers’ attitudes toward innovative service, it can enable them to strengthen their tactics in a competitive market.     

Internationalization journey of healthcare providers: The case of Turkish Acıbadem healthcare group

The advances in technology and global deregulation have led to the progressive internationalization of professional services, notably, the healthcare industry. The present case study examines the remarkable internationalization journey of Acibadem Healthcare Group (AHG) by scrutinizing the dynamics and outcomes of the agile and innovative strategies which propel their achievements. The case of AHG shows that successful internationalization in the service industry, in general, and healthcare, in particular, is not solely in the domain of large, established companies from advanced economies, but those ventures with liabilities of origin, newness, and size can also succeed with smart strategies and resourceful leveraging of their competitive advantages. The study provides unique insights on strategic management for successful internationalization of the healthcare services within an emerging market context and suggests future research avenues in this fast-growing field of inquiry.     

Measuring physician contribution to the healthcare safety net

There are an estimated 46 million Americans without health insurance and an even larger number for whom health insurance does not cover all needed medical services. These individuals and families have to rely more and more on government programs and physicians’ willingness to provide uncompensated services, most often described by providers as charity care. Previous studies have shown a downward trend in the percent of physicians willing or able to provide charity care. We extend this research by examining the results of the Medical Group Management Association's Cost Survey of Medical Group Practices for 2005, 2006, and 2007. It is important to examine the uncompensated care reported by medical groups because groups have policies that may govern how much, if any, charity care their physicians provide. This survey data shows that, overall, the number of medical practices providing charity care continues to decline. The results and analysis of the survey data indicate that uncompensated (charity) care is being offered by less than half of medical practices, and at less than 2% of total gross charges. We examined the results by potential explanatory variables: population density, practice size, physician practice specialty, practice ownership structure, payer mix, and practice financial performance. Results were consistent across all categories; charity care is declining. These results have major policy implications for both the federal government and all state governments, especially in light of the current recession and proposed healthcare reform legislation.     

Transformative service research and service design: synergistic effects in healthcare

ABSTRACT

This conceptual paper answers the question: How do we design service experiences in whole to increase the well-being of all participants in the healthcare system – patients, families, and caregivers? In order to do so, we position service design as an essential tool and even a mindset needed for transformative service research success. We discuss the transformative role service design plays in improving service and consumer entities’ well-being with a focus on how this approach can lead to improved healthcare service outcomes. We also add to the conversation surrounding service and consumer entities’ well-being by broadening the concept and application of service design to consider social, existential, psychological, and physical well-being. We particularly explore how healthcare services can benefit from further consumer engagement and collaborative patient–provider relationships, two key factors essential for redesigning the industry.     

构建新发展格局下物流业与制造业深度融合发展研究

物流业与制造业深度融合发展是构建新发展格局的必然要求,近年来一些地方进行了积极实践,探索了多种深度融合发展模式。两业融合发展不仅有助于推动制造业的转型升级和创新业态模式的融合,而且有助于物流业与制造业的降本增效,提升经济社会整体效益。在构建新发展格局的背景下,应加强物流业与制造业深度融合发展的规划、加强物流业与制造业深度融合发展的要素保障、加快物流业与制造业供应链综合服务商的培育、注重制造业供应链体系全球化专业化水平的提升,不断推动物流业与制造业深度融合发展。     

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.     

新医改背景下如何评价医疗服务质量——基于通用评估框架的探索与应用

评价和改进医疗服务质量是我国新一轮医药卫生体制改革的重要目标,这需要建立在拥有一套科学和完善的评价指标体系基础之上。然而,我国现有的医疗服务质量评价指标体系滞后于医疗卫生体制改革实践,缺乏系统的理论框架,仅侧重于医院等级评价和业务考察,而没有将评价看作是一个系统的过程,也就难以促进医疗服务质量的持续改进。尝试将广泛应用于公共部门绩效评价的通用评估框架引入医疗卫生服务领域,开发了一套包含三个评价层级共27个指标的医疗服务质量评价指标体系,并以北京S医院为例进行了应用和完善。研究表明,通用评估框架可以为我国医疗卫生质量评价提供新的思路,在实际应用中具有较好的效果,可以准确地呈现医院医疗服务质量的结果和影响医疗服务质量的因素,但也需要在今后的应用中不断更新评价指标,聚焦新医改的任务,增加客观性指标。     

Impact of Technology-Based Self-Service on Employees, Customers, and Sales in the Korean Services Market

For service providers, efficient production and delivery is becoming increasingly important. If customers can play the role of partial employees when participating in the service production and delivery, service providers can reduce the workload and achieve higher productivity. This study’s purpose is to investigate the impact of technology-based self-service (TBSS) which is designed for improvement of operational efficiency of service organizations on employees, customers, and sales, especially focused on South Korea’s service market. In-depth interviews with managers of large service providers and a questionnaire survey of employees were used as the research method. Our findings indicate that technology-based self-service positively influences employee satisfaction, but it provides disadvantages in sales, and in customer satisfaction when the services fail. Moreover, some interesting results were identified. We present the details of the statistical results and the implications found from the study.     

Social media's contribution to customer satisfaction with services

An important recent initiative in the effective transmission of healthcare services is the establishment of the patient-centered medicine (PCM) philosophy as a mechanism for enhancing customer satisfaction. Although the goals of PCM are important, there is less understanding of the means by which service providers can promote this philosophy.

This study examines the relationship between customers’ attitude toward and use of social media, PCM, and their satisfaction with healthcare services. Data were collected from a large, urban-based pediatric office in the northeast. The sample consisted of 234 respondents who were classified as ‘e-Patients’ – that is, they reported having access to the Internet and going online for health information. A three-stage regression analysis, conducted to establish the path coefficients for each stage in the model, shows that customers’ (patients’) attitude toward social media can be an effective method to enhance PCM and, ultimately, satisfaction. The findings contribute to theory in services by exploring the challenges of managing service delivery at the interface between customer satisfaction and the role and usefulness of adopting and effectively using social media.     

Exchanging knowledge through healthcare manager placements in research teams

This study contributes to service industry theory by revealing how employers in the health service understand knowledge exchange as ‘transaction’. Although under pressure to deliver better services without additional resource, health service providers do not seek customers, making them unlike commercial service industries. This paper reports a UK knowledge exchange programme designed to bring together healthcare managers and researchers. Case study data were gathered from 36 semi-structured interviews with health services managers (Fellows) embedded in research teams, research team leads, and Fellows' workplace line-managers. Interviews were analysed thematically using a coding frame. The importance of personal contact in knowledge exchange mechanisms was confirmed but the knowledge model varied by interaction pairings (Fellow/research team; Fellow/health service). When with researchers, an exchange model was commonly in operation, marked by collaborative engagement. In contrast, line-managers tended to adopt a transactional approach, driven by instrumental motives. This transactional model merits further research.     

Service bundling and strategic equilibrium in the information services industry

The information service industry is characterized by successive levels of access; e.g., network service and data base service. Within this structure firms may have incentives to bundle services and exclude independent service providers from media access. This multilevel structure is incorporated into mathematical models that can be used to characterize interactions between unregulated firms in a variety of industries, including switched network services, software, and television.Incentives for vertical merger between complementary service providers are evaluated for several cases. We show that cross subsidy occurs under vertical merger, and that the likelihood of merger is greatest when one of the firms can unilaterally exclude other complementary firms from media access. In this case the access controlling firm is in a position to enforce bundled pricing and limit the availability of independently supplied services. This ability to bundle services leads to cross subsidy and merger, even in the absence of economies of scale or scope.     

Hands-off? Lessons from high-touch professionals about going virtual

The COVID-19 crisis has fundamentally changed how many businesses operate and connect with their customers. Previously unheard-of government restrictions and sheltering-in-place requirements forced most professional services to transition to remote delivery methods (e.g., email, telephone, video consults, Shopify storefronts). Providers of low-touch services (e.g., lawyers, accountants) naturally lent themselves to remote delivery; however, those that offer high-touch services, particularly those in healthcare (e.g., doctors, chiropractors, physical therapists), experienced a drastic change in working conditions when going virtual. Despite a long history of resistance to virtual delivery, the pandemic created an unprecedented incentive for these high-touch professionals to experiment with underutilized care models such as telehealth: the provision of healthcare services remotely using telecommunications technologies. We examine the rapid adoption of telehealth during COVID-19 through the coming together or convergence of previously unrelated technologies, spaces, and practices. Our analysis reveals opportunities and challenges associated with going hands-off that apply to many other professionals providing high-trust services. Specifically, we offer nine guiding principles for building and protecting cognitive and affective trust in virtual and hybrid delivery models. This is important given the pace of compounding technology convergences that lie ahead for service professionals.     

Service quality delivery in a cross-national context

Consumption of a broad range of services ranging from tourism to hospitality by an increasingly global mix of customers, especially from the new millennium of the emerging middle class, is creating an interesting challenge for service providers. What are the macro-environmental (cultural, historical, economic, political etc.) influences on service culture and on service quality delivery? Drawing on the expectancy-disconfirmation theory, this qualitative study provides insights on profound macro-environmental drivers of attitudes towards service quality delivery from a cross-national context. Based on comparative, country-based industry insights that highlight employee attitudes from advanced and emerging markets, we discuss the impact from a cross-national service quality delivery perspective. By examining comparative country contexts in growing service sectors, as in hospitality and tourism, we develop and present a conceptual model of cross-national service quality delivery.