Conceptualizing value co-creation in health care delivery: the focal dyad perspective

Professor Alan Wilson and Kofi Osei-Frimpong

Service Management and Science Forum, Las Vegas, 2013

• To report on the conceptual thinking behind a programme of research in the health sector currently being undertaken in Ghana.

Objectives

• This study seeks to empirically test the concept of value co-creation in the public health care sector (free at point of use) from the dyadic perspective.

The Research

• In health care delivery, sharing of power and responsibility between the actors is important in patient-centredness care leading to positive outcomes in the service delivery (Mead and Bower, 2000)

• Physician over-dominance is prevalent (Cegala et al., 2007; Collins et al., 2007)

• The patient’s role is generally limited to functioning as a provider of information (Elg et al., 2012)

The Healthcare Context

• Drawing from the service dominant logic (Vargo and Lusch, 2004, 2006,

2008) and service logic (Gronroos,2008):

– Customers are considered as co-creators of value (Heinonen et al., 2010; Prahalad and Ramaswamy, 2004)

– Resource integration between the actors is critical

The SDL Context

• Health care is not about the collective authority of the professionals and the participation of the patient, but it is more about the consideration of the patient as a consumer (Nettleton, 1995).

• The patient must sacrifice time, energy and effort to gain benefits.

• Hence the need to understand how the interdependence in the provider-customer relationship can be managed and exploited for value co-creation to be realised (Lin and Hsieh, 2011).

• However, there is limited understanding of how the Patients and the Professionals jointly create value (Aarikka-Stenroos and Jaakkola, 2012).

SDL and Healthcare

• Knowledge Intensive Business Services- where the interaction process between actors affords them opportunities to facilitate value creation for and with each other (Aarikka-Stenroos et al., 2011)

• It is about sharing critical information and effective dialogue rather than one way communication

What can be learned from other types of business?

Creating effective dialogue may be particularly challenging in the context of complex offerings, where the suppliers are dependant on their customers to define their needs, requirements, and the usage context, but customers may lack the necessary knowledge and skills to articulate these elements to the supplier (Nordin et al. 2010 and Tuli et al, 2007)

Knowledge Intensive Business Services - similarities to health care?

The supplier’s high degree of specialisation may manifest a substantial disequilibrium of expertise and experience between the professional and the customer (Lovendahl, 2003)

K.I.B. -Diagnosing Needs and Designing Solutions

Supplier Resources• Expert Knowledge• Diagnosis Skills• Facilities/professional

equipment• Experience• Objectivity/ethics• Relationships with other

experts

Customer Resources• Information on Needs• Information on Context/

operational environment• Industry Expertise/

special circumstances• Production Material/

existing solutions• Effort/ Time/ Financial

Resources

Aarikka-Stenroos et al., (2011)

10

Tentative conceptual framework

Professional’s resources and capabilities

Patient’s resources and capabilities

Perceived expected value

Value capture (value to provider)

Collaborative processes leading to optimal value-in-use

Value creation (value to patient)

Interactions process

Outcome Outcome

• Value co-creation has been studied in health care from different perspectives:• Customer’s perspective (Dellande et al., 2004; McColl-Kennedy et al., 2012)

• Customer to customer (Elg et al., 2012)

• Online customers and health care organisations (Nambisan and Nambisan, 2009)

• Key factor in the value co-creation process is the interaction process (Gronroos, 2011)

• Value is considered as subjective (Helkkula et al., 2012) and context dependent (Chandler and Vargo, 2011)

• Value co-creation is considered to have two sides making it imperative to be examined from the dyadic perspective (Saarijarvi et al., 2013)

Method: The Need for a Dyadic Approach

• A programme of qualitative research incorporating the critical incident technique is currently being undertaken with 15 hospital doctors and 30 of their out-patients

• Also exploring how this can be effectively moved to a quantitative phase

Where are we now?

Questions?