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

1. 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

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

3. The Research • 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.

4. The Healthcare Context • 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)

5. The SDL 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

6. SDL and Healthcare • 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).

7. What can be learned from other types of business? • 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

8. Knowledge Intensive Business Services - similarities to health care? 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) The supplier’s high degree of specialisation may manifest a substantial disequilibrium of expertise and experience between the professional and the customer (Lovendahl, 2003)

9. 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. Perceived expected value Tentative conceptual framework Interactions process Patient’s resources and capabilities Professional’s resources and capabilities Collaborative processes leading to optimal value-in-use Value creation (value to patient) Value capture (value to provider) Outcome Outcome

11. Method: The Need for a Dyadic Approach • 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)

12. Where are we now? • 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

13. Questions?