TY - JOUR
T1 - Value capture and embeddedness in social-purpose-driven ecosystems
T2 - A multiple-case study of European digital healthcare platforms
AU - Pundziene, Asta
AU - Gerulaitiene, Neringa
AU - Bez, Sea Matilda
AU - Georgescu, Irène
AU - Mathieu, Christopher
AU - Carrabina-Bordoll, Jordi
AU - Rialp-Criado, Josep
AU - Nieminen, Hannu
AU - Värri, Alpo
AU - Boethius, Susanne
AU - van Gils, Mark
AU - Giménez-Garcia, Víctor
AU - Narbón-Perpiñá, Isabel
AU - Prior-Jiménez, Diego
AU - Vilutiene, Laura
N1 - Funding Information:
In contrast to PFI's prior research, digital healthcare platforms embedded within the social-purpose-driven ecosystem, be they the public or private sector, prioritise the platform's social impact and benefits for patients. A medical doctor, in the city of Hämeenlinna, on OmaOlo states: “Lifestyle-related chronic diseases are a major public health risk. OmaOlo enables patients to do lifestyle assessments at their own pace and get personalised guidance. OmoOla is a vital tool for preventative health care.” The Director of Medicine and Nursing at the Emergency telemedicine program continues: “Social returns and economic returns. Now I have to open up my description of this project. We know how we have calculated, we have calculated that about 13 percent of unnecessary transportation is from the districts to our medical institution and from our institution to the district, and we have calculated the costs and time costs of those transportations. And in Lithuania, it is challenging to calculate the benefits patients are experiencing. Because time spent unnecessarily contains a certain cost of health deterioration, it is complicated to calculate how much it will improve or worsen. However, purely from economic things, I have to open up now because I have been looking at that project as it was written for a long time, so now I am not going to say it any time soon.” The post-op tablet has been developed in a social-purpose, non-commercial context. Its development was funded by a public/state research and innovation fund to improve healthcare system efficiencies. Despite the multiple benefits generated by the post-op tablet, its non-commercial origins mean that when the project period is over it is unclear who will take over its operation, further development and maintenance. The project leader of the post-op tablet states: “At the moment, I own responsibility for all this [as project leader] everything that is on the tablets, all the service, all the insurance, and it all has been developed on a project grant. But the day it is to be turned over to the clinics, and we say now you the users have to take all the responsibility, to implement and maintain them [the tablets], we do not know how that will go.” So, while the demand side is secure and can expand, it is unclear who will assume the supply side.
Funding Information:
Public digital healthcare platforms like the Emergency telemedicine program, the post-op tablet or La Meva Salut started as nationally or international funded projects and are looking for support from the national health insurance fund: “I imagine that this should be covered by the compulsory healthcare insurance budget anyway” (Director for Public Health, Research and Education at Emergency telemedicine program). Cost savings for the national healthcare system comes as an argument in favour of many platforms. The post-op tablet allows the healthcare system to save money on in-patient care, as parents of medically stable patients who otherwise would stay longer in the hospital due to insecurity of the parents about assessing the condition of their child from home. In these cases, as the PI of the project states, “these children can in some cases go home earlier (with the post-op-tablet) because they have this bridge, this direct line to us, with them. We can offer much stronger support with the post-op- tablet”. The Director DigiHealth Finland, OmaOlo continues: “When patients do not always need to visit a doctor but can-do symptom assessment with OmaOlo from their home sofa and get guidance, municipalities and state save money and resources”. A medical doctor, in the city of Hämeenlinna, OmaOlo echoes: “When COVID-19 symptom assessment and time reservation was done automatically using OmaOlo, an average of 10 min of nurse's time was saved. With the massive number of assessments, time savings were really significant."
Funding Information:
We followed a two-step process to select our cases that would respect these bounding criteria. First, we selected the five countries (Finland, France, Lithuania, Spain, and Sweden) of the DiHECO project, European project funded by the Horizon 2020 programme to advance knowledge about digital healthcare platforms. Selecting countries belonging to this project ensures a spread of Northern and Southern, Eastern and Western European healthcare systems in which digital platforms are playing increasing roles. Table 1 is a detailed overview of the healthcare systems in the five countries. Analysis of the respective healthcare systems allows us to control the context of the study. Furthermore, the healthcare systems of the five countries are similar. Thus, similarity allows us to make a comparison of the digital healthcare platforms in the five countries later in the analysis (cf. criteria 1 and 2).
Publisher Copyright:
© 2023
PY - 2023/6
Y1 - 2023/6
N2 - We aim to answer the question of the effect of a social-purpose-driven ecosystem on value capture from digital health platforms. We call the social-purpose-driven ecosystem a phenomenon which seeks social impact before profits and aims to empower citizens for individual and collective well-being. Thus, capturing value from digital platforms embedded in a social-purpose-driven ecosystem fundamentally differs from profiting from purely commercial digital platforms and poses significant challenges to platform owners and public policy. Previous research has focused mainly on profiting from technological innovations but has yet to consider the contextual role of the social-purpose-driven ecosystem. We applied the Profiting from Innovation (PFI) framework to fill this gap. Furthermore, based on the results of the multiple-case study of five European digital healthcare platforms, we extend the PFI framework. As a result, we define four unique contingencies which enable value capture from digital healthcare platforms embedded in a social-purpose-driven ecosystem: 1) multilayer value creation, (2) multipurpose complementary assets, (3) emerging dominant design, and (4) distributed socio-economic returns mechanisms. The study offers two managerial and policy contributions. First, it calls on platform owners and policymakers to acknowledge the contextual effect of a social-purpose-driven ecosystem. Second, multilayer value creation, multiple complementary assets, dominant design and distributed socio-economic returns mechanisms can positively affect capturing value from digital healthcare platforms.
AB - We aim to answer the question of the effect of a social-purpose-driven ecosystem on value capture from digital health platforms. We call the social-purpose-driven ecosystem a phenomenon which seeks social impact before profits and aims to empower citizens for individual and collective well-being. Thus, capturing value from digital platforms embedded in a social-purpose-driven ecosystem fundamentally differs from profiting from purely commercial digital platforms and poses significant challenges to platform owners and public policy. Previous research has focused mainly on profiting from technological innovations but has yet to consider the contextual role of the social-purpose-driven ecosystem. We applied the Profiting from Innovation (PFI) framework to fill this gap. Furthermore, based on the results of the multiple-case study of five European digital healthcare platforms, we extend the PFI framework. As a result, we define four unique contingencies which enable value capture from digital healthcare platforms embedded in a social-purpose-driven ecosystem: 1) multilayer value creation, (2) multipurpose complementary assets, (3) emerging dominant design, and (4) distributed socio-economic returns mechanisms. The study offers two managerial and policy contributions. First, it calls on platform owners and policymakers to acknowledge the contextual effect of a social-purpose-driven ecosystem. Second, multilayer value creation, multiple complementary assets, dominant design and distributed socio-economic returns mechanisms can positively affect capturing value from digital healthcare platforms.
KW - Digital healthcare platform
KW - Embeddedness
KW - Multiple-case study
KW - Profiting from innovations
KW - Social-purpose-driven ecosystem
KW - Value capture
U2 - 10.1016/j.technovation.2023.102748
DO - 10.1016/j.technovation.2023.102748
M3 - Article
AN - SCOPUS:85150483203
SN - 0166-4972
VL - 124
JO - Technovation
JF - Technovation
M1 - 102748
ER -