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Ubiquitous revolution, customer needs and business intelligence? Empirical evidence from Japanese healthcare sector

Authors:

Abstract

The relationship between ubiquitous technologies and organisational matters remains under-Theorised. In this article, ubiquitous revolution is scrutinised within the framework of the 'service space' concept. The article argues that the healthcare field evolves so rapidly because of the continual introduction of new technologies and disruptive innovations. The role of healthcare related technologies and the drive by service providers to incorporate them to internet of things systems is likely to herald a significant departure in service delivery in the healthcare sector. The Japanese case study suggests that ubiquitous technologies accelerate social and societal change by focusing greater emphasis on customers' voices in the healthcare 'service space'. Moreover, the complexity and dynamics of this evolving 'service space'provide pivotal challenges for organisational adaptivity challenging the traditional organisational business and knowledge management models used by technology providers in various ways. The article suggests that further research is required to place this topic more firmly on the healthcare agenda.
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nt. J. Web Engineering and Technology, Vol. 11, No. 3, 2016  
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... The last decades have brought about tremendous changes in global politics and the emergence of service space, constituting of various institutions from public, private, and the third sector (e.g., Virtanen et al. 2016). Moreover, the rise of third sector organizations in developing countries, the changing role of the international aid agencies towards the aid receiving countries, and the significance of people's participation in development projects and action enforce to retheorize the role of public administration. ...
... The last decades have brought about tremendous changes in global politics and the emergence of service space, constituting of various institutions from public, private, and the third sector (e.g., Virtanen et al. 2016). Moreover, the rise of third sector organizations in developing countries, the changing role of the international aid agencies towards the aid receiving countries, and the significance of people's participation in development projects and action enforce to retheorize the role of public administration. ...
Chapter
This section of the book is especially based on the latest literature on public policy analysis. It discusses broadly the current challenges in organising and running public policies and health policy in particular. We argue that there is a lot of talk about complexity in society, but there is eventually little evidence on what actually constitutes this complexity and how public policies deal with the complexity domain. Moreover, it seems that the problem of existing policy-planning mechanisms and public policy-evaluation paradigms is that they do not fit in with, in particular, the current societal challenges and nexus problems (embedded and constructed somewhere in between existing policy areas). This, in turn, means that there is an urgent need to constitute new kinds of evaluation systems incorporated with the idea of intelligent public policy making. This calls for new methods and methodologies, new institutional settings for evaluation systems and new accountability understanding. This part of the book deals with what the promotion of intelligence presupposes from the perspectives of public policy, decision-making, implementation and evaluation. The starting point in our reasoning is especially knowledge management and decision-making procedures at the level of health policy. In this chapter, we discuss issues like forecasting and the urgent need to develop specific ex ante evaluation methods and procedures, and it underlines putting an emphasis on forecasting societal and health policy-related problems instead of ex post trials. As a result, we argue that a new governance model is evolving within the complexity framework: the New Public Integration. Moreover, this chapter analyses the emergence of new information bases for health policy and the role of big data and the Internet of (Intelligent) Things in particular.
Chapter
Healthcare organisations are not immortal, far from it. The service science approach highlights the role of service users in the service process. Their success and failure are dependent on performance measurement and evaluation. This chapter analyses the role of performance measurement and evaluation in the domain of intelligent policy making in the field of health. Traditionally, the role of evaluation and performance measurement has been central in the management doctrines and practices of public policy and public organisations. Performance measurement and evaluation are important features in the public policy process since they provide feedback information on how public authorities have attained the goals set for them. In this chapter we discuss the role and definition of key evaluation concepts within the framework of intelligent public policy and link these key evaluation concepts into a time-wise three-dimensional model of intelligent evaluative inquiry (ex ante, ex nunc and ex post). We aim to make a strong case for more intelligent public policy evaluation by addressing the simple fact that even though the world is practically full of information today, only part of it converts to knowledge for decision-makers and public policy makers. This chapter builds upon the evaluation practice related to ‘classical’ evidence-based medicine, addressing the role of evidence (albeit always contested to a certain extent) in fostering and nurturing decision-making in public policy and public organisations, but goes further towards public policy and public organisations. To this end, we stress the importance of deploying the best ideas of evidence-based medicine to strengthen policy- and organisation-based performance judgement. This chapter also explores the implications of this transformation for evaluation, performance monitoring and accountability, underlining that horizontal accountability referencing a wide democratic footprint is likely to become more explicit. Consequently, this chapter develops the idea of transformation of public sector performance management from the viewpoint of organisational intelligence. This chapter concludes that ‘hard nose’ rationalistic models of performance and evaluation are no longer fit for purpose in the health sector.
Chapter
This concluding chapter summarises the main contents of this book. It presents, in short, the main ten fundaments of the intelligence of health policy—deployable to other fields of public policies as well—divided in four cohorts of fundaments. These cohorts are orchestrated as contextual, conceptual, service-related and leadership-related fundaments. By fundament, we refer here to theoretical cornerstones—axioms or established principles if you like—of why and how we think intelligence will be rooted in the public policies of today and especially in the future. In our approach, contextual fundaments (i.e. the complexity of the society and societal change, the evolution of institutions, horizontal accountability and the value of increased public value in terms of legitimation of public policies) shape the societal setting for planning, running and evaluating health policy; conceptual fundaments (i.e. systems thinking, loosely coupled systems, open innovations, knowledge and agency) create and regulate the structure and the functioning logic of the public policy system; service-related fundaments (i.e. the service dominant—logic and value co-creation) reframe the production logic of public goods and services and heighten the role of service users in the heart of the health policy; and leadership-related fundaments (i.e. knowledge sharing and policy integration and new forms of public sector leadership) provide the practical functioning logic for the health policy actors and interventions. This final chapter of this book outlines these fundaments, providing short commentaries for each of the fundaments (and their sub-criteria) addressed.
Chapter
This chapter discusses the role of contemporary systemic governance challenges in society. Of particular interest is the question of how these challenges affect human health and well-being. By definition, health is a rather difficult concept since it contains many elements and dimensions. In this chapter, we argue that today we need a much broader understanding about human well-being than the ‘mere’ definition of health. Well-being addresses human life more comprehensively. Systemic governance challenges, based on the ongoing and pervasive technology revolution, exist as a result of changes in the quality and quantity of human beings, the stock of human knowledge particularly as applied to human command over nature and the institutional framework that defines the deliberate incentive structure of a society. These changes have an effect on the way we think, our ability to understand societal problems and our health and well-being. Governance challenges redefine the role of governance. We suggest that there are definitely limits for governing because of the complexity of society. Consequently, this affects how health policies and healthcare organisations operate in local, regional, national and transnational service spaces—service ecosystems consisting of public, private and non-governmental healthcare service providers. This also means that public sector management paradigms transform towards a new framework—a framework in which the role of government is to coordinate, integrate and set guidelines and meta-level societal objectives. This view holds that the current public sector management paradigms of the NPM and NPG have not only reached their maturity but will eventually come to an end. The complexity of society calls for complex public policies and a new understanding and analysis of the integrative role of the government. This, in turn, requires the competence to carry out a system-level redesign of healthcare.
Chapter
This chapter examines the characteristics of intelligent healthcare organisations. We propose that an intelligent organisation is able to operate interactively at the boundaries between different organisations and institutions. This view holds that an intelligent organisation shares its expertise and cross-social and healthcare professional silos, learns from mistakes, has unlearning capabilities and acts adaptively in relation to changes in the operating environment. This means that the existing and classical organisation theories do not suffice anymore. This chapter discusses the need for a new interpretation of organisational theories from the perspective of intelligence with special emphasis on research discussion concerning the crossing of organisational interfaces. We also discuss the role of isomorphic mechanisms in the field of healthcare: this view holds that healthcare organisations are becoming more and more homogeneous. In addition, we incorporate the concept of ‘service space’ into the development of intelligence in the field of healthcare organisations, developed and theorised by the authors in our earlier publications. To briefly formulate this concept, we understand a ‘service space’ as a space of relations and networks of service providers, embedded as integral parts in service (eco)systems, among agencies (personal, organisational) acting through communication (flows), utilising the possibilities of ubiquitous technologies and providing customer-driven services by deploying service-dominant logic. This chapter puts the healthcare organisations at the heart of the emerging service systems. This perspective includes the idea that intelligent organisations and service systems strengthen their legitimacy only if they take seriously the role of service users, patients and citizens in various forms of co-creation and co-production of services. The concrete topics of this chapter include the rise and fall of classical organisation theories, the evolution of ‘service space’ and the new challenges for public management leadership theories and service-dominant logic—putting service users at the heart of service planning and implementation. These topics highlight the transformation from co-production to co-creation and beyond, patient-centred service models and processes as well as the role of organisation’s development activities in enhancing organisational intelligence.
Article
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Introduction Although several measurement instruments have been developed to measure the level of integrated health care delivery, no standardised, validated instrument exists covering all aspects of integrated care. The purpose of this review is to identify the instruments concerning how to measure the level of integration across health-care sectors and to assess and evaluate the organisational elements within the instruments identified. Methods An extensive, systematic literature review in PubMed, CINAHL, PsycINFO, Cochrane Library, Web of Science for the years 1980–2011. Selected abstracts were independently reviewed by two investigators. Results We identified 23 measurement instruments and, within these, eight organisational elements were found. No measurement instrument covered all organisational elements, but almost all studies include well-defined structural and process aspects and six include cultural aspects; 14 explicitly stated using a theoretical framework. Conclusion and discussion This review did not identify any measurement instrument covering all aspects of integrated care. Further, a lack of uniform use of the eight organisational elements across the studies was prevalent. It is uncertain whether development of a single ‘all-inclusive’ model for assessing integrated care is desirable. We emphasise the continuing need for validated instruments embedded in theoretical contexts.