Rethinking digital transformation of healthcare - The role of technology and institutions in service innovation

Arto J. Wallin

Rethinking digital transformation of healthcare - The role of technology and institutions in service innovation

Julkaisun otsikon käännös: Terveydenhuollon digitalisoituminen ja muutos - Teknologian ja instituutioiden rooli palveluinnovaatiossa

Arto J. Wallin

Tuotantotalouden laitos

Tutkimustuotos: Doctoral Thesis › Collection of Articles

Abstrakti

Viimeaikainen teknologinen ja yhteiskunnallinen kehitys ovat synnyttäneet tarpeen uudistaa länsimaisia terveydenhuoltojärjestelmiä. Muun muassa kroonisten sairauksien levinneisyyden kasvaminen, uusien kalliimpien hoitojen kehittäminen ja huoltosuhteen heikkeneminen ovat aiheuttaneet haasteen, jota ei pystytä ratkaisemaan yksittäisillä teknologisilla innovaatioilla. Tämä on saanut useat tieteenalat kiinnostumaan siitä, miten terveydenhuoltojärjestelmän systeeminen muutos kohti kestävämpää mallia saadaan toteutettua. Todelliset ratkaisut ongelmaan ovat kuitenkin olleet vielä puutteellisia.Tässä neljään julkaistuun tutkimukseen perustuvassa artikkeliväitöskirjassa tutkitaan terveydenhuollon muutosta palveluinnovaatioiden näkökulmasta. Työssä käytetään abduktiivista tapaustutkimustastrategiaa, jota voi kuvailla jatkuvaksi teorian ja empirian vuoropuheluksi. Kaksi ensimmäistä tutkimusta toteutettiin kotihoidon kontekstissa ja palvelukehitys tapahtui yhteisrahoitteisissa tutkimus- ja kehityshankkeissa. Ensimmäinen tutkimus selvitti uuden digitaalisen vuorovaikutusteknologian mahdollistamia palveluja kotihoidossa ja niiden vaikutuksia palvelujen tuottavuuteen. Toinen tutkimus tarkasteli useiden toimijoiden yhteistyönä tapahtuvaa palvelukehitystä kolmivuotisen hankkeen aikana ja tunnisti hankkeessa esiin tulleita haasteita. Kolmas ja neljäs tutkimus keskittyivät nuoriin yrityksiin, jotka kehittivät uusia digitaalisia palveluinnovaatioita terveydenhuoltoon startup-kiihdyttämössä. Kolmas tutkimus pureutui yritysten kokemiin institutionaalisiin esteisiin, jotka rajoittavat innovaatioiden kaupallistamista. Neljäs tutkimus valottaa sitä, miten yritykset pyrkivät muuttamaan innovaatioita rajoittavia instituutioita. Yhdessä nämä neljä tutkimusta muodostavat kokonaisuuden, joka avaa terveydenhuollon muutoksen luonnetta kolmen toisiinsa kietoutuneen ilmiön kautta, joita ovat digitalisoituminen, palveluinnovaatio ja institutionaalinen muutos.Väitöskirja parantaa teoreettista ymmärrystä teknologian ja instituutioiden roolista palveluinnovaatioiden kehittämisessä. Se syventää ymmärrystä digitalisoitumisen vaikutuksista palvelujen tuottavuuteen ja palveluinnovaatioihin. Se luo uutta ymmärrystä siitä, miten instituutiot estävät, rajoittavat ja edistävät terveydenhuoltojärjestelmän ulkoa tulevia palveluinnovaatioita sekä toisaalta siitä, miten yritykset pyrkivät muuttamaan innovaatioiden leviämistä rajoittavia instituutioita. Työ edistää monitieteellistä palveluinnovaatioteoriaa ja luo paremman pohjan ymmärtää innovaatioita, jotka muuttavat terveydenhuollon vakiintuneita ajatusmalleja, tapoja ja sääntöjä.

Julkaisun otsikon käännös	Terveydenhuollon digitalisoituminen ja muutos - Teknologian ja instituutioiden rooli palveluinnovaatiossa
Alkuperäiskieli	Englanti
Pätevyys	Tohtorintutkinto
Myöntävä instituutio	Aalto-yliopisto
Valvoja/neuvonantaja	Rajala, Risto, Vastuuprofessori Toivonen, Marja, Ohjaaja
Kustantaja	Aalto University
Painoksen ISBN	978-952-60-8019-2, 978-951-38-8638-7
Sähköinen ISBN	978-952-60-8020-8, 978-951-38-8637-0
Tila	Julkaistu - 2018
OKM-julkaisutyyppi	G5 Artikkeliväitöskirja

Tutkimusalat

digitalisaatio
palveluinnovaatio
innovaatioiden kehittämisen haasteet
institutionaalinen muutos
terveydenhuollon uudistuminen

Pääsy asiakirjaan

http://urn.fi/URN:ISBN:978-952-60-8020-8Lisenssi: Määrittelemätön

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@phdthesis{390f02ebee764213b9c10371c5bc086e,

title = "Rethinking digital transformation of healthcare - The role of technology and institutions in service innovation",

abstract = "Due to the mounting prevalence of chronic diseases, increasing demand for expensive treatments and the growing old-age dependency ratio, there is a pressing need to augment the productivity and quality of health and elderly care. Although the potential of digital technologies is widely acknowledged, focusing on technological innovations and incremental improvements originating from the healthcare system does not appear to provide the desired results. Therefore, there is a need for innovation that breaks established rules and practices and enables systemic transformation in healthcare. This article-based doctoral thesis builds on four published studies employing abductive case research strategy: a dialogue between theory and empirical analysis. The first two studies were conducted under the framework of European innovation programmes. They explore how digitally-enhanced services improve service productivity in the elderly care setting, and provide insights into innovation challenges experienced during a three-year collaborative innovation project. The latter two studies focus on start-ups operating under a start-up business accelerator programme. They increase understanding of the institutional constraints experienced by entrepreneurs when developing innovations that diverge from the prevailing rules of healthcare, and of the ways in which they attempt to change the rules hindering the adoption of innovations. The thesis contributes to service research by constructing a more profound understanding of the mechanisms that advance, hinder, enable and constrain service innovation in the field of healthcare. In particular, the thesis contributes to integrating the perspective of institutional entrepreneurship in service innovation, highlighting the importance of actions that contribute to breaking prevailing 'rules of the game' (i.e. institutions) and creating new ones. In addition, the thesis depicts how digitalization reveals the pervasive role of technology in innovation. Jointly, these contributions advance the synthesis view on service innovation – a view that highlights the importance of both technological and service aspects in innovation. The policy and managerial implications of the thesis suggest that, in addition to a complex set of institutions that guide innovation in the field of healthcare, the development context may also have a notable impact on innovation. The institutional structures of collaborative innovation programmes should encourage collaboration outside project boundaries, in order to foster the actors' awareness of the institutional and market environment. Exposing innovation to institutional forces makes it easier to comprehend the necessary institutional change and to develop ways of justifying the change to actors that are vital for its support. The institutional perspective should be more tightly linked to the practice of innovation.",

keywords = "digitalization, service innovation, innovation challenges, institutionalisation, healthcare renewal, digitalisaatio, palveluinnovaatio, innovaatioiden kehitt{\"a}misen haasteet, institutionaalinen muutos, terveydenhuollon uudistuminen, digitalization, service innovation, innovation challenges, institutionalisation, healthcare renewal",

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year = "2018",

language = "English",

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TY - BOOK

T1 - Rethinking digital transformation of healthcare - The role of technology and institutions in service innovation

AU - Wallin, Arto J.

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N2 - Due to the mounting prevalence of chronic diseases, increasing demand for expensive treatments and the growing old-age dependency ratio, there is a pressing need to augment the productivity and quality of health and elderly care. Although the potential of digital technologies is widely acknowledged, focusing on technological innovations and incremental improvements originating from the healthcare system does not appear to provide the desired results. Therefore, there is a need for innovation that breaks established rules and practices and enables systemic transformation in healthcare. This article-based doctoral thesis builds on four published studies employing abductive case research strategy: a dialogue between theory and empirical analysis. The first two studies were conducted under the framework of European innovation programmes. They explore how digitally-enhanced services improve service productivity in the elderly care setting, and provide insights into innovation challenges experienced during a three-year collaborative innovation project. The latter two studies focus on start-ups operating under a start-up business accelerator programme. They increase understanding of the institutional constraints experienced by entrepreneurs when developing innovations that diverge from the prevailing rules of healthcare, and of the ways in which they attempt to change the rules hindering the adoption of innovations. The thesis contributes to service research by constructing a more profound understanding of the mechanisms that advance, hinder, enable and constrain service innovation in the field of healthcare. In particular, the thesis contributes to integrating the perspective of institutional entrepreneurship in service innovation, highlighting the importance of actions that contribute to breaking prevailing 'rules of the game' (i.e. institutions) and creating new ones. In addition, the thesis depicts how digitalization reveals the pervasive role of technology in innovation. Jointly, these contributions advance the synthesis view on service innovation – a view that highlights the importance of both technological and service aspects in innovation. The policy and managerial implications of the thesis suggest that, in addition to a complex set of institutions that guide innovation in the field of healthcare, the development context may also have a notable impact on innovation. The institutional structures of collaborative innovation programmes should encourage collaboration outside project boundaries, in order to foster the actors' awareness of the institutional and market environment. Exposing innovation to institutional forces makes it easier to comprehend the necessary institutional change and to develop ways of justifying the change to actors that are vital for its support. The institutional perspective should be more tightly linked to the practice of innovation.

AB - Due to the mounting prevalence of chronic diseases, increasing demand for expensive treatments and the growing old-age dependency ratio, there is a pressing need to augment the productivity and quality of health and elderly care. Although the potential of digital technologies is widely acknowledged, focusing on technological innovations and incremental improvements originating from the healthcare system does not appear to provide the desired results. Therefore, there is a need for innovation that breaks established rules and practices and enables systemic transformation in healthcare. This article-based doctoral thesis builds on four published studies employing abductive case research strategy: a dialogue between theory and empirical analysis. The first two studies were conducted under the framework of European innovation programmes. They explore how digitally-enhanced services improve service productivity in the elderly care setting, and provide insights into innovation challenges experienced during a three-year collaborative innovation project. The latter two studies focus on start-ups operating under a start-up business accelerator programme. They increase understanding of the institutional constraints experienced by entrepreneurs when developing innovations that diverge from the prevailing rules of healthcare, and of the ways in which they attempt to change the rules hindering the adoption of innovations. The thesis contributes to service research by constructing a more profound understanding of the mechanisms that advance, hinder, enable and constrain service innovation in the field of healthcare. In particular, the thesis contributes to integrating the perspective of institutional entrepreneurship in service innovation, highlighting the importance of actions that contribute to breaking prevailing 'rules of the game' (i.e. institutions) and creating new ones. In addition, the thesis depicts how digitalization reveals the pervasive role of technology in innovation. Jointly, these contributions advance the synthesis view on service innovation – a view that highlights the importance of both technological and service aspects in innovation. The policy and managerial implications of the thesis suggest that, in addition to a complex set of institutions that guide innovation in the field of healthcare, the development context may also have a notable impact on innovation. The institutional structures of collaborative innovation programmes should encourage collaboration outside project boundaries, in order to foster the actors' awareness of the institutional and market environment. Exposing innovation to institutional forces makes it easier to comprehend the necessary institutional change and to develop ways of justifying the change to actors that are vital for its support. The institutional perspective should be more tightly linked to the practice of innovation.

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KW - service innovation

KW - innovation challenges

KW - institutionalisation

KW - healthcare renewal

KW - digitalisaatio

KW - palveluinnovaatio

KW - innovaatioiden kehittämisen haasteet

KW - institutionaalinen muutos

KW - terveydenhuollon uudistuminen

KW - digitalization

KW - service innovation

KW - innovation challenges

KW - institutionalisation

KW - healthcare renewal

M3 - Doctoral Thesis

SN - 978-952-60-8019-2

SN - 978-951-38-8638-7

T3 - Aalto University publication series DOCTORAL DISSERTATIONS

PB - Aalto University

ER -

Rethinking digital transformation of healthcare - The role of technology and institutions in service innovation

Abstrakti

Tutkimusalat

Pääsy asiakirjaan

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