Healthcare innovation stalls when doctors, executives clash on priorities

<p>In healthcare, technologies have the potential to provide new and useful knowledge for both patients and healthcare professionals. However, to realize their full potential and become truly useful, these technologies must be integrated into a broader healthcare service ecosystem that includes a wide range of actors. Successfully integrating such technologies requires the coordination and collaboration of a diverse set of such actors, including healthcare professionals, public actors, and market actors. Understanding the challenges along the institutionalization process of new and useful knowledge derived from technology is essential for advancing service innovation within healthcare service ecosystems.</p><p>According to Service-Dominant (S-D) logic, innovation typically begins with the collection and refinement of ideas from a diverse set of actors. While the inclusion of this broad set of actors is essential for innovation, it can also lead to institutional conflicts or frictions between actors. These conflicts arise from competing or sometimes opposing ideas, which can be traced to multiple institutional logics—deeply ingrained norms, beliefs, and assumptions—that shape how actors frame and adopt ideas. Institutional logics also guides actors in how technologies, as carriers of ideas, are adopted, implemented and used. Institutional conflicts are critical obstacles to overcome during the innovation process; however, they are often overlooked. Studying these conflicts is particularly important because, in the worst-case scenario, they can become so severe that they block innovation within service ecosystems. The purpose of this thesis is to contribute to the understanding of service innovation that accounts for the multiplicity of institutional logics within a healthcare service ecosystem. Specifically, this thesis discusses a set of institutional conflicts and investigates how actors resolve or mitigate them. In this thesis, the actors proposing ideas for technology, including its integration within a healthcare service ecosystem, are broadly categorized according to three institutional logics: medical professional, market, and public welfare.</p><p>The results of this thesis discuss five recurring conflicts: differing meanings of technology, conflicting assumptions about medical responsibility, tensions in decision-making procedures, legal challenges related to resource ownership, and different expectations for resource sharing. To mitigate or resolve these conflicts, four recurring reconciliation strategies are identified: compromise, confrontation, mobilization, and avoidance. This thesis provides actionable recommendations on how to effectively manage institutional conflicts within a healthcare service innovation context. It makes three key contributions to service innovation research within the conceptual framework of S-D logic. The first theoretical contribution is the development of a novel typology of institutional reconciliation strategies. The second explores the factors that influence the success or failure of innovation within service ecosystems. Lastly, the managerial contribution identifies contemporary enablers and constraints that drives service innovation in healthcare ecosystems.</p>