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Institutional logics and the co-creation of value through self-service health care technology

Lookup NU author(s): Dr Josephine Go JefferiesORCiD


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This research examines how multiple institutional logics within service systems shape customer experiences and practices when using self-service technologies (SSTs). Service organisations increasingly harness SSTs as alternative or additional touchpoints across the service journey (Patricio et al., 2008; Chandler & Lusch 2015). SST literature reveals cognitive processes that underpin customers’ willingness and ability to use SSTs (Parasuraman, 2000; Meuter et al., 2005) but neglects the social embeddedness of service systems in which value co-creation takes place (Edvardsson et al., 2011). Our research investigates how social context shapes/is shaped by SST usage experiences and practices, drawing upon institutional logics, defined by Thornton and Ocasio (1999, p. 804) as ‘the socially constructed, historical patterns of material practices, assumptions, values, belief and rules by which individuals produce and reproduce their material subsistence, organize time and space, and provide meaning to their social reality’. Scholars recognise that multiple institutional logics are likely to be present within a particular field, requiring social actors to engage with conflicting elements of heterogeneous logics (Bishop and Waring, 2016). To examine this in relation to SSTs, we focus upon telehealth as a touchpoint for interactions with a health service system. We explore how consumers experience the conflicting institutional logics of their life-worlds and the technological, professional and bureaucratic logics that are evident in telehealth SSTs and the processes through which they transform service interactions to navigate value co-creation.We adopted a qualitative approach to the research. Participants included 18 people suffering from heart disease (ages 43-90 years; 11 males, 7 females; various ethnicities). All were actively involved in co-producing the service by regularly handling medical and electronic equipment for transmitting their vital signs and responses to diagnostic questions about their symptoms to a remote computer server for analysis by telehealth operators through computer-aided decision support software. Data were analysed via an iterative abductive process that involved tacking back and forth between the data and the literature (Eisenhardt, 1989).The findings reveal that participants’ experiences are grounded in the family and community logics of their own lifeworld, and related to their personal experience of (ill)health. These contrast with logics associated with the telehealth machine and the health care service system, which reflect features such as standardisation, precision, data-informed professional decisions and bureaucratic processes. Although the telehealth system obliges a degree of compliance, we show how participants navigate conflicts between family and community logics, and those inherent to the SST by adapting their use of the telehealth in purposeful ways. By making explicit the dynamics of competing logics, the study reveals how consumers disrupt institutional arrangements (van Dijk, et al., 2011), ways that technology facilitates elaboration of hybrid institutional logics and opens up possibilities for bottom up structural transformation.

Publication metadata

Author(s): Go Jefferies J, Hibbert S, Bishop S

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: 2018 Frontiers in Service Conference

Year of Conference: 2018

Print publication date: 07/07/2018

Online publication date: 07/07/2018

Acceptance date: 24/05/2019