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Digital transformation is one of the key concepts attached to the smart cities’ domain. The requirement to enhance strategically the way that business is delivered around different areas is a critical milestone for the digital transformation agenda and also for business performance management. In this short position chapter, we are focusing on the area of healthcare and we are providing key insights and lessons learned from Saudi Arabia. The main contribution of the chapter is a structured discussion on a digital healthcare strategy in the context of smart cities.

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

The purpose of this paper is to explore the antecedents and consequences of a value-dense environment in healthcare service delivery.

A structural model was developed based on a literature review. Circulation of a 31-indicator questionnaire among service receivers in the healthcare system across India generated 279 valid responses. The research model was assessed using a cross-sectional research design, and the data were analyzed by partial least squares-structural equation modeling.

Integrated supply chain performance (ISCP), internal service quality (ISQ) and coordinated care are antecedents of a value-dense environment, which drives patient-centricity. The leagile supply chain strategy strengthens the relationship between ISCP and coordinated care. Employee trust and commitment acts as a moderator between coordinated care and ISQ.

By adopting the perspective of service receivers, this paper highlights the influence of value-density on patient-centricity in healthcare organizations. Future research should include healthcare professionals’ perceptions of value-dense environment creation.

The study provides suggestions to practitioners for designing patient-centric healthcare services by leveraging ISCP, coordinated care and ISQ in the value-creation process. Recognizing the relationships among these constructs can aid the timely formulation of corrective actions and future policies.

This study underscores patient-centric care as a basis for effectively delivering healthcare as a social good.

This paper contributes to the body of knowledge by identifying and empirically validating the relationships between patient-centricity and value co-creation.

This study aims to explore the institutionalization of value-based healthcare (VBHC) in the public healthcare system in the state of Victoria, Australia.

The empirical part of this paper is based on a content analysis of 34 policy and industry-commissioned reports that have guided the development of health-care strategy in Victoria from 1988 to 2020.

This study sheds light on how VBHC in Victoria has been institutionalized over time, through three key phases (centralization, transitioning and digitalization), how the conceptualization of best value has changed in each phase and the implications each phase has presented for other actors in the health-care system.

This study highlights the key opportunities and challenges for organizational actors that emerge when a health-care system transitions toward VBHC, and derives implications for vendors, health-care procurement, policymakers and governmental agencies.

This study develops a longitudinal analysis that describes the evolution and institutionalization of a VBHC approach in a complex societal system over three decades and highlights the key implications for other organizational stakeholders.

This paper explores the enablers of modular healthcare services.

A survey-based approach was adopted with specialised hospitals as the unit of analysis. A structural model was developed based on a literature review and assessed using a cross-sectional research design. A 23-indicator questionnaire was circulated among service providers in the healthcare system across India, and 286 valid responses were received. The data were analysed using partial least squares-structural equation modeling (PLS-SEM).

The results reveal that professional competence, technological versatility, clear division of tasks, channelised flow of information and professional autonomy act as enablers that may drive modular service delivery.

By examining service providers' perspectives, this paper highlights the influence of the identified enablers on modular service delivery in healthcare organisations.

For practitioners, the study provides suggestions for designing patient-centric healthcare services via modular healthcare delivery. The identified structural relationships can facilitate immediate corrective actions and the formulation of future policies. The findings will help practitioners foresee opportunities for patient participation in value co-creation, meet patients' varying needs, decompose service offerings, mix and match components develop sets of rules as interfaces between service modules and design service packages on an ongoing basis.

This study underscores the emergence of patient-centric care and may aid the design of processes that deliver health to the patient as a person.

This paper identifies and empirically validates relationships between healthcare service delivery processes and modular service delivery.

The purpose of this paper is to identify major healthcare service quality (HSQ) dimensions, their most preferred service levels, and their effect on HSQ perceptions of patients using a Taguchi experiment.

This study adopted a sequential incidence technique to identify factors relevant in HSQ and examined the relative importance of different factor levels in the service journey using Taguchi experiment.

For HSQ, the optimum factor levels are online appointment booking facility with provision to review and modify appointments; a separate reception for booked patients; provision to meet the doctor of choice; prior detailing of procedures; doctor on call facility to the room of stay; electronic sharing of discharge summary, an online payment facility. Consultation phase followed by the stay and then procedures have maximum effect on S/N and mean responses of patients. The appointment stage has a maximum effect on standard deviations.

Theoretically, this study attempted to address the dearth of research on service settings using robust methodologies like Taguchi experiment, which is popular in the manufacturing sector. The study implies the need for patient-centric initiatives for better HSQ through periodic experiments that inform about the changing priorities of patients.

The trade-off between standardization and customization create challenges in healthcare. Practically, a classification of processes based on standardization vs customization potential is useful to revamp processes for HSQ.

This study applied the Taguchi approach to get insights in re-designing a patient-centric healthcare servicescapes.

The last few years have seen a stronger emphasis on patient-centred care within the international healthcare setting. Patient-centred care is clearly perceived to be important to optimise the satisfaction and well-being of patients. The purpose of this paper is to review current patient-centred practices for outpatients in both private clinics and public hospitals in Dubai. Such a comparison contributes to the identification of best management practices as a means of enhancing healthcare delivery.

This study is based on an independent survey consisting of self-administered questionnaires, in which patients were asked to rate several aspects of private clinics or government hospitals in Dubai. The questionnaire used has been drawn from the Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey, Version 3.0. Responses from 420 patients form a data set that is analysed quantitatively.

In total, 420 respondents took part in this survey. The results of the survey show that there is a considerable difference between the expectation levels of patients from government hospitals and patients from private clinics. Patients from government hospitals consistently show that time is a critical aspect of the service received, with 68 per cent of the respondents reporting this issue. Additionally, poor customer care, as reported by 14 per cent of the respondents, is also a critical issue. Timely service and appointments are among the main factors that contribute to patient satisfaction. Patients in private clinics, instead, particularly value clear explanations from doctors and nurses – this is corroborated by the fact that 11 per cent of the respondents reported appreciation of this type of service.

This paper draws attention to a patient-centric perspective of healthcare, and highlights the importance of educating patients through clear explanations.

Little evidence exists on the standards of healthcare in Dubai. The authors explore this area and present direct evidence on quality standard implementation, identify implementation shortcomings and make recommendations for future research and practice.

The purpose of this paper is to propose a typology of institutions enabling or constraining customer centricity and value co-creation in service ecosystems; illustrate the various types of institutions with examples from healthcare; and provide case study evidence on how pharmaceutical companies react to and induce institutional change.

First, a typology of institutions enabling or constraining customer centricity and value co-creation is proposed and illustrated with examples from healthcare. Next, to clarify how companies deal with these institutions by reacting to or inducing institutional change, two case companies from the pharmaceutical industry are described.

The research identifies and illustrates nine types of institutions (culture, structure, processes, metrics, language, practices, IP, legislation and general beliefs) grouped by three levels of analysis (micro, meso and macro). Furthermore, the findings of the two case studies indicate that companies react to, but also proactively induce, institutional change.

The investigation is limited to two case studies.

Organizations need to understand the micro-, meso- and macro-level institutions of their service ecosystem; react to institutional changes imposed by other actors; and proactively change institutions by breaking, making or maintaining them.

Pharmaceutical companies can improve patient well-being by inducing institutional change.

This research develops a mid-range theory of service ecosystem institutions by developing a typology. This typology is empirically examined in a healthcare context.

Empowered patients are allies to the healthcare system, especially in emergency situations. Social media use has emerged to be a major means by which patients interact with the healthcare system, and in times such as the current COVID-19 situation social media has to play an even greater crisis management role by empowering patients. Social media channels serve numerous beneficial purposes, despite them also being blamed for the spread of misinformation during this crisis. In this Gulf Cooperation Council (GCC) focused case study, we will discuss the increasingly greater role being played by the social media in healthcare in the region and how that empowers not just the patients but the system as a whole. In the GCC region, the healthcare sector is found to reflect a steady growth, leading to an increased drive for empowering patients by lowering the barriers to effective communication and consultation through online media. As of today, social media has become an element of the telehealth infrastructure being deployed in the region. During COVID-19, patients are seen to leverage it pointedly for online health consultations thereby lowering the stress on the healthcare system and adding to efficiencies.