Networked Health Care: Organizing for Coproduction of Value Authors and Affiliations

Creating better value healthcare service today is very challenging. The social pressure to do so is real for every healthcare system leader. Real benefit has been achieved in manufacturing sector work by the use of... [ view full abstract ]

Creating better value healthcare service today is very challenging. The social pressure to do so is real for every healthcare system leader. Real benefit has been achieved in manufacturing sector work by the use of “value-chain” thinking. This mental model assumes that the work is a series of linked processes necessary to make a product. For those activities in healthcare systems that are similar, this mental model may be very helpful. Attempts to “install” the value chain widely in healthcare systems have, however, been frustrating. As a result, well-meaning leaders seeking better value have resorted to programs of cost reduction, rather than service redesign. Professionals have not been very happy or willing participants.

The work of healthcare invites an expanded mental model of value creation, one that better matches the work. This paper proposes a networked architecture that can mobilize and integrate the resources of healthcare professionals, interested patients, family, and other community members in the delivery and improvement of healthcare systems. It also suggests how this value-creation architecture might contribute to research and the development of new knowledge. Two cases illustrate the proposed architecture and outline implications and challenges for system design and practice, technology development, and roles and responsibilities of all actors involved in healthcare systems.

We believe that this model better fits the need of healthcare service delivery and improvement. An expanded understanding of how value is created invites attention by senior leaders, by those attempting to facilitate the improvement of current systems, by those involved in the daily work of healthcare service provision, by those charged with the preparation and formation of future professionals, by those who measure and conduct research in healthcare services, and by those leading policy, payment and reimbursement systems.