Collaborative Strategies and Tools Enabling Change in the Healthcare Ecosystem: a Brazilian Exploratory Study
The research articulates Collaborative Economy, Service-Dominant Logic and Healthcare to understand how collaborative strategies and tools could help align the actors´ purposes in order to improve the Healthcare ecosystem´s sustainability. Itconsiders the challenging Brazilian context which has the biggest public healthcare system in the world, but suffers with funding and access inequalities and poor service quality.
Collaborative Economy is a multidimensional movement, based on distributed networks connecting individuals and communities through technology-intensive tools, transforming the way we operate, favoring access over ownership, decentralizing power and catalyzing businesses’ growth as service ecosystems. The research proposes that S-D Logic premises, its multilevel ecosystem vision and value cycle are embedded in collaborative players´ culture. It also supports traditional incumbents, as Healthcare, to reveal and address social-economic challenges through collaborative lenses, suggesting a new set of competences, strategies and tools to equip its actors to effectively and efficiently integrate resources and build relevant value propositions aiming viability. The work discusses the role of collaboration, technology and leadership as change enablers in Healthcare towards reframing its Product-Dominant mindset and value creation cycle from physician and disease-centered to a patient and health-centered S-D Logic perspective.
The exploratory qualitative research applies a zoom out/zoom in perspective following a four-phase process: (1) design the ecosystem and its actors, (2) build a value matrix to map the actor´s main purposes, exchanges and expectations towards each other, (3) understand main misalignments among dyadic relations and (4) evidence collaborative enablers to act upon identified drivers helping mitigate misalignments and build collaborative outcomes. Desk research is complemented by participant observations and interviews with 15 Healthcare leaders in Brazil, including providers, payers and patients.
The scenario shows it is improbable that collaboration happens organically, revealing systemic conflicts of interests, intense fragmentation, information asymmetry and a silos mindset based on disease as value generator, favoring providers, not in health or wellbeing, benefiting patients and payers. Technology is seen as a collaborative enabler to end the perverse zero sum cycle. Digital platforms can mediate resource integration, boosting the ecosystem´s viability cycle, decentralizing execution and shifting power from centralized organizations to the crowd. They scale assertive access to health, bring transparency, data interoperability and accountability, promoting dialog through new negotiation agendas more based on trust and collaboration, fostering social wellbeing as desired collaborative outcomes.
Despite its impact, there is no significant academic work articulating S-D Logic, Collaborative Economy and Healthcare. The research bridges theory and practice by proposing a process and frameworks to help a traditional environment to adopt a collaborative mindset and be prepared to address changes led by agile insurgents.