2.4 Service Science for Understanding Innovation in Clinical
Informatics
Looking at innovation in medical technology in a boarder perspective than product
development directs us to consider service and its underlying generation processes.
By service we refer to “the application of specialized competencies (knowledge and
skills) through the deeds, processes, and performances for the benefit of another
entity of the entity itself” (Vargo & Lusch, 2004). It finds its premises in the
proposition that the customer is always a cocreator of value (Maglio & Spohrer,
2008) with a focus on the interaction of the customer and the provider in the valuecreating processes. Service science is the study of value cocreation interactions
among entities, known as service systems.
The meaning of the customer concept has shifted: from a recipient of a service
provided, through being one who participates in creating value in service experiences (Prahalad & Ramaswamy, 2004) to the view of being an active actor who
cocreates value in close interaction with a provider (Maglio & Spohrer, 2008;
Spohrer, Anderson, Pass, Ager, & Gruhl, 2008). In the medical context, service
studies have described the patient as exposed and dependent on the immediate
environment and seen as an object in medical discourse (Berry & Bendapudi,
2007; Edvardsson, Enquist, & Johnston, 2005; Lovelock & Gummesson, 2004).
The system of innovation places innovation and learning processes at the center
of the focus (Edquist, 1997). This emphasis on learning acknowledges that innovation is a matter of producing new knowledge or combining existing elements of
knowledge in new ways. Recently, process innovation and service innovation have
been studied as an outcome of system of innovation to emphasize this central
dimension of knowledge creation or recombination (Lusch, Vargo, & Tanniru,
2009). This is central in our proposed systemic service model.
By considering the medical imaging industry in the frame of the “sectoral
innovation system” (Malerba, 2004), it emphasizes the innovation process as an
outcome of learning processes by heterogeneous agents (technological change from
firms, clinical practice from medical users). These processes are based on a knowledge base spread around patient diagnosis, disease treatment, and availability of
technological solutions, taking place in specific institutional settings that greatly
influence the involved agents. In turn, this innovation process transforms the various
actors, namely lead users in medical organizations, firms, and patients through the
introduction and the diffusion of new processes or practice and this substantially
changes the institutional environment and the current knowledge bases (technological and clinical).
• Medical users in medical organizations (public hospitals and private clinics).
In healthcare, university hospitals play a major role in expanding the range of
uses: by testing for safety and efficacy in clinical trials, university hospitals
validate the prototypes or upgrades coming from the rapid rate of technological
change (Gelijns, 1991). In our model, medical lead users are primary practicing
112
J. Galbrun
Informatics
Looking at innovation in medical technology in a boarder perspective than product
development directs us to consider service and its underlying generation processes.
By service we refer to “the application of specialized competencies (knowledge and
skills) through the deeds, processes, and performances for the benefit of another
entity of the entity itself” (Vargo & Lusch, 2004). It finds its premises in the
proposition that the customer is always a cocreator of value (Maglio & Spohrer,
2008) with a focus on the interaction of the customer and the provider in the valuecreating processes. Service science is the study of value cocreation interactions
among entities, known as service systems.
The meaning of the customer concept has shifted: from a recipient of a service
provided, through being one who participates in creating value in service experiences (Prahalad & Ramaswamy, 2004) to the view of being an active actor who
cocreates value in close interaction with a provider (Maglio & Spohrer, 2008;
Spohrer, Anderson, Pass, Ager, & Gruhl, 2008). In the medical context, service
studies have described the patient as exposed and dependent on the immediate
environment and seen as an object in medical discourse (Berry & Bendapudi,
2007; Edvardsson, Enquist, & Johnston, 2005; Lovelock & Gummesson, 2004).
The system of innovation places innovation and learning processes at the center
of the focus (Edquist, 1997). This emphasis on learning acknowledges that innovation is a matter of producing new knowledge or combining existing elements of
knowledge in new ways. Recently, process innovation and service innovation have
been studied as an outcome of system of innovation to emphasize this central
dimension of knowledge creation or recombination (Lusch, Vargo, & Tanniru,
2009). This is central in our proposed systemic service model.
By considering the medical imaging industry in the frame of the “sectoral
innovation system” (Malerba, 2004), it emphasizes the innovation process as an
outcome of learning processes by heterogeneous agents (technological change from
firms, clinical practice from medical users). These processes are based on a knowledge base spread around patient diagnosis, disease treatment, and availability of
technological solutions, taking place in specific institutional settings that greatly
influence the involved agents. In turn, this innovation process transforms the various
actors, namely lead users in medical organizations, firms, and patients through the
introduction and the diffusion of new processes or practice and this substantially
changes the institutional environment and the current knowledge bases (technological and clinical).
• Medical users in medical organizations (public hospitals and private clinics).
In healthcare, university hospitals play a major role in expanding the range of
uses: by testing for safety and efficacy in clinical trials, university hospitals
validate the prototypes or upgrades coming from the rapid rate of technological
change (Gelijns, 1991). In our model, medical lead users are primary practicing
112
J. Galbrun