Digital if Possible, Physical if Needed: Value Co-creation through Digi-physical Integration in Born-digital Service Firms: A Theoretical Framework Based on the Swedish Telehealth Industry

Abstract

Purpose: The purpose of this paper is to explore how the actors in a telehealth ecosystem interact. A theoretical framework will uncover the touchpoints among the involved actors; namely, payers, customers, providers, and telehealth firms. Challenges that potentially hinder value co-creation will be reviewed. Methods: This is a cross-sectional qualitative multi-case study with the epistemology of interpretivism. An abductive approach was employed for this multi-method qualitative study where in-depth interviews and focus groups were conducted to gather empirical data. Theory: The main areas of the theoretical parts are telehealth, S-D logic, and value co-creation in a service paradigm. The service science perspectives of S-D logic by two of the main scholars in the field, Vargo and Lusch, is applied to review how the stakeholders in telehealth, influenced by Fürstenau and Auschra, interact and derive value in the context of the Swedish telehealth ecosystem. Data: The data was obtained through in-depth interviews with seven professionals representing three stakeholder groups; two focus groups represent the fourth and final group. The recorded interviews and focus group discussions were transcribed, coded, and presented as empirical data. Conclusion: The main findings of this thesis are three-fold. Firstly, four challenges were uncovered that can hinder value co-creation: 1) social, cultural, and behavioural attitudes, 2) external operant resources, 3) internal operant resources, and 4) regulations and payments. Secondly, a digiphysical integration strategy was presented as a solution that can bring all actors to a joint sphere of value co-creation. Lastly, this thesis proposes that the client-centric view of S-D logic should be revised since the service providers can influence the telehealth service. Also, not only customers are the beneficiary who can determine value, but all actors are.