Service innovation through resource integration: An empirical examination of co-created value using telehealth services
| Author | Sally Hibbert,Simon Bishop,Josephine Go Jefferies |
| DOI | 10.1177/0952076718822715 |
| Date | 01 January 2021 |
| Published date | 01 January 2021 |
| Subject Matter | Articles |
Public Policy and Administration
2021, Vol. 36(1) 69–88
Service innovation through
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resource integration: An
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DOI: 10.1177/0952076718822715
empirical examination of
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co-created value using
telehealth services
Josephine Go Jefferies
Newcastle University Business School, UK
Simon Bishop
Nottingham University Business School, UK
Sally Hibbert
Nottingham University Business School, UK
Abstract
Scholars, policymakers and practitioners recognise the potential to improve public
services through active citizen involvement and much research has examined the
formal opportunities to ‘co-produce’ changes in the structures and cultures of public
services. Yet scholars have devoted little attention to the opportunities for service and
social innovation that emerge from the everyday activities of service users and their phe-
nomenological experiences of realising value from service interactions. This qualitative
study of telehealth users explores how and why public service beneficiaries co-create
value. It argues that understanding citizens’ approaches to co-create phenomenological
value is a vital component of the collaborative processes that generate social benefit.
Keywords
Co-production, health care, service-dominant logic, telehealth, value co-creation
Introduction
There has been longstanding deliberation in public administration theory and prac-
tice on how public services can be improved through active citizen involvement
Corresponding author:
Josephine Go Jefferies, Newcastle University Business School, 5 Barrack Road, Newcastle upon Tyne, Tyne &
Wear NE1 4SE, UK.
Email: Josephine.Go-Jefferies@newcastle.ac.uk
70
Public Policy and Administration 36(1)
(Osborne, 2017b; Parks et al., 1981; Pestoff, 2006), and the ‘co-production’
of services is frequently cited as driving contemporary policy reforms. The term
co-production has been applied to a range of activities by different actors; as such it
has been defined as ‘an umbrella term that captures a wide variety of activities that
can occur in any phase of the public service cycle and in which state and lay actors
work together to produce benefits’ (Nabatchi et al., 2017: 772). Much scholarship
on co-production has concentrated on the potential for changes in the structures
and cultures of public services to bring higher levels of engagement and involvement
of clients, patients and users to address a ‘democratic deficit’ (Fung, 2015), a concept
linking the effectiveness of complex governance arrangements with individual, col-
lective and multi-sectoral participation in framing problems and their solutions.
Participation has been considered, for example, in relation to the increasing hetero-
geneity in the organisational environment of public services, including the increase of
third sector, voluntary or membership organisations into the delivery and co-man-
agement of services (Osborne and McLaughlin, 2004). Co-production has similarly
been considered in relation to changing modes of governance (Bovaird, 2005;
Osborne, 2010) and shifting relations between public services and wider civic organ-
isations and activities (Ackerman, 2004).
In this paper, we align with Osborne and colleagues (Osborne, 2017a) in con-
sidering the applicability of service-dominant (S-D) logic (Vargo and Lusch, 2004)
to public services. This perspective is strongly rooted in services marketing schol-
arship (Gummesson, 1994) and debate within this field has generated some of the
principle developments to S-D logic over the last decade (Vargo and Lusch, 2008).
Here we pay particular attention to a key distinction between the ‘co-production’
and the ‘co-creation’ of services (Oliver, 2006; Vargo and Lusch, 2004). This dis-
tinction has been examined in relation to public services (Osborne et al., 2016;
Voorberg et al., 2014b, 2015) but studies are yet to consider how the constitutive
involvement of service users in the co-creation of value holds implications for the
process of service innovation.
Realising co-production of public services can be challenging (Osborne, 2017a;
Ostrom, 1996) especially when aiming for social innovation involving changes to
relationships, positions and rules to create long-lasting social benefit (Pol and Ville,
2009; Voorberg et al., 2015). The need for institutional change in order that social
innovation can occur implies that governance issues are the primary motive for
involving service users in the co-production of public services. In this paper, we
argue that focusing on governance issues at scale creates a blind spot obscuring
everyday activity that underpins social innovation by improving experience at the
individual level. We conceive this as a process of service innovation (Ng, 2007, 2014),
specifically ‘experiential service innovation’ (Helkkula et al., 2018), which is charac-
terised as co-creating phenomenological value through everyday service interactions
that shape service user experiences. In ascribing to a phenomenological understand-
ing of knowledge acquisition through experience that is intersubjectively validated
(Hegel, 2001; Hirschheim, 1992; Lo¨bler, 2011), the concept of value co-creation
suggests service interactions are motivated by the search for value, where ‘value is
Go Jefferies et al.
71
always uniquely and phenomenologically determined by the beneficiary’ (Vargo and
Lusch, 2008: 32). Here then, value co-creation refers to service users’ efforts to realise
value within their own lifeworlds, rather than their participation in formal opportu-
nities set out by provider organisations. Service innovation implies a governance
element that occurs through the process of introducing micro level adaptations
that service users experience during everyday interactions. Service innovation can
involve fundamental changes to relationships, positions and rules, to meet social
needs at the micro level but unlike social innovation, does not necessarily suggest
the benefits are long-lasting or require institutional change.
This conceptual lens challenges prior conceptualisations of how and where gov-
ernance issues matter. We propose that experiential value co-creation by individ-
uals is an important basis for meso level changes and service innovation. We argue
that service innovation takes place through processes of individual resource inte-
gration that indirectly alters designed-in, proposed value. In other words, service
innovation involves provider-led value propositions being altered by the service
user experiences in practice (Ska˚le´n et al., 2014). We present findings describing
how citizens find ways of augmenting the designed-in or proposed value of a
telehealth service to co-create value, and show that this occurs by engaging in
resource integration processes primarily to make the service function for them
as well as for the service system. This point highlights how value co-creation
(Vargo and Lusch, 2008, 2016) in concert with service co-production, particularly
‘co-implementation’ (Voorberg et al., 2015), are integral to the user experience of
the service system. Our findings provide insight on the blind spot within public
service research into co-production, co-creation and social innovation (Ansell
et al., 2017; Voorberg et al., 2013, 2017).
In the next two sections, we set out the approach of S-D logic (Vargo and Lusch,
2004) and highlight its relevance to service innovation. Then we report on an empir-
ical investigation of a co-produced telehealth service for chronic disease sufferers.
Co-production as the study of passive user engagement
Recent literature (Denhardt and Denhardt, 2000; Osborne et al., 2012; Osborne
and Strokosch, 2013) makes the case for greater concentration on the service aspect
of public service organisations and argues that the nature of service demands
reconsideration of the nature of co-production by users and providers. Osborne
and colleagues (Osborne et al., 2012; Osborne and Strokosch, 2013) urge a move
away from the models and analogies drawn from manufacturing organisations,
which dominated thinking about public service reform. Instead they advocate
public service (dominant) logic (Osborne, 2017a) building on the notion of ‘S-D
logic’, which emerged from the field of service research, to develop new approaches
to understanding the activities, processes and outcomes of service organisations.
Of particular importance to public services, this approach emphasises the roles,
experiences and value(s) of service users. It also highlights the importance of user
perspectives on quality and effectiveness, which are neglected in approaches to
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Public Policy and Administration 36(1)
public service research and practice that are pre-occupied with improving the effi-
ciency of intra-organisational processes (Denhardt and Denhardt, 2000).
A number of papers have shed light on the nature of co-production by providing
examples of active user involvement in public services production in contexts of
childcare (Pestoff, 2006), social housing (Needham, 2008), postnatal care (Fowler
et al., 2012), community redevelopment and residential care (Bovaird et al., 2015).
Such studies have provided insight into the nature and facilitators of, and barriers
to, the involvement of users in active efforts to allow co-production in public ser-
vices. However, the research remains focused upon examples of purposeful citizen
involvement, brought about through the purposive actions of public agencies pur-
suing forms of...
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