Co-created decision-making: From co-production to value co-creation in health care

Identifying categories of patient-driven health services innovation: insights from Taiwan's health services sector

PURPOSE

This study aims to build a typology of patient-driven health services innovation (PDHSI) and propose their relationships with healthcare quality.

DESIGN/METHODOLOGY/APPROACH

Guided by value co-creation theory (VCC), this study adopted in-depth interviews and focus groups to collect qualitative data in Taiwan's health services sector. The collected data were analyzed using manual thematic analysis, following the standard procedures for transcribing, encoding and identifying themes. This approach allowed for a comprehensive identification of unique types of PDHSI.

FINDINGS

This study found four types of PDHSI. They are Human-Computer Interaction Mode (HCIM), Online Social Network Mode (OSNM), Co-created Decision-Making Mode (CDM) and Channel Complementarity Mode (CCM). This study defines these typologies and explains their fundamental properties, key outcomes and important determinants. Finally, through qualitative analysis, four propositions on the relationship between health services innovation and health service quality are put forward.

PRACTICAL IMPLICATIONS

By constructing a patient-driven typology of health services innovation, this study helps medical institutions understand the strategic behavior of the doctor-patient relationship, to improve the quality of medical service and contribute to patient education and consulting practice.

ORIGINALITY/VALUE

This study contributes to the theoretical understanding of PDHSI by identifying and categorizing the types of such innovations. It provides a comprehensive typology that is useful for both academic research and practical application in healthcare management. This typology offers new insights into the roles of patients in co-creating healthcare services, addressing a gap in the existing literature regarding PDHSI and supporting the development of patient-centered approaches to healthcare.

Co-creation in healthcare and research to improve service delivery for young people with chronic pain

Introduction

The process of co-creation can enable more effective, agile and integrated healthcare solutions achieving outcomes that effectively translate to healthcare delivery. Collaborative knowledge generation is particularly important in fields such as pediatric chronic pain where there is a complex interplay between biological, social, environmental, emotional, familial and school factors. The co-creation initiative described here was designed to amplify the voices of youth with chronic pain and their families and a variety of key stakeholders and generate novel approaches to the management of chronic pediatric pain in the setting of the South Australian Pediatric Chronic Pain Service.

Methods

Stakeholders who were identified as influential in this ecosystem were allocated to 6 groups. A skilled facilitator co-prepared and delivered the workshop, engaging participants in three structured activities. Firstly, the challenges to service delivery were outlined, followed by the groups discussing what is currently working. The second activity involved lateral thinking without restrictions on time, resources or system to generate solutions to the key challenges presented. Finally, stakeholders were asked to agree on a generated solution from Activity 2 and build a case for actionable implementation of this solution. Data were summarised by the workshop facilitator and reflexive thematic analysis was used for coding and generating themes.

Results

From Activity 1, six themes collectively demonstrated that stakeholders valued many of the existing strengths of the service delivery, but some areas such as pain education was undervalued. Activity 2 generated solutions from high-level ideas to more day-to- day management strategies. Each of six groups generated unique solutions to an identified challenge for Activity 3.

Discussion

Engaging a wide variety of stakeholders in collaborative knowledge generation successfully provided the South Australian Pediatric Chronic Pain Service with a variety of novel, scalable solution across the healthcare continuum. Equally important is that this initiative helped to raise awareness about the complex issues faced in pediatric chronic pain care and helped to establish new partnerships that have led to enhanced service delivery.

Perceptions of foot health services from the perspective of patients with rheumatoid arthritis in Finland

BACKGROUND

Foot health services for people with rheumatoid arthritis (RA) are an important part of their comprehensive care. However, little is known about the perceptions of people with RA have about foot health services. This study aimed to explore how people with RA perceive foot health services.

METHODS

A descriptive cross-sectional survey design was applied. The electronic survey data were collected in April 2023 from people with RA through a national patients' association (N = 2400, response rate 24%, n = 565). The statistical data were analysed using descriptive statistics and textual data with thematic analysis.

RESULTS

Most of the respondents (n = 322, 59%) had used foot health services provided by chiropodist or podiatrist. Those who had used services were mostly satisfied but considered patient education about foot health insufficient. One third reported no visits to foot health services at all because of personal and health service system-related factors.

CONCLUSIONS

Those people with RA who have access to foot health services value and appreciate the services. However, many people with RA do not use foot health services because they perceive availability of such services limited and thus unequal and hard to access. There is a need to develop foot health services for people with RA so that they are easy to access, correspond to their foot health needs and have seamless care paths at different levels of the health care system.