Users' search mechanisms and risks of inappropriateness in healthcare innovations: The role of literacy and trust in professional contexts

In the context of professional service organizations, user engagement with knowledge search might generate significant risks of inappropriateness to innovation processes. Previous research suggests that professionals would then keep users at arms' length, controlling the design and implementation of innovations internally. This study overcomes this view investigating how professional service organizations can enable users' knowledge search while controlling for the risks of inappropriateness. Combining a qualitative research on 5 innovation processes in healthcare organizations with quantitative research on 110 service users, our findings highlight that professional providers, such as senior clinicians, shaped their tactics according to the ‘threats’ of laggards, i.e. users searching knowledge outside of professional logics of appropriateness; more than to the opportunities of lead-user communities. Professional providers sought to “activate” users' engagement with knowledge search by investing on their literacy, i.e. showing the basics of the logic of appropriateness informing their decision; and on trust relationships, i.e. becoming transparent on the criteria of knowledge selection during the innovation processes.

[1]  Gabriel Szulanski.  Exploring internal stickiness: Impediments to the transfer of best practice within the firm , 1996 .

[2]  M. Lodge,et al.  Why People “Don’t Trust the Evidence” , 2015 .

[3]  Patrick G. Maggitti,et al.  Top management attention to innovation: The role of search selection and intensity , 2009 .

[4]  David F. Larcker,et al.  Structural Equation Models with Unobservable Variables and Measurement Error: Algebra and Statistics: , 1981 .

[5]  Marjorie A. Lyles,et al.  Inter-Organizational Knowledge Transfer: Current Themes and Future Prospects , 2008 .

[6]  Jin Chen,et al.  The influence of scope, depth, and orientation of external technology sources on the innovative performance of Chinese firms , 2011 .

[7]  Mark S. Granovetter.  T H E S T R E N G T H O F WEAK TIES: A NETWORK THEORY REVISITED , 1983 .

[8]  Allan Afuah,et al.  Users as Innovators: A Review, Critique, and Future Research Directions , 2009 .

[9]  Ellen H.M. Moors,et al.  User producer interaction in context , 2012 .

[10]  Colin D. Furness,et al.  The system of professions , 2019, Educ. Inf..

[11]  A. Nerkar,et al.  Beyond local search: boundary‐spanning, exploration, and impact in the optical disk industry , 2001 .

[12]  Andrew C. Inkpen,et al.  Social Capital, Networks, and Knowledge Transfer , 2005 .

[13]  M. McMullan.  Patients using the Internet to obtain health information: how this affects the patient-health professional relationship. , 2006, Patient education and counseling.

[14]  Christian Wagner.  End Users as Expert System Developers? , 2000, J. Organ. End User Comput..

[15]  Birgit Renzl.  Trust in management and knowledge sharing: The mediating effects of fear and knowledge documentation , 2008 .

[16]  W. Sofka,et al.  Search patterns and absorptive capacity: Low- and high-technology sectors in European countries , 2009 .

[17]  C. Köhler,et al.  Selective search, sectoral patterns, and the impact on product innovation performance , 2012 .

[18]  Suvi Nenonen,et al.  Managing Co‐Creation Design: A Strategic Approach to Innovation , 2015 .

[19]  Emanuele Lettieri,et al.  Knowledge Sharing and Innovative Work Behaviour in Healthcare: A Micro‐Level Investigation of Direct and Indirect Effects , 2014 .

[20]  E. Hippel,et al.  Lead users: a source of novel product concepts , 1986 .

[21]  Rocio Garcia-Retamero,et al.  Do the media provide transparent health information? A cross-cultural comparison of public information about the HPV vaccine. , 2012, Vaccine.

[22]  Cristina Masella,et al.  Patient Empowerment and its neighbours: clarifying the boundaries and their mutual relationships. , 2015, Health policy.

[23]  Morten T. Hansen,et al.  The Search-Transfer Problem: The Role of Weak Ties in Sharing Knowledge across Organization Subunits , 1999 .

[24]  Cornelius Herstatt,et al.  The Lead User Method: An Outline of Empirical Findings and Issues for Future Research , 2004 .

[25]  Tammy L. Rapp,et al.  Team Effectiveness 1997-2007: A Review of Recent Advancements and a Glimpse Into the Future , 2008 .

[26]  David A. Kindig,et al.  Health literacy : a prescription to end confusion , 2004 .

[27]  Z LevinDaniel,et al.  The Strength of Weak Ties You Can Trust , 2004 .

[28]  A. Salter,et al.  Searching high and low: what types of firms use universities as a source of innovation? , 2004 .

[29]  Zackary Berger,et al.  Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review , 2013, BMJ quality & safety.

[30]  K Walshe,et al.  Evidence-based management: from theory to practice in health care. , 2001, The Milbank quarterly.

[31]  R. Yin.  Case Study Research: Design and Methods , 1984 .

[32]  Brian Kahin,et al.  Democratizing Innovation: The Evolving Phenomenon of User Innovation , 2006 .

[33]  E. Boyko,et al.  Brief questions to identify patients with inadequate health literacy. , 2004, Family medicine.

[34]  E. Salas,et al.  Shared mental models in expert team decision making. , 1993 .

[35]  Tjabe Smid,et al.  Media coverage on electromagnetic fields and health: Content analysis of Dutch newspaper articles and websites , 2012 .

[36]  E. Hippel.  Sticky Information and the Locus of Problem Solving: Implications for Innovation , 1994 .

[37]  Robert F. Dedrick,et al.  Development of the Trust in Physician Scale: A Measure to Assess Interpersonal Trust in Patient-Physician Relationships , 1990, Psychological reports.

[38]  Tracey Coule,et al.  INSTITUTIONAL LOGICS, INSTITUTIONAL WORK, AND PUBLIC SERVICE INNOVATION IN NON-PROFIT ORGANIZATIONS , 2013 .

[39]  K. Eisenhardt.  Building theories from case study research , 1989, STUDI ORGANIZZATIVI.

[40]  S. Llewellyn.  `Two-Way Windows': Clinicians as Medical Managers , 2001 .

[41]  Fares Alahdab,et al.  New evidence pyramid , 2016, Evidence-Based Medicine.

[42]  Alan Wilson,et al.  Patient co-creation activities in healthcare service delivery at the micro level: The influence of online access to healthcare information , 2018 .

[43]  R. Blendon,et al.  Ebola in the United States--Public Reactions and Implications. , 2015, The New England journal of medicine.

[44]  Shingo Takahashi,et al.  Role of community in user innovation generation and diffusion—Focusing on non-brand communities in the mountain climbing market , 2014 .

[45]  Scott B. MacKenzie,et al.  Common method biases in behavioral research: a critical review of the literature and recommended remedies. , 2003, The Journal of applied psychology.

[46]  Judith H Hibbard,et al.  Do increases in patient activation result in improved self-management behaviors? , 2007, Health services research.

[47]  Mirko Noordegraaf,et al.  Risky Business: How Professionals and Professional Fields (Must) Deal with Organizational Issues , 2011 .

[48]  P. Keinz,et al.  Synergies among Producer Firms, Lead Users, and User Communities: The Case of the LEGO Producer–User Ecosystem† , 2014 .

[49]  P. Bentler,et al.  Fit indices in covariance structure modeling : Sensitivity to underparameterized model misspecification , 1998 .

[50]  E. Rogers.  Diffusion of Innovations , 1962 .

[51]  Catherine Holtgräfe,et al.  Multifaceted determinants of online non-prescription drug information seeking and the impact on consumers’ use of purchase channels , 2012, Health Informatics J..

[52]  V. Mangematin,et al.  Orchestrating innovation with user communities in the creative industries , 2014 .

[53]  M. Polanyi.  Personal Knowledge: Towards a post-critical philosophy , 1959 .

[54]  J. Sloan,et al.  Patient engagement in research: a systematic review , 2014, BMC Health Services Research.

[55]  O. Gassmann,et al.  Managing the Risk of Customer Integration , 2005 .

[56]  John W. Creswell,et al.  Research Design: Qualitative, Quantitative, and Mixed Methods Approaches , 2010 .

[57]  D. Harrison,et al.  What's the difference? Diversity constructs as separation, variety, or disparity in organizations. , 2007 .

[58]  Judith H Hibbard,et al.  Development and testing of a short form of the patient activation measure. , 2005, Health services research.

[59]  Julian Birkinshaw,et al.  Organizational Ambidexterity: Balancing Exploitation and Exploration for Sustained Performance , 2009, Organ. Sci..

[60]  Isabelle Aujoulat,et al.  Reconsidering patient empowerment in chronic illness: a critique of models of self-efficacy and bodily control. , 2008, Social science & medicine.

[61]  Ralph A. Heidl,et al.  Knowledge, Networks, and Knowledge Networks , 2011 .

[62]  Andrew von Nordenflycht.  What Is a Professional Service Firm? Toward a Theory and Taxonomy of Knowledge-Intensive Firms , 2010 .

[63]  Urmimala Sarkar,et al.  Lower Health Literacy is Associated with Poorer Health Status and Outcomes in Chronic Obstructive Pulmonary Disease , 2012, Journal of General Internal Medicine.

[64]  Michael E. Wallace,et al.  Innovation in health care teams. , 1991 .

[65]  Justin Waring,et al.  Institutional Work to Maintain Professional Power: Recreating the Model of Medical Professionalism , 2012 .

[66]  A. Abbott.  The System of Professions: An Essay on the Division of Expert Labor , 1988 .

[67]  J. Gabbay,et al.  Evidence based guidelines or collectively constructed “mindlines?” Ethnographic study of knowledge management in primary care , 2004, BMJ : British Medical Journal.

[68]  Justin J. P. Jansen,et al.  Inter- and Intra-Organizational Knowledge Transfer: A Meta-Analytic Review and Assessment of its Antecedents and Consequences , 2008 .

[69]  Balaji R. Koka,et al.  The Reification of Absorptive Capacity: A Critical Review and Rejuvenation of the Construct , 2006 .

[70]  B. Deer,et al.  How the case against the MMR vaccine was fixed , 2011, BMJ : British Medical Journal.

[71]  Lars Huemer,et al.  Trustworthiness, Risk, and the Transfer of Tacit and Explicit Knowledge between Alliance Partners , 2008 .

[72]  J. Deegan.  On the Occurrence of Standardized Regression Coefficients Greater Than One , 1978 .

[73]  Donald E. Conlon,et al.  Justice at the millennium: a meta-analytic review of 25 years of organizational justice research. , 2001, The Journal of applied psychology.

[74]  Kevin G. Corley,et al.  Seeking Qualitative Rigor in Inductive Research , 2013 .

[75]  Abbas Tashakkori,et al.  Foundations of Mixed Methods Research: Integrating Quantitative and Qualitative Approaches in the Social and Behavioral Sciences , 2008 .

[76]  Morten T. Hansen,et al.  Knowledge Networks: Explaining Effective Knowledge Sharing in Multiunit Companies , 2002 .

[77]  M. Parchman,et al.  A proposed 'health literate care model' would constitute a systems approach to improving patients' engagement in care. , 2013, Health affairs.

[78]  D. Nutbeam.  The evolving concept of health literacy. , 2008, Social science & medicine.

[79]  V. Albino,et al.  Search and Recombination Process to Innovate: A Review of the Empirical Evidence and a Research Agenda , 2017 .

[80]  D. Lei,et al.  Collaborative Innovation with Customers: A Review of the Literature and Suggestions for Future Research , 2012 .

[81]  J. Mathieu,et al.  The influence of shared mental models on team process and performance. , 2000, The Journal of applied psychology.

[82]  Daniel Z. Levin,et al.  The Strength of Weak Ties You Can Trust: The Mediating Role of Trust in Effective Knowledge Transfer , 2004, Manag. Sci..

[83]  C. Fulmer,et al.  At What Level (and in Whom) We Trust , 2012 .