Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
Customer Value Creation In Healthcare - Network Perspective
Justyna Matysiewicz* and Slawomir Smyczek**1
The dynamic development of medical services sector in European Union creates the
demand for analysis and evaluation of the medical organization operating in this sector. This
issue deserves attention both from the theoretical and practical the point of view. In the
healthcare sector, different healthcare providers, such as home care, primary care,
pharmacies and hospital clinics but also a financial institution, collaborate in order to
increase values for patients, such as better health state, more complex services, high quality
of services, and increased feeling of safety. By creating a value, flexible healthcare network
providers and additional actors create the value through collaboration. The issues addressed
in the article focuses on marketing activities of healthcare services networks in the context of
customer value creation. The aim of the study is identification and description the process of
value for customer creation in healthcare networks.
JEL Codes: M31, D12, and D14
1. Introduction
Well-developed economies are characterized by the interaction of two important trends: an
increased role of services in the economy, and an increased role of knowledge in the technological
and social innovation development process (emergence of the information society and knowledgebased economy and innovation). Nowadays, knowledge has become a central element of
production of goods and services, and learning itself constitutes an important process in the
economic development. Peter F. Drucker characterized this new type of economy by emphasizing
the role of leading groups composed of skilled workers or trained practitioners who are able to use
the knowledge for production purposes (Drucker, 1999). M. Castells has also pointed out that the
key element of knowledge economy is a network organization, and network, as a form of
organization of production, distribution and management, is an analogy to contemporary economic
development (Castells 2011). Increased access to resources, distribution of responsibility and risk
reduction, flexibility and adaptation to the changing global environment, mobility of knowledge and
skills are the main advantages of network structures.
Essential to any business networks is the underlying system through which it produces value. This
value–system construct is based on the notion that each product/service requires a set of value
creating activities performed by a number of actors forming a value-creating system (Möller and
Rajala, 2007). A value-creating system is a set of activities that create value for consumers
(Parolini, 1999). Various resources are used in carrying out these activities, linked by various kinds
of flows. Value-creating systems contain several economic actors who may be involved in more
than one value-creating system. Within the value net model, economic activity is thought of not in
terms of a set of economic actors who internally perform a set of activities, but as a set of activities
that create value for final customers (Parolini, 1999).
1
*Justyna Matysiewicz Ph.D, University of Economics in Katowice, Department of Market Policy and Marketing
Management, 1 Maja 50, 40–287, Katowice, Poland, justyna.matysiewicz@ue.katowice.pl
**Prof. Slawomir Smyczek Ph.D, University of Economics in Katowice, Department of Consumption Research, 1 Maja
50, 40–287, Katowice, Poland, slawomir.smyczek@ue.katowice.pl
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
The issues addressed in the article focuses on marketing activities of healthcare services networks
in the context of customer value creation. The aim of the study is identification and description the
process of value for customer creation in healthcare networks.
Research was finance by National Center of Science (NCN) based on decision number DEC2013/11/B/HS4/01470.
2. Literature Review
The category of value frequently appears in social sciences, including economics. Despite this,
scientists find the category difficult to define and often avoid precise definition thereof, which
results in ambiguities hindering the process of researching the consumption value for customers.
Due to subjective and situational character of the value, analysis should be focus on the concept of
customer in consumption sphere.
The term customer value was first introduced into the marketing theory in 1954 by P. Drucker on
the occasion of presenting the concept of marketing corporate management (Drucker, 1954).
Towards the end of 1960s, this category appeared in the theory of consumer behavior and referred
to the concept of utility (benefit) and satisfaction, known from the theory of consumer choice
(Howard and Sheth, 1969, Kotler and Levy, 1969). Later, the use of its original sense was dropped,
and the concept of “value” appeared only in studies into consumer behavior where it was
considered as declared and respected values, or as values preferred by buyers (customer values).
The notion of value for money recurred in its broader use in economic sciences at the end of 1980s
thanks to M. Porter’s research into corporate competitive advantage and his development of a
chain model of added-value (Porter, 1985).
M. Porter’s views on customer value (called by him value for buyer) were based on his abundant
scientific work on consumer, containing results of research into consumer satisfaction carried out in
1980. Thanks to M. Porter’s study, the term of customer value has been widely adopted in the
contemporary concepts, including: Total Quality Management, Business Process Reengineering,
Supply Chain Management, Value Based Management and Customer Relationship Management
(Szymura-Tyc, 2003).
Also in 1990s the category reappeared as a subject of scientific interest in the theory of marketing
supported by the theory of consumer choice, consumer behavior and consumer psychology. The
term customer value was used alongside such notions as utility, benefits, needs and satisfaction.
Reasons for development of research into customer value were diverse. First, the concept of utility,
a basic category of consumer choice theory, did not put enough emphasis on costs borne by the
consumer in the process of buying and using some definite goods. In the consumer choice theory,
utility was regarded as tantamount to consumer satisfaction with benefits from using a product
(Kamerschen et al., 1991). Research into consumer satisfaction proved, however, that satisfaction
experienced by the consumer depends not only on benefits that the consumer gains from buying
and using a product (utility), but from relevant costs that he /she must bear - Theory of Exchange
Fairness (Jachnis and Terelak, 1998). This necessitated development of a category which could
both reconcile gained benefits and costs to be borne by the consumer. Secondly, research into
consumer satisfaction showed that satisfaction appeared only when results from buying and using
a product exceeded customer’s expectations of a product at the very moment of product selection Model of Expected Discrepancy (Furtak, 2003). Considering product utility and satisfaction as
equal did not allow for identification of this relation. Thus, it was necessary to find a category that
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
could enable researchers to study the relationship between consumer satisfaction, his/her
expectations with respect to products and results of purchase and consumption thereof, with full
consideration of both benefits to be gained and costs to be borne by the buyer.
All the research into the consumer and marketing has resulted in the development of the notion of
customer value. The definition of the category was based not only on classical marketing theories,
but also on modern theories of behavior and consumer psychology. The notion development was
also supported by achievements of service marketing and conclusions drawn from a contemporary
concept of relationship marketing. Researchers have also referred to M. Porter’s chain model of
added-value, which combines value for the customer with added-value for the buyer and the
company. Many attempts have been made to define the concept of value for the customer, as well
as to determine attributes of the category and ways of measuring thereof.
V. Zeithaml defines customer value by exploiting the concept of product utility. Here, the value is
an aggregate consumer evaluation of product utility based upon consumer’s perception of what is
gained against what is given (Zeithaml, 1988). V. Zeithaml emphasizes that customer value is a
subjective and differently perceived category, whereas price constitutes a significant criterion, but
its influence on consumers may vary. The author also notices that clear and legible use instruction
manual or an assembly manual may be an important factor in consumer perception of a product
value. Moreover, this value may be looked upon differently, depending on circumstances of its
consumption.
K. Monroe, in turn, claims that the value perceived by buyers comes from the relation between the
quality or benefits that the buyer recognizes in a product and perceived sacrifices (loss) he/she
makes by paying a given price. K. Monroe claims that perceived benefits are composed of physical
attributes of a product, attributes connected with accompanying services and technical support
during product utility, as well as of price and other quality indexes. Perceived costs, in turn,
comprise costs borne by the buyer during the purchase, such as: product price, costs of purchase
related to e.g. transfer of title deeds, costs of assembly, costs of exploitation, maintenance (repairs)
costs, failure risk or product malfunction risk costs. By assuming that most buyers operate within
financial constraints (in the theory of consumer choice – financial constraints, K. Monroe
maintained that buyers were more susceptible to borne costs (sacrifices, losses) than to potential
benefits), he proposed customer value to be measured by the ratio of benefits to costs, and not by
the difference existing between them. It is valuable in adding that the proposed concept did not
elicit big response in marketing literature. However, majority of the authors are inclined to define
the value as a difference (excess) between the perceived benefits and costs. This seems justified
inasmuch as the concept of the perceived costs signifies the cost which is subjectively perceived
by the customer. Nonetheless, it should be borne in mind that different customers have diverse
reactions to particular cost components (price, effort, time, etc.). With certain financial constraints
related to their income, buyers may be more or less susceptible to price and other components of
perceived costs (Szymura-Tyc, 2005).
Considerate contribution to the definition of customer value was made by A. Ravald and Ch.
Gronroos, researchers connected with the concept of relationship marketing, who extended the
definition of value proposed by K. Monroe. They pointed out to the fact that, apart from the value
of a product itself (company’s offer), there exists a distinct value, being a result of the relationship
between transaction parties. In their opinion, there are many situations where, despite consumer
dissatisfaction with one of transactions, some prior positive experience which contributed to
development of the relationship between the customer and the company encourages him/her to
seek compromise. With regard to this, A. Ravald and Ch. Gronroos proposed to take into account
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
costs and benefits ensuing from the relationship between the buyer and the seller, alongside
unpredicted “accidental” costs and benefits connected with a given transaction, as they jointly
influence the value perceived by the customer. Thus, they referred to concepts elaborated by
consumer psychology, known as transaction and accumulated satisfaction, and to the Affective
Model of consumer satisfaction. According to the authors, the so-called aggregate unpredicted
accidental value is represented by the ratio of accidental benefits and benefits resulting from the
relationship to accidental costs and costs resulting from the relationship (Ravald and Gronroos,
1996).
The concepts of transaction satisfaction, accumulated satisfaction and the so-called attributive
satisfaction, being notions of the consumer psychology, were used at great length by R. Woodruff
in his approach to customer value, which he defined as a composition of preferences experienced
and evaluated by the customer. These preferences refer to attributes of a product itself, of its
functioning, and finally of product consumption effects, thanks to which the customer can (cannot)
achieve his/her goals and intentions in the process of product consumption (Woodruff, 1997). This
definition represents a hierarchical system of customer value, which implies a need for its
assessment at the level of attributes of a product and product consumption as well as customer
goals and intentions. Moreover, this system reveals not only the process of value development, but
also best represents the relation between customer value and satisfaction. Thus, it can be treated
as a basis for measuring satisfaction derived from assessment of value delivered to the customer
(Woodruff, 1997). In his approach to the value definition, R. Woodruff demonstrates a dynamic
character of customer value, which means that it may change with time. The need for a dynamic
approach to the customer value is also emphasized by A. Parasuraman, who points out to the fact
that customers who make a purchase for the first time tend to concentrate on product attributes,
whereas those who do it repeatedly pay more attention to effects of product consumption and
possibilities of achieving certain goals relating to definite goods (one product) or a service
(Parasuraman, 1997).
Customer value has been also a subject of Ph. Kotler’s analyses who defined it as a difference
between the total customer value and the total customer costs. The total value is composed of a
bundle of benefits anticipated by the customer, whereas the total cost is made up of a bundle of
costs expected by the customer in connection with the evaluation, purchase and consumption of a
product or service (Kotler, 1997). According to Ph. Kotler, the total customer value comprises an
anticipated value of a product, service, personnel and corporate image. The total cost, on the other
hand, is composed of such costs as money, time, energy and psychical cost expected by the
customer (Smyczek, 2012). In his definition, Ph. Kotler (1997) underlines the fact that customer
value is not delivered to the customer (as Ph. Kotler initially declared), but is expected by him/her.
Alongside the above-mentioned definitions of customer value, marketing literature presents several
others which, in great detail, refer to some selected issues connected with the concept of customer
value. All the definitions reflect the multifaceted character of studies conducted by scientists and
marketing theorists occupied with research into the category. Although not all of them are
considered successful, the overview of the definitions helps in understanding problems
encountered by researchers. To provide some examples, B. Gale defines customer value as
quality perceived on the market in relation to price of a given product (Gale, 1994). The value on
industrial markets is, in turn, a perceived equivalent, expressed in monetary units, of a bundle of
economic, technical, social or service benefits gained by the customer’s company for a price paid
for a product with respect to offers and prices of other deliverers (Anderson et al., 1993). According
to S. Slater and J. Narver (2000), customer value appears when product-related benefits outweigh
costs of the life cycle of a product being consumed by the customer. For the institutional customer,
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
the benefits materialize along with the growth of a unit profit or with an increase in the number of
sold product units. The costs of life cycle of a product being consumed by the customer comprise
costs related to product finding, to product operational costs, product disposal costs and to its price.
Customer value is perceived as an emotional relation between the customer and the producer as a
result of consumer consumption of a product or a service which, in his/her opinion, provided
him/her with added value (Butz and Goodstein, 1996).
Bearing in mind the above-presented definitions and contemporary achievements in the theory of
consumer behaviors, consumer psychology and marketing theory, it can be concluded that
customer value appears in the process of consumption of a purchased product. This value is
developed through consumer’s subjective estimation of costs and benefits after product purchase
and consumption. These costs and benefits are the only significant element in the assessment of
the value obtained by the customer, and customer value itself represent predominance of benefits
over costs perceived by the customer. Based on this, one can venture a statement that customer
value is an excess of subjectively perceived benefits over subjectively perceived costs related to
purchase and consumption of a given product.
Benefits gained by customers are connected with needs they want to satisfy through some product
purchase and product consumption. Individual customers seek benefits which can meet their
consumption needs. Costs, in turn, have generally a financial dimension connected with exchange
of goods and money between the company (seller) and its customer (buyer). Beside the financial
costs, there are costs which refer to consumer time loss, inconvenience, customer extra efforts,
negative emotions, etc.
In the discussion of customer value, distinction should be made between the value which is
expected and the value which is obtained by the customer. The value expected by the customer
can be referred to as an excess of subjectively perceived and expected benefits and costs relating
to product purchase and consumption. In light of this definition, such a value constitutes basis for
customer market choices, and is tightly related to the concept of utility in the theory of consumer
choice. As for value gained by the customer, i.e. customer value, it can be defined as an excess of
subjectively perceived customer benefits over subjectively perceived customer costs, being the
result of product purchase and consumption (Glowik and Smyczek, 2015). Such a definition of a
customer value corresponds with the notion of customer advantage in the theory of consumer
choice and with added-value introduced to the management literature by M. Porter.
With respect to the above-discussed issues, the following attributes of customer value can be
distinguished:



subjectivity – customer value is not dependent solely on a service itself, but on customer’s
individual needs to be satisfied by a company, and on customer’s individual capability of covering
costs related to product purchase and product use,
situational character - benefits and costs related to purchase and use of a product are always
conditional on a situation in which product is bought; depending on a situation, the same customer
may have different perception of benefits to be won and costs to be borne,
perceived value - this means that the assessment of a customer value comprises only benefits
and costs which are perceived (recognized) by the customer, and not benefits which were really
gained or costs which were borne by him/her; the very process of benefit and cost perception is
connected not only with cognitive processes, but also with the emotional ones (Glowik and
Smyczek, 2015) .
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
All the attributes of customer value do not allow direct measuring of the category. Although
customer satisfaction can be used as a basic benchmark for customer value estimation, yet, it
should be remembered that satisfaction itself is not exclusively dependent on the value gained, but
also the value expected by the customer. Even more so, satisfaction appears only when effects of
product purchase and use go beyond consumer expectations of these results.
Another important attribute of customer value concerns its dynamic character, which means that
the value changes over time, embracing the whole process of service purchase and product use. In
its endeavor to provide a customer with some value, a companies ought to focus on the whole life
cycle of a product, including all costs and relevant benefits. Thus, customer value represents a
complex set of benefits and costs perceived by the customer in the process of buying and using
products. It is impossible to enumerate all benefits and costs, being components of value for the
customer, because their number and variety correspond with the number of customer’s needs,
expectations and constraints. These needs, expectations and constraints are subject to alterations,
since satisfaction of some needs opens the door to other, more superior ones. Needs change or
diversify, and new ones arise, thus necessitating development of new products which can meet
customers’ changing needs and expectations, and which can adapt to customers’ varying
constraints. Being aware of the fact that benefits and costs are the only determinants of a customer
value perceived by the customer, companies tend to arrange miscellaneous activities which are
designed to teach customers to appreciate attributes of their products. In practical terms, a
companies can create and model customers’ needs and expectations with respect to offered
product, and ultimately, may affect assessment of the final value gained by customers.
Marketing is about managing profitable customer relationships. The twofold goal of marketing is to
attract new customers by promising superior value and to keep and grow current customers by
delivering satisfaction (Armstrong & Kotler, 2007). Creating value for customers has been
recognized as a key concept in marketing (e.g. Sheth & Uslay 2007; AMA definition of marketing,
Chartered Institute of
Creation and delivery of the value for the customer, being the prerequisite for a competitive edge,
is especially significant with respect to system-based health care services. An increasingly
common systemic character of products and services results from the customer’s perception of
their value, namely their existence in a definite and developed system of products and/or services
and in networks of their users. Possible benefits gained from the purchase and from the use of
systemic products depend on existence and operation of other related products or services
(Parolini, 1999; Matysiewicz, 2014).
Healthcare Value Networks
According to Kähkönen (2010) a value net is a dynamic, flexible network in which the actors create
value through collaboration (e.g. Allee, 2003; Bovet and Martha, 2000a,b; Jarillo, 1998; Parolini,
1999). The value net model was developed to facilitate the analysis, description and study of valuecreating systems, and takes activities rather than companies as the key elements of strategic
analysis (Parolini, 1999). Companies are regarded as complex nodes in complex interdependent
value nets, where success comes through collaboration and creating a business environment in
which each actor can be successful (Allee, 2003). Any network where the participants are engaged
in these kinds of exchange relations can be seen as a value network, whether the value network
has been acknowledged by its participants.
Nowadays it can be noticed the growing interest of value net concept in healthcare. Progressing
integration of the medical sector actors is indicated by the emergence of healthcare value nets. To
the major advantages connected with the value network strategy of HCOs are (Matysiewicz 2007):
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
-
possibilities of widening the existing offers with new services, and at the same time
broadening the range of service offers,
-
possibilities of diminishing of doctors’ mistakes, because of the bigger number of
operative specialists,
-
ensuring the safety flowing from the safety of customers directed to the organization from
other co-operating doctors,
-
motivation for investment in new technologies what allows rising the quality of services,
-
bigger resources for marketing activity flowing from the synergy effect.
co-
Healthcare organizations develop value nets to increase the chances of them being able to survival
and grow. Healthcare value nets concern service-oriented collaboration between at least two
independent entities, which build economic and business relationship (Powell et al., 1996).
Networks in the field of medical services it is a joint effort of companies already operating in the
market (although on a smaller scale) in order to search for new market opportunities in the field of
exploring new markets, identify new customers, create new, often more integrated market offers
what can respond to costomers' expectations better. The process of integration of medical services
can be divided into three main components, the areas of networking (Fleury, Mercier 2002):
-
Functional Area / Administration, responsible for the supervision, management, marketing,
information flow, resource allocation, and effectiveness.
-
Clinical area, responsible for improving service process. It means that service have to be
synchronized according to treating periods (eg. before and after hospitalization), and during the
period of treatment (eg.: psychological support, home care). This component forms the basis for
the creation of the process of service delivery.
-
The area of the medical system. It is directly responsible for the quality of medical personnel
and treatment process involves the active participation of doctors in the network.
The integration process affects all of these components. It means restructuring medical practices,
service offerings, organizational structures adoption.
Knowledge Transfer in Value Networks
One of the main role of value networks is related to the knowledge transfer. A network allows a
better sharing of newest findings in order to reuse in during new knowledge creation. The
knowledge transfers allows to create and deliver much more advanced value for the consumer.
The critical knowledge type that is distributed throughout the network is tacit knowledge. This
phrase was first coined by Polanyi (1966) and used to describe a form of knowledge that cannot be
explicated and that is embodied through practice. At the heart of this concept is the notion of tacit
‘knowing’: here, the outcome of action is the focal, or proximal, point and the doing (achieving the
outcome) is characterised as a distal process. The critical skills and knowledge of employees and
their social practices may become localised within a project team, network or a more informal
community-of-practice (Wenger, 2000; Yanow, 1999) within the organisation. It is essential for the
success of the organisation that this knowledge is integrated between the different pockets and
shared throughout. Connections need to be made between the potentially disparate parts of the
organisation if the knowledge is to be developed (Swart, Kinnie, 2003).
The basic approach to knowledge transfer is to consider knowledge transfer as knowledge sharing
among people (Dyer and Nobeoka, 2000). Knowledge sharing implies the giving and taking of
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
information framed within a context by participants involved. Knowladge transfers requires the
willingness of the group or individual to work with others and share knowledge to their mutual
benefit. Without sharing, it is almost impossible for knowledge to be transferred to other person.
This shows that knowledge transfer will not occur in an organization unless its employees and work
groups display a high level of co-operative behaviuor (Goh, 2002).
Some researchers view knowledge transfer as a process through which knowledge moves
between a source and a recipient and where knowledge is applied and used (Szulanski, 1996,
2000; Szulanski, Cappetta and Jensen, 2004). Within an organization, knowledge can be
transferred among individuals, between different levels in the organizational hierarchy and between
different units and departments. Szulanski (1996, 2000) defines knowledge transfer as “dyadic
exchanges of knowledge between a source and a recipient in which the identity of the recipient
matters” (Babinska, Matysiewicz 2014). The level of knowledge transfer is defined by the level of
knowledge integrated within an individual and the level of satisfaction with transferred knowledge
expressed by the recipient. Almeida, Song and Grant (2002) view knowledge transfer as a process
of creation, transfer, application and subsequent development through combination of the
transferred knowledge with the recipient’s existing knowledge. Others focus on the resulting
changes to the recipient by seeing knowledge transfer as the process through which one unit is
affected by the experience of another (Argote and Ingram, 2000). Similarly, Davenport and Prusak
(2000) suggested that the knowledge transfer process involves two actions: transmission of
knowledge to potential recipient; and absorption of the knowledge by that recipient that could
eventually lead to changes in behavior or the development of new knowledge. Model introduced by
Nonaka and Takeuchi (1995) explains knowledge transfer based on knowledge conversion model.
Modes of knowledge transfer can take four forms, i.e. Socialization, Externalization Combination
and Internalization (SECI). According to Nonaka and Takeuchi (1995), socialization refers to an
organizational process through which tacit knowledge held by some individuals is transferred in
tacit form to others with whom they interact. Externalization refers to the transformation of some
tacit knowledge into explicit knowledge, via theories, concepts, models, analogies, metaphors and
so on. Combination refers to the conversion of codified knowledge into new forms of codified
knowledge. Internalization is a process of conversion of explicit knowledge into a tacit form. Each
mode of conversion constitutes one means of knowledge transfer and creation (Cohendet et al,
1999).
3. Reserch Methodology
The research was conducted in 2014 by means of exploratory, case research method. The
research design was qualitative and exploratory in nature. As stated by McCracken (1988)
qualitative research does not survey the terrain, it mines it, and therefore can be seen as more
intensive than extensive in its objectives. Similarly Eisenhardt (1989) focuses on utilising a casebased approach for theory-driven research.
The basis for selecting the case studies was the approach applied by J. Collins and J.I Porras
(1994). They studied 'truly exceptional companies' and compared them with another set of very
good companies. In every case, they put their iconic company up against a comparator, at some
point, held equal stature in the same industry. They studied how the two diverged from that point
on and then looked for patterns across all the winners. Both semi structured interviews and
analysis of secondary data were used for data collection. The companies selected for the research
are healthcare medical unitis, representing the network organisation. Case A is represented by
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
Leader, a multinational company which has been actively involved in development of a network of
medical entities in EU since 1994. Currently, it is run 100 centers and cooperates with a network of
1500 independent medical entities throughout EU. The company provides healthcare services to
one million patients. Case B represents a comparative company called Specialist which has been
operating on the Polish market for three years. The company owns 3 medical centers in Poland,
yet, its pace of growth is high and exceeds that of the competition. Interviewees were senior
managers within their firms, possessing international experience in international markets. The main
objective of the research was to determine the role, the scope and significance of value networks in
the process of developing and delivering the value for the consumer of health care services. The
research included two health care networks operating in in Poland.
4. Results of Research And Discussion
The two cases did not provide the same amount of information under each research question and
themes but the phenomenon under investigation is well represented in every case and in this
manner the stories that unfold across the two cases aggregately provide a comprehensive
understanding.
Leader can be assigned to the current network. It is a network of individuals with a very secure and
stable bases of operation. Relationship between network elements suggest creating a network of
vertical and horizontal connection. The main objective of the operation is to increase its access to
complementary resources, increase operational efficiency, growth opportunities, and access to a
wider group of customers. Its important feature is the hierarchical coordination of distribution
network. The network is integrated, formal and highly structured and open for new entities. Leaders
in addition to the distribution network (horizontal relationships), responsible for delivering value,
builds a network of its own units (initiating, taking over) responsible for the enrichment and
comprehensive service offerings (value creation). Relationships between them are vertical and
based on the value added. Value creation system itself is well illustrated in the network, and the
network itself has a relatively stable resources and processes forming a specific customer value.
The units responsible for value creation are an integral part of the Leader. Relationships between
units and the Leader are highly structured and formal.
In the case of Leader network it can be noticed that the system of knowledge management
comprises all entities/units. The system of knowledge management in such a multinational network
is composed of definite standards and procedures, e.g. with respect to marketing, financial matters
or human resources. In this context, huge formalization and strict procedures in all aspects of
corporate operation appear as a disadvantage, yet, they are designed to create more transparent
and easy-to-manage structure all over the world. The network represented by Leader has a good
system of security of knowledge transfer including the so-called emergency system. Another
important element positively affecting operation of the company is transfer information between
network units as well as between the external environment.
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
Figure 1: The value creation in Leader healthcare network
Benefits of Network
Medicover
Medical center
Medcover (1)
Medical
packages
(systemic
product)
Medicover
insurance
MC Medcover (n)
Medicopharma
Syneva
Med
ivov
er
Gru
p in
Pola
nd
MC independent
MC independent
(2)
Mass
individualisation
of the product
Value
for
custome
r
MC independent
InviMed
Medicover Poland
Medicover Hospital
Medicover Poland
MC Medcover (2)
Patient
Brand
Service
standards
availability 48h
mobile services
service i on-line
independent
N
Telephone
services
Care Expert
Relationship Marketing
Creating the Value
Communicating the value
Delivery the value
Leader attaches great importance to communication processes, and therefore uses a lot of internal
communication tools such as trainings, conferences, regular information meetings as well as the
Intranet and teleconferencing. It is noteworthy that, due to its dominant position on the market,
Leader enjoys greater freedom in gaining information from network partners than the partners
themselves. Network units are obliged to maintain regular contacts and to report its performance to
Leader. However, it is a common practice for Leader to keep certain information and not to
disclose it to other network partners, which reveal a unilateral character of this communication.
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
Figure 2: The value creation in Specialist healthcare network
Benefits of Network
Medical
Acupuncture
Psycho
prevention
Individual
medical
systemic
product
Medical center
Katowice (1)
Medical center
Warszawa (2)
Brand
Imane
Service
standards
PATIENT
Anti-aging
medicine
Medical Centre Preveneo
Micro nutrition
Value for customer
for customer
Medical balance
Medical center
Bielsko-Biała(3)
Functional
Rehabilitation
Relationship Marketing
Creating the Value
Communicating the value
Delivery the value
The second researched entity on the medical market is Specialist. It is an emerging network. It is a
network of professional individuals with a relatively unstable structure of the operation. From the
goal point of view they adopt a similar structure to the dominant design networks. However,
because of intangibility of the services the basics of its operation are different. The project
approach is focused around new, innovative, highly customized methods for creating and offering
services or customer contact. The advantage of the network is built based on cooperation within
the network, in a situation where a single company can not just get such a dominant position. An
important feature of this network it is building the structures around the customer value process.
Specialist network consists of branches mainly cooperating on a contractual agreements
(organisationally and financially independent units) within certain areas of activity. The network
builds horizontal relations and it is open to new elements. There are no rigidly defined acceptance
criteria. The decision is made after analysis of each particular case. It is important The
relationships between units are diagonal, partly competing and partly complementary. In a formal
sense, there is a center / core of the network. The units responsible for customer value creation are
well known. As mentioned earlier the links between them are less structured and open. The
network models differ significantly in the area of network organization, type of network connections,
and the process of creating, communicating and delivering the customer value.
Specialist, as a company operating on the medical market does not possess a clearly definite
system of knowledge management within the network. The company’s idea is to provide and share
knowledge in every possible way, whereas the security system of knowledge transfer is not of such
great concern as in the case of Leader. Specialist is willing to share its knowledge through trainings
or publications. Another important element positively affecting operation of the studied companies
is information transfer between network units as well as between the external environment. In the
case of Specialist, internal domestic communication is dominated by direct contacts, telephone
conversations and e-mails. In addition, Specialist arranges trainings for its personnel, yet, in a
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
limited scope. On the international level the communication within the network takes place through
mailing, tele-conferencing and traditional correspondence (Matysiewicz et al., 2014).
Compared healthcare networks differ significantly in terms of: network organization, the process of
creating, communicating and delivering value, formation/levels of customer value and participation
of the patient in the process of value creation. Features presented in Table 1 became the basis for
comparison.
Table 1: Qualitative comparative analysis of healthcare networks’ in the context of the creation of
value for the customer
Features
1. It creates strong network links
2. Open to new network elements
3. Selection of the candidates for networks
4. It owns the brand
5. Coordinates the activities of the network
6. A large number of network elements
7. It is a large company
8. Long operating on the market
9. It has a defined value for the customer
10.
Network participants create value for the
customer
11. Participants in the network have an impact on
value creation for the customer
12. The patient is a participant in the value creation
process
13. Builds long-term relationships with clients
14. It offers systemic products
15. The flow of information and knowledge in the
network is free
16. Communicates the value
17. It uses an integrated marketing information system
18. It uses new technologies
19. It has an extensive distribution and sales network
20 It has a marketing department
21. Conducts marketing research
In total
Leader
√
√
√
√
√
√
√
√
√
√
Specialist
X*
√**
√
√
√
X
X
X
√
√
X
√
X
√
√
√
√
√
√
√
√
√
√
√
√
√
19
√
√
X
X
X
√
13
* not having the specific characteristics ** having the specific characteristics
In terms of network management features 1- 3 are referring to acquiring process of new members
of the network (elements), number 5 refers to supervision of the network. Figures 6 and 7 describe
network size, while features 9-14 are associated with the process of creating value for the
customer. Features 16,17 describe the communication process and 18,19 are responsible for the
process of delivering value. Features 20,21 and 4 refer to the concept of market operations.
The results of the qualitative comparative analysis allows for comparison of the processes of
building, communicating and delivering value for the patients in both healthcare networks. In terms
of build and control the entire network (features 1-8) Leader meets all the criteria, which means
strict control and the highly structured structure. It creates and controls the concept of customer
value in an autocratic manner with minimal other network elements involvement. Specialist is much
more flexible in terms of active inclusion of members of the network in the process of creating
value, also enables patients as part of this process. Despite the different time functioning on the
Proceedings of Annual Tokyo Business Research Conference
9 - 10 November 2015, Shinjuku Washington Hotel, Tokyo, Japan, ISBN: 978-1-922069-88-7
market and size, both networks are open to new elements and expand the structure of value
delivery. Leader utilizes brand and reputation as a tool for growth market penetration together with
the concept of mass customization of their products. Specialist is geared towards greater
individualization of its offer, more direct, almost a family relationship with the patient and
recommendations are used
5. Conclusion
The main conclusions of the research suggest that all companies under the research fall in the
group category of the so-called present networks. The operation of these networks is based on
solid foundations, and is oriented on building relations between network components and,
simultaneously, on developing both vertical and horizontal networks. The main objective of the
network operation is to increase access to complementary resources and to gain a wider customer
portfolio, as well as to boost effectiveness and get new market opportunities. These networks are
also characterized by hierarchic coordination of distribution within the network; they are formal and
significantly structured, but also open to new elements. Value-creation system is well defined in the
surveyed companies. However, the Leaders’ system unlike Specialist one is highly structured and
standardized. It is assumed no consumer involvement in the process of value creation.
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