Managing shifts to value-based healthcare and value digitalization as a multi-level dynamic capability development process

Abstract

Hospital care worldwide changes with the needs and expectations of patients, caregivers, clinicians, and communities. Given that the value-based healthcare (VBHC) approach and the digital technology's role to add value receive increasing attention, the literature provides compelling evidence of their advantages for patients and healthcare transformation generally. Shifts to VBHC and digital health require hospitals to undertake organizational changes, balance countervailing processes within their organizations, and build new dynamic capabilities. Yet, the literature remains silent about managing shifts to VBHC and digital health. By focusing on perspectives of public healthcare service providers, this research conducted a qualitative study of a major European public hospital's cardiology department. Building on the multi-level theory of dynamic capability, this research shows that the development of new capabilities in healthcare occurs by linking micro-levels (individual levels) and macro-levels (hospital levels) through a constructive dialogue at the meso‑level (department and interdepartmental level) and by acknowledging the improvement processes' iterative nature. The paper contributes with new insights on managing and digitalizing VBHC as a multi-level dynamic capability development process.