The Bright Side and the Dark Side of Patient Empowerment: Co-creation and Co-destruction of Value in the Healthcare Environment

97 Pages·2017·1.674 MB·English

by  Rocco Palumbo (auth.)

SPRINGER BRIEFS IN PUBLIC HEALTH
Rocco Palumbo
The Bright Side and the
Dark Side of Patient
Empowerment
Co-creation and
Co-destruction of
Value in the Healthcare
Environment
SpringerBriefs in Public Health
SpringerBriefs in Public Health present concise summaries of cutting-edge
research and practical applications from across the entire field of public health,
with contributions from medicine, bioethics, health economics, public policy,
biostatistics, and sociology.
Thefocusoftheseriesistohighlightcurrenttopicsinpublichealthofinteresttoa
global audience, including health care policy; social determinants of health; health
issues in developing countries; new research methods; chronic and infectious dis-
ease epidemics;and innovative health interventions.
Featuring compact volumes of 50 to 125 pages, the series covers a range of con-
tent from professional to academic. Possible volumes in the series may consist
of timely reports of state-of-the art analytical techniques, reports from the field,
snapshots of hot and/or emerging topics, elaborated theses, literature reviews, and
in-depth case studies. Both solicited and unsolicited manuscripts are considered
for publication in this series.
Briefs are published as part of Springer’s eBook collection, with millions of users
worldwide. In addition, Briefs are available for individual print and electronic
purchase.
Briefsarecharacterizedbyfast,globalelectronicdissemination,standardpublishing
contracts,easy-to-usemanuscriptpreparationandformattingguidelines,andexpedited
productionschedules.Weaimforpublication8–12weeksafteracceptance.
More information about this series at http://www.springer.com/series/10138
Rocco Palumbo
The Bright Side and the Dark
Side of Patient Empowerment
Co-creation and Co-destruction of Value
in the Healthcare Environment
123
Rocco Palumbo
Department ofManagement andInnovation
Systems
University of Salerno
Fisciano
Italy
ISSN 2192-3698 ISSN 2192-3701 (electronic)
SpringerBriefs inPublic Health
ISBN978-3-319-58343-3 ISBN978-3-319-58344-0 (eBook)
DOI 10.1007/978-3-319-58344-0
LibraryofCongressControlNumber:2017939308
©TheAuthor(s)2017
Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpart
of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission
orinformationstorageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilar
methodologynowknownorhereafterdeveloped.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publicationdoesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfrom
therelevantprotectivelawsandregulationsandthereforefreeforgeneraluse.
The publisher, the authors and the editors are safe to assume that the advice and information in this
book are believed to be true and accurate at the date of publication. Neither the publisher nor the
authorsortheeditorsgiveawarranty,expressorimplied,withrespecttothematerialcontainedhereinor
for any errors or omissions that may have been made. The publisher remains neutral with regard to
jurisdictionalclaimsinpublishedmapsandinstitutionalaffiliations.
Printedonacid-freepaper
ThisSpringerimprintispublishedbySpringerNature
TheregisteredcompanyisSpringerInternationalPublishingAG
Theregisteredcompanyaddressis:Gewerbestrasse11,6330Cham,Switzerland
To Anna,
To whom I owe all that I know
Foreword
Patient empowerment is a delicate issue for scholars and practitioners interested in
public health. Many studies have discussed the different shades which build this
construct, providing a wide array of conceptual perspectives from which patient
empowerment could be investigated. Far from paving theway for a consistent and
agreed definition of patient empowerment, the growing scientific interest in this
fieldhasproducedalargenumberofcompetingdefinitions,tothepointthatpatient
empowerment may mean various things for different audiences.
Fromthispointofview,writingabriefwhichaimsatprovidingasynopticview
ofpatientempowermentmaybeachallengingtask.RoccoPalumboundertookthis
effort and I was fascinated when I read the first proof of this book.
Anin-depthexaminationofpatientempowermentispointedout,whichconcerns
both the bright and the dark sides of the process of patient involvement in the
deliveryofhealthservices.Ontheonehand,patientempowermentmayleadtothe
awakening of sleeping resources, thus contributing toa more appropriate access to
care and better health outcomes. On the other hand, there is a significant risk that
the engagement of patients in the design and delivery of care may turn into value
co-destruction. This is especially common when either patients lack the basic
functional, interactive and critical health-related skills to properly navigate the
healthcare service system or healthcare organizations are not able to establish
friendly and co-creating relationships with the patients. Drawing on these consid-
erations,theenhancementofindividualandorganizationalhealthliteracyshouldbe
recognized as a fundamental strategy to realize the full potential of patient
empowerment initiatives.
Health policy makers and managers of healthcare organizations may benefit
fromreadingthisbrief.Infact,itprovidesanoverviewoftheroleplayedbypatient
empowerment in inspiring the future shapes of the healthcare service system, thus
informing both strategic and organizational decisions aimed at involving the
patients in value co-creation. Besides, healthcare professionals may appreciate this
book, which suggests a recipe for the effective implementation of patient
empowermentinitiatives.Lastbutnotleast,thisbookinspiresanagendaforfuture
vii
viii Foreword
research,encouragingscholarstoinvestigatetheattributesofpatientempowerment
interventions and the consequences which could derive.
Ultimately,thisbookisaneffectivesynthesisofthecurrentstateoftheartofthe
scientific knowledge in the field of patient empowerment, paving the way for
further developments aimed at pushing forward the understanding of the specific
attributes and effects of initiatives intended to empower patients.
Salerno, Italy Paola Adinolfi
February, 2017
Preface
Patient empowerment is a hot topic in healthcare management and public health,
which is attracting the growing interest of scholars and practitioners. However,
thereisstilllittleagreementonwhatismeantbypatientempowerment.Moreover,
little is known about the distinguishing attributes and the consequences of patient
empowerment interventions. Drawing on these considerations, this brief aims at
pushingforward theknowledge inthefieldofpatient empowerment, inanattempt
tofillthecurrentgapsinthescientificliterature.Forthesepurposes,itdiscussesthe
positive role of patient empowerment in shaping the healthcare service system
of the future; besides, it investigates the “dark side” of patient empowerment,
examining the risks of value co-destruction which could be attached to the
engagement of patients in the delivery of care.
As compared with the existing literature, this brief strives for providing the
reader with a full-fledged understanding of the patient empowerment concept. On
the one hand, patient empowerment is depicted as a paradigm shift from the tra-
ditional bio-medical/industrial model of care toward a patient-centered approach,
which is largely consistent with the contents of the healthcare reforms of most of
Western countries. On the other hand, the side effects of patient empowerment are
dealtwith,emphasizingthatpatientinvolvementinthedesignanddeliveryofcare
may result in the misuse of available resources. This is especially true when the
patientsandthehealthcareprofessionalsbringcontrastingexpectations,conflicting
inputs anddiverging endsinthehealthcare environment,paving theway for value
co-destruction.
Ratherthanfocusingontheimplementationissuesofpatientempowermentina
specific healthcare setting—such as primary care or hospital care—this book con-
ceivespatientempowermentasamainstreamstrategy,whichisabletodeeplyaffect
thefutureshapesofthehealthcareservicesystem.Notwithstanding,thisbriefisnot
biased by an excessively optimistic interpretation of patient empowerment. As
anticipated, it delves into both the bright and the dark sides of patient empower-
ment,inordertoidentifythekeyingredientswhichshouldbeincludedintherecipe
for effective patient empowerment. From this point of view, this book is not tar-
geted to a specific audience. Rather, it is addressed to the general public of
ix
x Preface
students, scholars and practitioners who are interested in healthcare management
and public health. Among others, health policy makers, senior managers of
healthcareorganizationsandhealthcareprofessionalsmaybenefitfromreadingthis
brief.
Thebookisorganizedinfourchapters,whicharestrictlyintertwined.Chapter1
introducesthemaintopicofthevolume.Inparticular,itprovidesthereaderwitha
contextualization of patient empowerment, pointing out the key attributes which
build this construct. The roots of the patient empowerment concept are outlined.
Moreover, the different perspectives suggested by the scientific literature to deal
with this construct are investigated, in an attempt to devise an overarching defi-
nitionofpatientempowerment.Inlightofthisconceptualframework,therequisites
to patient empowerment interventions are discussed, embracing a relational inter-
pretation. In fact, the effective implementation of patient empowerment initiatives
does not solely rely on the enablement of patients; rather, it requires the
enhancement of the healthcare organizations’ ability to establish a friendly and
co-creating relationship with the patients.
Chapter 2 delves into the bright side of patient empowerment. First of all, it
builds a conceptual link between patient empowerment and value co-creation.
Empowered patients are considered to be more willing to participate in health
decision making and to establish a co-creating partnership with the providers of
care. In other words, patient empowerment reframes the patient-provider relation-
ship, identifying the former as an active agent rather than as a sheer consumer of
health services. Therefore, patient empowerment is argued to be an antecedent of
healthservices’co-production.Actually,empoweredpatientsaremorewillingtobe
involved in the design and delivery of care, thus performing as service
co-producers. Patient involvement allows a better distribution of responsibilities
betweenthepatientsandtheprovidersofcare,reducingtheinappropriateaccessto
care and enhancing health outcomes. Hence, patient empowerment initiatives may
pave the way for lower healthcare costs and increased sustainability of the
healthcare service system.
Chapter 3 discusses the dark side of patient empowerment. Drawing from the
mostrecentconceptualdevelopmentsinthefieldsofservicescienceandhealthcare
management, patient empowerment is claimed to be not enough to realize patient
engagement. In fact, patient empowerment does not necessarily produce the
involvement of the patient in the provision of care, if it is not associated with a
processofpatientenablement.Empoweredpatientswhoarenotableorunwillingto
actively participate in the design and delivery of care are at risk of co-destroying
value. Sticking to these considerations, a need for enlightening the dark side of
patientempowermentisargued,inanattempttodeviseandimplementappropriate
strategies intended to overcome the barriers to value co-creation in the healthcare
service system.
The concluding Chap. 4 points out the role of health literacy in empowering
patients. Health literacy is presented as a multifaceted concept, which shows an
individualandanorganizational shade.Ontheonehand,individualhealthliteracy
concerns the patients’ ability to access, understand, process and use health