Brokers as catalysts for the E-health market

In elligen In o ma ion Managemen , 2017, 9, 177-188 h p://www.sci p.o g/jou nal/iim ISSN Online: 2160-5920 ISSN P in : 2160-5912 DOI: 10.4236/iim.2017.95009 Aug. 24, 2017 177 In elligen In o ma ion Managemen B oke s as Ca alys s o he E-Heal h Ma ke Vi ian Vima lund1,2, C aig Kuziemsky3, Ch is ian Nøh 4, Pi kko Nykänen5, Nicolas Nikula6 1In e na ional Business School, Jönköping Uni e si y, Jönköping, Sweden 2Depa men o Compu e and In o ma ion Science/Human-Cen e ed Sys ems, Linköping Uni e si y, Linköping, Sweden 3Uni e si y o O awa, O awa, Canada 4Aalbo g Uni e si y, Aalbo g, Denma k 5Uni e si y o Tampe e, Tampe e, Finland 6Pos -No d, S ockholm, Sweden Abs ac In his s udy we use he expe iences om he se ice indus y and explo e p e- equisi es o he e-heal h ma ke which will need o achie e o s imula e bo h sides o he ma ke ( endo s, heal hca e o ganiza ions, go e nmen , i n- s i u ions, co po a ions and se ices o ganiza ions) o in e ac wi h each o he and de elop demand d i en se ices and social inno a ions. The esul s p e- sen ed in his pape may be o in e es o decision make s, indus ies (e.g. so wa e o echnology designe s), small and medium en e p ises (SME) and en ep eneu s wi h an in e es in becoming a pa o he e- heal h ma ke , and o consume s (e.g. heal hca e pe sonnel and pa ien s) ha a e willing o i n- luence he ma ke h ough hei choices. The ou comes o he s udy shown ha he ole o i ual b oke s is essen ial o he u he de elopmen o a su s- ainable e- heal h ma ke globally because i s ole as ca alys o in e ac ion be ween he wo-sides o he ma ke s, i s e ec s on he educ ion o compe i- i e cons ains, i s e ec s on he accessibili y o b oade ne wo k o ac o s and i s e ec s on he suppo o public-p i a e exchanges o knowledge and exp e- ience. Keywo ds Vi ual B oke s, Two-Sided E-Heal h Ma ke , Demand D i en Se ices, Social Inno a ions 1. In oduc ion O e he las ew yea s, he end has been o inno a e heal hca e deli e y h ough inc easing pa ien in ol emen and engagemen as pa o de eloping a How o ci e his pape : Vima lund, V., Kuziemsky , C., Nøh , C., Nykänen, P. and Nikula , N. (2017) B oke s as Ca alys s o he E -Heal h Ma ke . In elligen In o m a- ion Managemen , 9 , 177-188. h ps://doi.o g/10.4236/iim.2017.95009 Recei ed: July 15, 2017 Accep ed: Augus 21, 2017 Published: Augus 24, 2017 Copy igh © 201 7 by au ho s and Scien i ic Resea ch Publishing Inc. This wo k is licensed unde he C ea i e Commons A ibu ion In e na ional License (CC BY 4.0). h p://c ea i ecommons.o g/licenses/by/4.0/ Open Access V. Vima lund e al. DOI: 10.4236/iim.2017.95009 178 In elligen In o ma ion Managemen pa ien -cen e ed e-heal h sys em [1] [2] [3] [4]. Fo his eason, much e o has been pu o imp o e in e ac ions be ween and wi hin p oduce s and consume s o heal hca e se ices in o de o co-c ea e social inno a ions1 [4] [5]. S a egies ha e been de eloped a ound he wo ld o mee he challenges ha he ansi ion o a mo e pa ien -cen e ed sys em demands [6] [7]. In pa allel wi h his, he e-heal h indus y2 con inues o expand as a push ma ke 3. Vendo s de elop p oduc s ha a e aimed o add ess he heal hca e challenges o he millennium (e.g. Imp o e p oduc i i y, pe sonalized medicine, ound he clock moni o ing, and empowe men o pa ien s ) and o ind a enas o in e ac ion be ween p o- duce s and consume s and p i a e and public ac o s o iden i y and co-c ea e demand d i en se ices ha ma ch p e e ences and needs o consume s (e.g. heal hca e o ganiza ions and pa ien s) [8]. Demand d i en inno a ions a e essen ial o companies o emain compe i i e in an inc easingly complex, unce ain and changing en i onmen such as he e-heal h ma ke . While he possibili y exis s o inc ease adap abili y while p o- iding se e al di ec bene i s o he p oduce s and, consequen ly, o i s cus om- e s, e.g. quicke and cheape inno a ion cycles, educ ion o ansac ion cos s, access o embedded in o ma ion, e c., he co-c ea ion o social inno a ions p e- supposes he exis ence o ca alys s ha make he igh connec ions and links be ween p oduce s and seeke s o se ices while also acili a ing he in e ac ion be ween he wo sides o he ma ke . In he pas , he discussion abou issues ha can con ibu e o de eloping a sus ainable ma ke o e-heal h se ices has been limi ed o iden i ying issues ela ed o de ining, designing and implemen ed spe- ci ic e-heal h se ices. The ma ke o social e-heal h inno a ions, howe e , in addi ion o o e good come cializable ideas ha spin ou new business, o ha imp o e exis ing business, has shown he need o mo e p oac i ely use i ual pla o ms as ools o o acili a e ma ching be ween he wo sides o he ma ke [12] [13] [14] and as a media o ha b ing bene i s, angible and in angible, o bo h sides [15]. In his s udy we use he expe iences om he se ice indus y o explo e p e- equisi es he e-heal h ma ke needs o achie e o s imula e bo h sides o he ma ke ( endo s, heal hca e o ganiza ions, go e nmen , ins i u ions, co po a- ions and se ices o ganiza ions) o in e ac wi h each o he , and o de elop de- mand d i en se ices and social inno a ions. The esul s o his s udy may be o in e es o decision make s, indus ies (e.g. so wa e o echnology designe s), small and medium en e p ises (SME) and en ep eneu s who a e in e es ed in 1Social inno a ions include se e al di e en ac o s ha c oss he bounda ies o o ganiza ions o in- no a e and co-p oduce se ices. Social inno a ions in a heal hca e con ex include ac o s om bo h public and p i a e o ganiza ions [9]. 2E- heal h e e s o heal h se ices and in o ma ion deli e ed o enhanced h ough he In e ne and ela ed echnologies. In a b oade sense, he e m cha ac e izes no only a echnical de el opmen , bu also a s a e-o -mind, a way o hinking, an a i ude, and a commi men o ne wo ked, global hin k- ing, o imp o e heal h ca e locally, egionally, and wo ldwide by using in o ma ion and communic a- ion echnology [10]. 3The e- heal h ma ke was es ima ed o ha e a ma ke size o app oxima e USD 85.44 billion in 2014 and is expec ed o each USD 308.0 billion by 2022 [11]. V. Vima lund e al. DOI: 10.4236/iim.2017.95009 179 In elligen In o ma ion Managemen becoming a pa o he e-heal h ma ke in he u u e, and o consume s (e.g. heal hca e pe sonnel and pa ien s) who a e willing o in luence he ma ke h ough hei choices. 2. Me hod The p esen s udy is based on p e ious esea ch ha was pe o med by he au- ho s and epo ed in a book en i led “E-heal h wo sided ma ke s: Implemen a- ion and business models, 2016”. We use also expe iences om one se ice in- dus y ha uses i ual pla o ms as b oke s which enable pa ies o bene i om ade o om in e ac ions wi h pa ne ships. These bene i s a ise because he pa ies enjoy a educ ion o ansac ions cos s by minimizing cos s o duplica- ion, ad e ising and media suppo . We also use in o ma ion ha was ob ained om a se ies o in e iews and om a li e a u e e iew ha was pe o med in wo p e ious s udies [16] [17]. The i s o hese s udies iden i ied he challenges ha cus ome s and p o ide s conside o impo ance o de elop a sus ainable ma ke o social inno a ions. The second s udy sampled knowledge abou chal- lenges and oppo uni ies associa ed wi h he de elopmen o a ma ke o social inno a ions. We use he knowledge gained in hose s udies o illus a e he de- mands and expec a ions consume s and en ep eneu s ha e o join he e-heal h ma ke and o compa e expec a ions om he wo sides o he e-heal h ma ke wi h he goals he se ice ma ke has when using b oke s. The pape has he ollowing s uc u e. Fi s we discuss i ual b oke s and he se ice indus y and iden i y a lis o ou comes ha enable he de elopmen o social inno a ions. We hen discuss he e-heal h ma ke and desc ibe how he a o emen ioned ou comes could enable he de elopmen and co-c ea ion o so- cial inno a ions o e-heal h. We hen sugges speci ic equisi es ha he e- heal h ma ke should gua an ee o a ac he wo sides o he ma ke . 2.1. Vi ual B oke s and he Se ice Indus y The numbe o s akeholde s in he se ice indus y ha e g ea ly inc eased and hei in e ac ions be ween hese s akeholde s has become mo e complex [18] [19]. This inc ease in complexi y has made coope a ion o inno a ion less s aigh o wa d. Vi ual b oke s4 a e hus equi ed o es ablished links and o suppo he low o in o ma ion among he ac o s, bu also o incen i e hem o enhance coope a ion. Fo many yea s he se ice indus y has mo ed om push ma ke o pull ma ke ha begins wi h he demand a he han he supply. In such a ma ke , i ual pla o ms, a e used as b oke s ha emo e ba ie s o communica ion, build a enas o in e ac ion be ween he wo sides o he ma ke , consume s and p oduce s, and also o e he necessa y ma ke ing in as uc u e ha allows o 4 The e m “b oke ” has gi en ise o he conno a ion o i ual pla o ms ha b ings people oge he and ha o e s he possibili y o s a egically in e ac and ma ch ac o s ha pu sue simila objec i es. B oke s a e acili a o s o in e ac ion and coope a ion in inno a ion sys ems, and hei ac i i ies e x- end h oughou he wo-sides o he ma ke . V. Vima lund e al. DOI: 10.4236/iim.2017.95009 180 In elligen In o ma ion Managemen diminishing comme cializa ion e o s, he de elop o inno a i e business mod- els, he use o dis ibu ion channels ha made he se ices uni e sally accessible and ha a he same ime o e demand d i e se ices [19]. The use o b oke s has acili a e he de elopmen o a space whe e in e ac ions can ake place be- ween s akeholde s ha a e di e en enough o ha e new knowledge bu ela ed enough o unde s and each o he . This leads o he c ea ion o inno a ions in a many o many ela ionship as demanded by he se ice indus y [20] whe e b oke s a e expec ed o ha e he ole o “sys emic in e media ies”. B oke s in he se ice indus y, a e howe e , no only pla o ms ha acili a e in e ac ion be ween di e en s akeholde s, hey also o e so wa e applica ions, inno a i e supply chain models [12], and mechanism o s a egies ha allow he ollow up and e-use o se ices o u he inno a e. The use o i ual b oke s has esul ed in ha i ms o di e en sizes can en e o he ma ke and bene i om using common i ual pla o ms ( he b oke ). Some o he bene i s include he educ ion o compe i i e cons ains, access o b oade ne wo k o ac o s who exchange ideas and alues, and he suppo o public-p i a e exchanges o knowledge and expe ience [17]. The use o b oke s in he se ice indus y has made i possible o: • P o ide a pla o m ha enables p oduce s and consume s in e ac wi h each o he as hey iden i y demand d i en se ices. • P o ide access o an in as uc u e ha he consume s canno access in single ma ke s (one p oduce , one consume ). • Signal ele an ma ke ac i i y ha make he bo h sides aluable o join up he pla o m. • Apply p inciples, policies, and use ne wo ks ha encou age consume s o use and us he b oke . • Use inno a i e business and paymen models. • O e mul i-homing al e na i es h ough he p esence o se e al p o ide s and supplie s (mul i-homing) ha o e compa able se ices and ha ha e simila deg ees o accep ance among he consume s. Vi ual b oke s u he allow he se ice indus y he possibili y o change he s uc u e o he indus y. This has been ealized in e ms o e ical in eg a ion ( o igh e con ol and highe p o i ex ac ion powe ) and in e ms o e ical disin eg a ion (by using licenses ha help o expand he ma ke ) [19]. One o he mos impo an cha ac e is ic ha i ual b oke s possessed is he ac ha hey a e en ep eneu - ocused (as opposed o simple business ocused). They help inno a o s and en ep eneu s ealize hei ini ial ideas all he way h ough o p oduc s ha di ec ly bene i om such collabo a ion and ne wo k- ing. Consequen ly, he sus ainabili y o he b oke s , much depends on ac o s such as: he exis ence o co po a e social esponsibili y, he exis ence o policies and guidelines o gua an ee quali y, secu i y and sa e y issues o ele ance o he wo sided o he ma ke , he exis ence o ne wo ks ha gua an ee anspa ency and p e en ma ke ine iciencies (e.g. monopolies, ca el, and nega i e ex e nal V. Vima lund e al. DOI: 10.4236/iim.2017.95009 181 In elligen In o ma ion Managemen e ec s) [21] , and he capaci y o gua an ee he de elopmen o long- e m s a- egic planning and a dynamic e olu ion o he ma ke [22]. 2.2. Vi ual B oke s and Social Inno a ions: Is he E-Heal h Ma ke Ready o Use Vi ual B oke s o S imula e he Co-C ea ion o Social Inno a ions? Technological de elopmen s, inno a ions, and he use o elec onic de ices ac oss he wo ld p o ide nume ous oppo uni ies o p ominen playe s in o he e-heal h ma ke o achie e he goals o he e-Heal h Ac on Plan, namely o inno a e heal hca e o he 21 cen u y [6]. The inc easing use o able s, sma phones, as a quick and easy mode o communica ion is likely o supplemen he g ow h o he ma ke . Howe e , conce ns ela ed o he lack o eimbu semen policies and he absences o b oke s who can acili a e in e ac ion o he wo sides o he ma ke cu en ly hampe g ow h in he e-heal h ma ke place. No e ha in his ma ke inno a ions a e c ea ed by using embedded knowledge om ac o s ou side he bounda ies o he o ganiza ion [23] [24] [25] [26]. To mee he demands o his ma ke place, a se ies o po als and i ual pla - o ms, no mally owned by heal hca e au ho i ies, coun y councils, insu ance companies e c, has been globally and na ional de eloped. These po als and pla o ms usually allow ee access o pa ien s o, o ins ance, heal h eco d sys ems and ad ice om heal hca e pe sonnel. They a e, howe e , no speci i- cally buil a enas o o um whe e in e ope abili y o an in e change o know- ledge be ween he wo sides o he ma ke can ake place. Ou pu s om in e - iews wi h ep esen a i es om he wo sides o he ma ke s (cus ome s and supplie s) and om he li e a u e e iew pe o med in p e ious s udies, as men- ioned in he me hod chap e , shown ha he e a e a numbe o challenges ha a e o key ele ance o o achie e and de elop a sus ainable e-heal h ma ke ha can s imula e co-c ea ion and a he same ime p oduce and deli e social inno- a ions. In gene al i seems ha he lack o a enas in which consume and p oduce s can communica e and in e ac [26] o educe cos s ela ed o in e ope abili y o de elop demand d i en social inno a ions, a e he majo issues ha cons ain he de elopmen o he e-heal h ma ke oday. Fu he , he e seems o be a need o o cla i y ules and o o de elop s uc u es and a ena ha can be used o suppo in e ope abili y and in e ac ion be ween consume s and p o ide s o be able o access and use he embedded knowledge hey ha e in o de o de elop demand d i en se ices and social inno a ions [13] [24] [26]-[31]. The de el- opmen o inno a i e and al e na i e business models ha sus ain al e na i e paymen and eimbu semen al e na i es also seems o be impo an [32] o he wo sides o he ma ke . No wi h s anding his, he absence o in o ma ion o speci ic laws and egula ions o di e en con ex s and o ganiza ions, as well as obs acles o communica ion due o a changing en i onmen al and changes in he ac o s also poses p oblems o hose who has he ambi ion o join he e- heal h wo-sided ma ke o oday [27] [28]. V. Vima lund e al. DOI: 10.4236/iim.2017.95009 182 In elligen In o ma ion Managemen Compa ing he ou pu s iden i ied by p o ide s and consume s in he s udies ocused in he e-heal h ma ke , wi h he ou comes he use o i ual b oke s ha e made possible o he se ice indus y, i seems ha he e a e no majo di e - ences be ween hem (See he Table 1). An impo an ques ion is how i ual b oke s in e-heal h can mee demands o anspa ency in owne ship, secu i y and sa e y, and us in communica ion [33]. Whils simul aneously being sub- jec o an open ma ke ha ollows ules o he supply o se ices and egula es he en ance in o he ma ke . Table 1. Lis o issues ha a e conside ed o key ele ance by bo h sides o he e-heal h ma ke and i s co espondence wi h he main ou comes iden i ied in he se ice indus y as a consequence o he use o i ual b oke s. Lis s o issues conside ed o key ele ance by bo h sides o he e-heal h ma ke o p oduce and deli e social inno a ions Main ou comes o use b oke s in he se ice indus y • A new iew o doing business • P o ide a pla o m ha enables p oduce s and consume s in e ac wi h each o he as hey iden i y demand d i en se ices • Accessibili y o equi alen se ices • In o ma ion abou he ype o se ices o e ed (complemen a y, subs i u es, equi alen , belonging a base baske o conside ed as “luxu y se ices” no necessa y bu use ul o sample and egis e indi idual based in o ma ion) • O e mul i-homing al e na i es h ough he p esence o se e al p o ide s and supplie s (mul i-homing) ha o e compa able se ices and ha ha e simila deg ees o accep ance among he consume s. • An open ma ke ha allows ac o s o compe e and collabo a e wi h each o he • Rules o he supply o se ices and en y o ma ke • Signal ele an ma ke ac i i y ha made he bo h sides aluable o join up he pla o m • In e ope able s uc u es ha educe ansac ion cos s • S uc u es ha allow o use consume s’ embedded knowledge • P o ide access o an in as uc u e ha he consume s canno access in single ma ke s (one p oduce , one consume ) • Al e na i e inno a i e business, paymen and eimbu semen models • Knowledge o c ea e new se ices ha b ing added alue • Use inno a i e business and paymen models • Knowledge abou he needs and he kind o se ices ha ma ch in e - and in a o ganiza ional demands • Sha ed accesses o indi idual da a o pe sonaliza ion o se ices • O ganiza ional demands and e en ual legal di e ences be ween di e en kinds o o ganiza ions • Apply p inciples, policies, and use ne wo ks ha encou age consume s o use and us he b oke F om he abo e, i seems a ional o a gue ha b oke s in he e-heal h ma ke , in addi ion o acili a e an a ena o in e ac ion and co-c ea ion o social inno a- ions, need o gua an ee he ma ch be ween speci ic eques ha he e-heal h ma ke p esupposes and he demand o a ac ing i ms and o ganiza ion o p oduce and co-p oduce demand d i en se ices. We sugges he e o e, ha e- heal h b oke s who wan o de elop a sus ainable a ena o in e ac ion and co- c ea ion whe e bo h sides o he ma ke a e p esen conside o: • De elop guidelines and policies ega ding owne ship o se ices and p e- equisi es o access o he ma ke and clea s ipula e whe he . o The se ices should be owned 1) by an in e media y ( o example a coun y council, a heal hca e uni , an insu ance company, a pha maceu ical compa- ny); 2) by agen s ( o example a pa ien o ganiza ion, o by he company ha p oduce he se ice), o 3) whe he an al e na i e owne ship model should exis . V. Vima lund e al. DOI: 10.4236/iim.2017.95009 183 In elligen In o ma ion Managemen o Con ac ual a angemen s and p ope y igh s should be 1) gene ic o 2) spe- ci ic depending he ype o he se ices. o Access o any i ual b oke should be es ic ed o a limi ed numbe s ake- holde s o whe he he b oke will use an open sou ce p inciple. o P ope y igh s a e o be egula ed by con ac s o whe he he se ices be open sou ce. • O e Mul i-home al e na i es. In a ma ke in which consume s’ p e e ences a e su icien ly homogenous (due he na u e o he se ices o e ed) and gi - en ha hey will gua an ee quali y, sa ely and p i acy, he exis ence o se e al p o ide s can con ibu e o an inc ease in social wel a e. This is especially he case; i he e a e se e al p o ide s o he same ype o se ices ha can gua - an ee he access o al e a i e ha a e equal equi alen o each o he (“ mul- i-homing ”) Mul i-homing al e na i es should u he inc ease he deg ee o compe i ion while con ibu ing o di use inno a ions o a highe numbe o cus ome s. • De elop ne wo ks ha diminish isks. The main challenge is he de elop- men o a cohe en , sus ainable and us ing a ena we e all ele an in o ma- ion can be ans e ed om all p oduce s o all consume s in a s uc u ed, well de ined, comple e, and undis o ed manne . To o e an a ena o in e- ac ion ha will a ac isk-ad e se ac o s, b oke s will u he need o gua an ee he exis ence o se e al ypes o ne wo ks such as: o Knowledge ne wo ks o de elop new ways o hinking, whe e secu i y and sa e y issues ha can be help ul in sol ing ansna ional p oblems can be discussed. Knowledge ne wo ks should u he suppo knowledge c ea ion a ound p oduc s, se ices, goods and dissemina e ideas o social inno a ion and o de o align de elope s and cus ome s¨ needs in a ealis ic manne . o Policy ne wo ks o c ea e policies e en hough hey a e no necessa ily ne - wo ks o go e nmen policy make s. Ne wo ks ac i i ies should co e he ull ange o s eps in policy p ocess (beyond o policy p oposals) including agenda se ing, policy o mula ion, ulemaking, coo dina ion, implemen a- ion, and e alua ion and de eloping o secu i y policies and p inciples. o Ad ocacy ne wo ks o change he agenda o policies o go e nmen s, co po- a ions o o he ins i u ions. An ad ocacy ne wo k challenges business lead- e s o e hink no only hei business s a egy, bu also hei la ge pu pose and ole in he global ma ke place. Such a ne wo k should con ibu es o he isualiza ion o impo an issues o he e-heal h a ea as well as he p e- equisi es di e en heal h-ca e sys ems demand. o Wa chdog ne wo ks o ensu e business o anspa ency, whe e ins i u ions a e sc u inized so as o ensu e ha hey beha e app op ia ely. Topics ange om co up ion and he en i onmen o inancial se ices. Cus ome s and p oduce s can e alua e he alue o se ices a le els no possible be o e. The a ea o in e ac ion he b oke s o e should cha ac e ized as anspa en , p epa ed o de eloping a b and o epu a ion ha is sus ainable o e ime, V. Vima lund e al. DOI: 10.4236/iim.2017.95009 184 In elligen In o ma ion Managemen acili a es managemen sys ems, ea ly wa ning sys ems and he isualiza ion o open sou ce suppo sys ems. 3. Discussion While he e-heal h ma ke is apidly becoming undamen al o he p o ision o heal h and social ca e, e o s o es ablishing a ma ke in which consume s and p o ide s can in e ac wi h each o he , bene i om each o he and co-p oduce social inno a ions has inc ease. In iew o he challenges he e-heal h ma ke is con on ed wi h as i s i es o achie e sus ainabili y, i ual b oke s can ha e an s a egic ole o bo h accele a ing he di usion o se ices, and in acili a ing in- e ac ion and in sus aining collabo a ion be ween he wo sides o he ma ke [34]. We hus conside he e-heal h ma ke as a “pull ma ke ” in which consum- e s and p oduce s in e ac wi h each o he as hey de elop demand-d i en se - ices. A mayo di icul y o he e-heal h ma ke oday, is he ac ha many inno- a ions a e o en inc emen al and o m pa o a con inuous p ocess o nume - ous small-scale ad ances. Ou looks o he-e-heal h ma ke o en discuss he need o co e s se e al pe spec i es including poli ical, echnological, economic pe - spec i es, and issues ela ed o in e na ional coope a ion, In addi ion, he needs o de elop us , secu i y and cos -e ec i eness o he se ices a e also o impo - ance. Fu he mo e, he e-heal h ma ke needs o conside socio- echnical and economic issues as i suppo s a sus ainable ela ionship among he a ious in- dus y pa icipan s, p o ide s o e-heal h se ices and cus ome s. This is done so ha he is able o sol e ex e nali ies ha a ec he ma ke , in- cluding laws, egula ions, policies, ma ke es ic ions ( o example, he p ice he consume s pay o he se ices, as in he case o he Scandina ian coun ies whe e he p ices a e egula ed by policies and demand solu ions such as sub en- ions, oo p ices , exis ence o public owned monopolies, e c.). The ma ke mus also imp o e ope abili y so as o be e maximize bene i s o bo h sides o he ma ke , namely he ma ke and he indi iduals (consume s and pa ien s) who use he e-heal h sys em. F om he in e iews and he li e a u e e iew ha was p e iously pe o med, we lea n ha a gene al cons ain o u he de elopmen o he ma ke is he absence o “connec ed se ices”. The lack o in o ma ion on whe he some se - ices will be complex, single, o example is also an issue because he le el o e- sponsibili y p o ide s can ha e. In oday’s ma ke i is no clea who will be o - e ing he se ices, how hey will be accessible and how consume s’ knowledge will be used o imp o e se ices. En ep eneu s do no seems o be willing o bo h dis ibu e and inance he se ices. A cen al ask o he u u e o he e-heal h ma ke is, he e o e, o ac i ely in es iga e wha se ices o social inno a ions consume s ac ually wan . I is no longe an inno a ion o me ely o e deli e y o d ugs o deli e y o medical de- ices, o o o e “bank se ices” ( i.e. online paymen , e c.) and so on. The lack o V. Vima lund e al. DOI: 10.4236/iim.2017.95009 185 In elligen In o ma ion Managemen capaci y o cap u e embedded knowledge, indi idual p e e ences and a i udes [34], o knowledge abou he in e - empo al use o e-heal h se ices, a e majo hu dles o en e he ma ke . Consequen ly, conside able e o needs o be made in he u u e, i we a e o be e unde s and and in eg a e cus ome o ien a ion in o he design and deploymen o e-heal h se ices and in e media y pla o ms. Inno a ion esea che s emphasize he impo ance o b oke s in ne wo ks. B oke s connec s akeholde s who a e no amilia o each o he bu also allow hem o imp o e upon he new combina ions ha a e essen ial o he demand o inno a ion [34]. Vi ual e-heal h b oke s may bundle ea u es ha p o ide alue o bo h sides o he ma ke and maximize social wel a e. Finally, because sus- ainable de elopmen o he e-heal h ma ke depends a g ea deal upon he ma ke s uc u es ha will be de eloped, he in e media ies will ake he ole as b oke s and he de elopmen o in as uc u es ha allow in o ma ion o low wi hin and be ween he wo sided o he ma ke . Lea ning om he se ice in- dus y and ex apola ing good expe iences om his indus y will allow us o a oid con inuing o wo k wi h explo a i e app oaches. Ins ead, conc e e ma ke inno a ions should be made. Much o he desi ed imp o ed collabo a ion be- ween he wo sides o he e-heal h ma ke equi es a long- e m pe spec i e, and a willingness in in es o s ha is based on he expec a ion ha he collabo a ion will con inue o a long ime. I is a ely possible o speci y in ad ance exac ly how his migh ake place. I he se ice indus y succeeds 1) in de eloping i - ual b oke s ha wo k and 2) in de eloping co-owned join en u es wi h gua - an ees o con inued coope a ion be ween hei business pa ne s, hen he e-heal h ma ke should de ini ely bene i om hei expe iences. The cu en impe ec in e ac ion be ween he wo sides o he e-heal h ma ke is o en no a esul o unwillingness o he conce ned pa ies o in e ac wi h each o he , bu o a lack o capaci y, s uc u es, and incen i es o in e ac e ec i ely. En e p ises o o ganiza ions ha will play a ole as i ual b oke s in he u u e can close he gap. This will especially be he case i b oke s can be shown o ha e a good epu a ion and a deg ee o independence om he majo s akeholde s in he p ocess and he o e all inno a ion sys em. This does no mean ha b oke s nec- essa ily need o belong o specialized o ganiza ions, as is he case o he majo - i y o he po als ha ha e been de eloped in he a ea oday. I can also be possi- ble ha o ganiza ions wi h legi imacy in he se ice a ea ac a wa chdog ne - wo ks and gua an ee he legi imacy o he b oke s. In his con ex , hey ha e an impo an po en ial ole in con ibu ing o he de elopmen o policies and guidelines and o he discussion o hese policies and guidelines wi h indus ies and s akeholde s who a e in e es ed in becoming b oke s, locally and e en glob- ally. 4. Conclusion The ole o i ual b oke s is essen ial o he e olu ion o he se ice ma ke . They ha e con ibu ed o he p omo ion o se ices; hey ma ch he demand