Service Logic and Service Design: Innovation from a citizen and customer perspective 1
This research aims to increase our understanding of how innovations that are rooted in the needs and value creating processes of customers and citizens can be achieved. Methods based on the involvement of customers have emerged from various scientific disciplines. By changing the roles of customers and citizens, new by reformulating the ways in which organizations create value, opportunities for new innovations are created.
The goal is better public services and more competitive companies. For instance, how can primary care centers do to not only care for the sick, but also prevent disease and support well-being in the community? How can small businesses go from selling products to support their customers' processes?
The research is carried out in an action research approach, and conducted in close collaboration with various stakeholders - public organizations as well as private companies - who want to renew their development processes and business models. Research questions include how systematic innovation work can be achieved, how new business models are created and what the necessary conditions are.
The goal is better public services and more competitive companies. For instance, how can primary care centers do to not only care for the sick, but also prevent disease and support well-being in the community? How can small businesses go from selling products to support their customers' processes?
The research is carried out in an action research approach, and conducted in close collaboration with various stakeholders - public organizations as well as private companies - who want to renew their development processes and business models. Research questions include how systematic innovation work can be achieved, how new business models are created and what the necessary conditions are.
Final report
The purpose of the project and development during the project period
I carried the out the project at SVID, the Swedish Industrial Design Foundation, which aims to increse the use of design methodologies in business and society at large. In line with SVID's purpose, my research in this project has aimed to explore ways in which user-focused design methods can be used in development work, primarily in the public sector.
SVID is a small organization, with limited own operations, but with active cooperations with other organizations. My research work has also focused on collaboration with SVID's collaborative organizations, Sweden's municipalities and county councils (SALAR) and others. I have done my research through action research, research where I, as the researcher, together with a staff in the business, identify challenges, and through change explore these challenges.
Overview of the project
I have carried out my research in the form of a number of sub-studies. These projects are briefly described below:
Study 1: "Well-Being Boxholm" (In collaboration with SALAR and Boxholm's primary care center.) The study aimed to explore innovation at an ecosystem level to improve health in a community. As a researcher, I contributed with advice, and wrote a manifesto for the work, which was based on the care center acting as coordinator in proactive work for well-being, especially psychological well-being, where the municipality, unions, business, citizens and others cooperate. We conducted service design workshops, where leaders in the community participated in collecting and analyzing data. I ended the study early, when the local project encountered difficulties, including illness in key people and financial constraints. However, the health center took up the work, albeit at a slower pace. The chief Lars Karlsson, was named "Health care leader of the Year" in 2018 as a result of the care center's work with Well-Being Boxholm.
Study 2: "Segmentation and modularisation for innovation and patient focus in primary care" (in collaboration with SKL). To create a more customer-focused care (and public sector) through increased understanding of segments in the population. Together with a SKL and a consulting firm, I conducted a segmentation of the population (n = 1024, interviews n = 24). We identified 4 segments, and have developed a model for creating modules in healthcare, which based on the different characteristics and needs of the segments, in order to achieve greater equality and person-centeredness in healthcare. The model has been successfully evaluated through a workshop with several health centers, which perceived the model as both valuable and practically implementable. Healthcare personnel in, among others, Stockholm County have been trained on the segments.
Study 3: "Evaluation of the Innovation Guide" (in collaboration with SVID / SALAR). The Innovation Guide is a program where employees in the public sector are trained in service design, while also carrying out projects in their own organization. I have followed research on their work, for increased understanding of how innovation support and training in service design can be provided through distance support, with IT and coaches. My interview study with participants, at various stages in their work on design, has helped to further develop the initiative, and contributes to research on the conditions and opportunities of service design in the public sector.
Study 4: "Lead patients" (Karolinska Institutet, caregivers, patient organizations and business). The purpose is to investigate how innovative and or patients can be involved in development and research. In particular, I am working on an interview study on patients employed by health care, to better incorporate the patient perspective into health care (ongoing work).
Study 5: "Big data for improved public health". (Angered district administration, Foundation for Future Students, LIU and others). The study aims to investigate how a data-driven approach can be used to predict school absenteeism, and lead to more proactive work. My sub-study is about how the user and citizen perspective can be supported. It also provides an opportunity to study the application of AI in the public sector in general. I have been developing a digital solution, and in particular worked with user involvement.
The project's three main results and contributions
An important contribution of my research is the model for modularized care that better meets the needs of individuals but at the but also meets the requirements for standardization and treatment according to the best evidence. This research ties together research on segmentation, modularization and service design, in a new way.
My research on staff-led service design in the public sector contributes to an increased understanding of the relevance of design in the public sector. The study shows that design-driven approaches focus on the needs of the citizen in a way that other improvement work usually does not. The study also shows that contact with users in development work through interviews and other means creates an emotional connection with citizens and an understanding of their situation. The study also shows several structural barriers to improvement work, which alead to stress and frustration among employees.
There is also high relevance to research on AI in the public sector, and how such solutions can be developed in ways that are beneficial to citizens and system users. The limited previous research on AI in the public sector, has often been at a more conceptual level, or touches on solutions in governmental application such as police to predict where there is an increased risk of crime. I believe there are great opportunities for AI and other data-driven approaches at a more operational level, which is the case in our research. Our research contributions follow the form of design science research, where an artifact (the actual IT system) and a meta-artifact (design principles for developing systems) are contributions.
Research questions generated by the project
The research project has generated new research questions. In the below I briefly discuss what I think are the most important ones:
- Patient segment identification in the individual encounter
We have tested segmentation in relation to service development. Healthcare professionals have suggested that the segmentation model could be used in relation to individual healthcare encounters too. That patients fill out a form, and a segment affiliation is caluclated and visible to healthcare staff. A consequent research question what the effects of that would be - positive or negative.
- Concerning AI in the public sector
Introducing AI and other data-driven methods today presents several ethical and legal challenges, not least as these methods often function as a "black box" where it is difficult to understand how the algorithm produces a certain result (for example, a recommendation). There may be trade-offs between benefit on the one hand, and integrity and risk of built-in discrimination. My research has shown that there are currently no processes for conducting a discussion with various stakeholders regarding ethics in relation to AI. This has been emphasized by the City of Gothenburg as an important, but lacking point, which recurs in several projects. We are now seeking funds to continue exploring this issue, while also intending to scale up testing and use of the developed system. I also plan to explore opportunities for "nudging" for increased school attendance - that the developed system can automatically send encouragement or encouragement to students, for increased attendance.
- Systems for improvement in the public sector
A general question that arises based on the overall experience of my work in the project concerns the conditions for improvement work in the public sector. My experiences in recent years have shown great deficiencies in the ability to carry out improvement work in the public sector. The resources, processes and leadership is often lacking. Improvement work often conducted in an ad-hoc form and typically do not involve end users. The ways in which improvement work can be carried out in a sustainable way is an important research issue that needs to be interdisciplinary.
Unforeseen technical and methodological problems
Action research builds on collaboration with other organizations. Changing conditions in these organizations influences the conditions for the research. This has been the case in my case. SVID, where I had my employment, went through an economically challenging period, with staff reductions, and new directives. The project Flippen lost staff and was ended earlier than anticipated. The project in Angered was affected by major reorganization of school administration.
While these changes have been troublesome, and sometimes led to co-authors not being able to continue to participate, it has at the same time increased my understanding of the challenges of driving change in the public sector.
I carried the out the project at SVID, the Swedish Industrial Design Foundation, which aims to increse the use of design methodologies in business and society at large. In line with SVID's purpose, my research in this project has aimed to explore ways in which user-focused design methods can be used in development work, primarily in the public sector.
SVID is a small organization, with limited own operations, but with active cooperations with other organizations. My research work has also focused on collaboration with SVID's collaborative organizations, Sweden's municipalities and county councils (SALAR) and others. I have done my research through action research, research where I, as the researcher, together with a staff in the business, identify challenges, and through change explore these challenges.
Overview of the project
I have carried out my research in the form of a number of sub-studies. These projects are briefly described below:
Study 1: "Well-Being Boxholm" (In collaboration with SALAR and Boxholm's primary care center.) The study aimed to explore innovation at an ecosystem level to improve health in a community. As a researcher, I contributed with advice, and wrote a manifesto for the work, which was based on the care center acting as coordinator in proactive work for well-being, especially psychological well-being, where the municipality, unions, business, citizens and others cooperate. We conducted service design workshops, where leaders in the community participated in collecting and analyzing data. I ended the study early, when the local project encountered difficulties, including illness in key people and financial constraints. However, the health center took up the work, albeit at a slower pace. The chief Lars Karlsson, was named "Health care leader of the Year" in 2018 as a result of the care center's work with Well-Being Boxholm.
Study 2: "Segmentation and modularisation for innovation and patient focus in primary care" (in collaboration with SKL). To create a more customer-focused care (and public sector) through increased understanding of segments in the population. Together with a SKL and a consulting firm, I conducted a segmentation of the population (n = 1024, interviews n = 24). We identified 4 segments, and have developed a model for creating modules in healthcare, which based on the different characteristics and needs of the segments, in order to achieve greater equality and person-centeredness in healthcare. The model has been successfully evaluated through a workshop with several health centers, which perceived the model as both valuable and practically implementable. Healthcare personnel in, among others, Stockholm County have been trained on the segments.
Study 3: "Evaluation of the Innovation Guide" (in collaboration with SVID / SALAR). The Innovation Guide is a program where employees in the public sector are trained in service design, while also carrying out projects in their own organization. I have followed research on their work, for increased understanding of how innovation support and training in service design can be provided through distance support, with IT and coaches. My interview study with participants, at various stages in their work on design, has helped to further develop the initiative, and contributes to research on the conditions and opportunities of service design in the public sector.
Study 4: "Lead patients" (Karolinska Institutet, caregivers, patient organizations and business). The purpose is to investigate how innovative and or patients can be involved in development and research. In particular, I am working on an interview study on patients employed by health care, to better incorporate the patient perspective into health care (ongoing work).
Study 5: "Big data for improved public health". (Angered district administration, Foundation for Future Students, LIU and others). The study aims to investigate how a data-driven approach can be used to predict school absenteeism, and lead to more proactive work. My sub-study is about how the user and citizen perspective can be supported. It also provides an opportunity to study the application of AI in the public sector in general. I have been developing a digital solution, and in particular worked with user involvement.
The project's three main results and contributions
An important contribution of my research is the model for modularized care that better meets the needs of individuals but at the but also meets the requirements for standardization and treatment according to the best evidence. This research ties together research on segmentation, modularization and service design, in a new way.
My research on staff-led service design in the public sector contributes to an increased understanding of the relevance of design in the public sector. The study shows that design-driven approaches focus on the needs of the citizen in a way that other improvement work usually does not. The study also shows that contact with users in development work through interviews and other means creates an emotional connection with citizens and an understanding of their situation. The study also shows several structural barriers to improvement work, which alead to stress and frustration among employees.
There is also high relevance to research on AI in the public sector, and how such solutions can be developed in ways that are beneficial to citizens and system users. The limited previous research on AI in the public sector, has often been at a more conceptual level, or touches on solutions in governmental application such as police to predict where there is an increased risk of crime. I believe there are great opportunities for AI and other data-driven approaches at a more operational level, which is the case in our research. Our research contributions follow the form of design science research, where an artifact (the actual IT system) and a meta-artifact (design principles for developing systems) are contributions.
Research questions generated by the project
The research project has generated new research questions. In the below I briefly discuss what I think are the most important ones:
- Patient segment identification in the individual encounter
We have tested segmentation in relation to service development. Healthcare professionals have suggested that the segmentation model could be used in relation to individual healthcare encounters too. That patients fill out a form, and a segment affiliation is caluclated and visible to healthcare staff. A consequent research question what the effects of that would be - positive or negative.
- Concerning AI in the public sector
Introducing AI and other data-driven methods today presents several ethical and legal challenges, not least as these methods often function as a "black box" where it is difficult to understand how the algorithm produces a certain result (for example, a recommendation). There may be trade-offs between benefit on the one hand, and integrity and risk of built-in discrimination. My research has shown that there are currently no processes for conducting a discussion with various stakeholders regarding ethics in relation to AI. This has been emphasized by the City of Gothenburg as an important, but lacking point, which recurs in several projects. We are now seeking funds to continue exploring this issue, while also intending to scale up testing and use of the developed system. I also plan to explore opportunities for "nudging" for increased school attendance - that the developed system can automatically send encouragement or encouragement to students, for increased attendance.
- Systems for improvement in the public sector
A general question that arises based on the overall experience of my work in the project concerns the conditions for improvement work in the public sector. My experiences in recent years have shown great deficiencies in the ability to carry out improvement work in the public sector. The resources, processes and leadership is often lacking. Improvement work often conducted in an ad-hoc form and typically do not involve end users. The ways in which improvement work can be carried out in a sustainable way is an important research issue that needs to be interdisciplinary.
Unforeseen technical and methodological problems
Action research builds on collaboration with other organizations. Changing conditions in these organizations influences the conditions for the research. This has been the case in my case. SVID, where I had my employment, went through an economically challenging period, with staff reductions, and new directives. The project Flippen lost staff and was ended earlier than anticipated. The project in Angered was affected by major reorganization of school administration.
While these changes have been troublesome, and sometimes led to co-authors not being able to continue to participate, it has at the same time increased my understanding of the challenges of driving change in the public sector.