LINK BETWEEN SOCIAL CAPITAL AND INNOVATIONS MEDIATED BY KNOWLEDGE SHARING AND TECHNOLOGY

European, Mediterranean & Middle Eastern Conference on Information Systems 2014 (EMCIS2014) October 27th – 28th 2014, Doha, Qatar

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LINK BETWEEN SOCIAL CAPITAL AND INNOVATIONS

MEDIATED BY KNOWLEDGE SHARING AND

TECHNOLOGY

Anjum Razzaque

MIS Department, College of Business & Finance

Ahlia University, Manama, Kingdom of Bahrain.

[email protected]

Tillal Eldabi

School of Information System, Computing and Mathematics

Brunel University, Uxbridge

Middx, UB8 3PH United Kingdom

[email protected]

Abstract

Patients demand for the improvement in healthcare (HC) quality through HC innovations. Even

though there are ample introduced HC innovations, various barriers have been reported in

published research, which complicate the adoption and the use of HC innovations. Based on

the critiqued need in research; this study aims to critique the effect of, social capital (SC) of

relations, within a virtual community environment, on innovation mediated by sharing of

knowledge and technology. The context of this study is the occurrence of knowledge sharing

within the VC. Various journal and online resources were reviewed and critiqued in this study.

Other sectors, in addition to the HC sector, were reviewed and critiqued in this paper. As a

result, this study proposed a model depicting the relationship between SC, knowledge sharing,

technology and innovation. There is no other published research that has yet critiqued or tested

a relationship between SC, knowledge sharing and innovation. Furthermore such relations

have not been considered for further empirical analysis in the HC sector even though published

literature reports various gaps in research evidencing the need for such relationship to narrow

the HC innovation based barriers to improve HC quality.

Keywords: Social Capital, Knowledge Sharing, Innovation, Healthcare, Virtual Community

1 INTRODUCTION:

The current population has incurred an increased number of long term and inveterate diseases. This is

why patients demand for improved healthcare (HC) service quality (Coccia, 2012). This is not

surprising, considering that the HC sectors is a highly regarded sector that has complex integration

with various HC stakeholders, like patients, physicians, suppliers, etc (Thakur, Hsu, & Fontenot,

2012). To make this possible the HC sector needs a transition, possible through innovation based on

products, systems or technologies and services (Janssen & Moors, 2013). Innovation is vital in the HC

sector; e.g. innovation for drug discovery (Coccia, 2012) since HC, a technology based and a service

oriented sector involves information and communication technology (ICT). Such a sector can survive

only if it encourages innovation. The survival here is of essence since such firms experience hyper-

competition from their market place (van Riel, Lemmink, & Ouwersloot, 2004). An initiative such as


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innovation is globally a high priority governmental focus (Rosenberg-Yunger, Daar, Singer, &

Martin, 2008).

The HC sector has seen a wide spread of medical innovations since the past century (Omachonu &

Einspruch, 2010). The HC sector is a 2.5 trillion dollar service oriented industry, e.g. transportation,

retail, wholesale, governmental, education; etc. (Oke, 2007). The HC sector has scientifically

advanced achieving higher survival rate for diseases, which used to kill patients 20 years ago. This

sector introduced doctors to thousands of medications and has leading edge technological devices,

which improved surgical strategies, hence improved the service delivery of HC. This is due to the

mediating system, which facilitated the delivery of care. Yet such a system is immature. The HC

sector is still using nineteenth century practices while delivering twenty first century medicine. E.g.

the doctors still note down orders by hand. It was also reported that patients have passed through

multiple CT scans just because such images were lost during logistics. Such negligent actions have

raised the HC costs to shoot out of control. Henceforth, the published research has expressed the need

for innovations like the electronic health record (EHR). Such an innovation was reported as an

expensive encounter (Jha, 2011).

Another issue in the HC sector is that even though HC has innovative systems, these systems do not

communicate with one another (Jha, 2011). Even though innovation in the HC sector is considered

positive; when getting adapted it is still considered complex, since, in the HC sector, innovation is

regulated through government and changing physicians’ minds is not easy, especially during

circumstances when any new HC practice is first thoroughly examined. Such a situation makes

adaption of a HC innovation a complicated task and a complex venture (Länsisalmi, Kivimäki, et al.,

2006). On the other hand; certain quickly adapted innovations could get less valuable or unproven

comparatively to others that are slowly adapted. Rapidly adapted innovations could be used by

physicians, simply because they would want to enjoy such innovations for their face validity, without

the awareness of their associated risks. Such rapidly adapted innovations are consumer fads, which

are aggressively marketed for profit purposes. Such innovations are a threat to service quality. Some

innovations are merely adapted as defence means to avoid future criticism. Innovation diffusion is a

failure if they lack evidence of efficiency (Dixon-Woods et al., 2011). If the HC sector is flourishing

in a country where the HC industry is competitive with ample beds in hospitals, then, adaptability of a

HC innovation is easier (Länsisalmi, et al., 2006).

On the other hand, it is common for the HC industry to simply not attract any market share for

disruptive cost cutting innovations, which could also be advantageous for patients and the HC

professionals; due to their dominating threatened competing companies. Such companies are

threatened by those disruptive innovations, which will never let them in the market. This lack of

support will also cascade to hospitals, which would only want patients to keep on coming in. Hence,

in the US, the HC sector is in calamity. Such disruptive innovations can be a solution to such HC

related crisis provided that such just-mentioned hurdles get out of way and aid new low-cost systems

of superior quality. Even though such disruptive innovations are cost effective, much less is spent on

the HC research findings to learn on low-cost afflicting innovations (Christensen, et al., 2000). E.g.

from the perspective of the HC innovations, the HC sector can experience lower cost using remote

systems where lower count of staff would hence be bearable (Larsen, 2008). Even in history,

disruptive innovations faced similar adaption issues. The disruptive innovation can attain better rate of

adaption when a problem is viewed from a different angle, so to apply such lower costing disruptive

innovations (Christensen, et al., 2000).

Considering the significance of these problems, it is important to consider that:

(1) Since innovations are interactive, innovations are possible within the dynamics of a group of

actors surrounded by the systemic context (Janssen & Moors, 2013) where

(2) IT is one means of revolutionizing the HC sector through the application of virtual communities

(VCs) as well as the use of

(3) EHRs are promising HC innovations, since paper based records are costly.

|As a result, it is the proposition of the authors of this study that innovations like VCs and EHRs, if

they are integrated with one another, will form a collective solution for improving the HC service

quality.


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The rationale behind such a proposition is that EHRs can facilitate physicians and patients to provide

immediate patients’ record access anywhere (Omachonu & Einspruch, 2010). So, lower costing

innovations, e.g. the VCs, could be integrated with expensive innovations, like EHRs. Such a

proposition could: lower the holistic innovation costs. This way, one innovation could support the

other (Jha, 2011). In addition to understanding the importance of EHR as a HC initiative, its

integration with VCs is important since there is a relationship between the social capital of

relationships within a network of relations (expressible through the social capital theory (SCT)) (Wu

& Hsu, 2012) and innovation, as also studied by various researchers. For example: (Wu & Hsu, 2012;

Rijn, et al., 2012; Florida, et al., 2002), etc. From another angle even though not in relation with the

HC sector, it is important to consider that SC helps innovation to improve the adaption of the first

hand agricultural technologies (Rijn, Bulte, & Adekunle, 2012). First of all, it is good idea to consider

the importance of VCs, as an effective initiative for improving HC service quality, from the stand

point of view of their SC of relations since research has been encouraged in the area of professional

networks. This is since future research is needed for assessing the effectiveness of HC networks

(Cunningham et al., 2011; Länsisalmi, Kivimäki, Aalto, & Ruoranen, 2006). Henceforth, the above

argument supports the need for an integration and collaboration between one initiative, such as a VC,

and another initiative, being EHR.

Even though, an IT based innovation has played an important role in facilitating the HC sector to

improve its services pertaining to treatment, diagnostics, etc; there is narrow research in the area of

HC innovation (Omachonu & Einspruch, 2010). Furthermore, the study of innovation in the service

sector is recent and limited (Petrou & Daskalopoulou, 2013). The service sector is a significant

contributor in most evolving economies worldwide (Yang & Hsiao, 2009). Furthermore, there is no

agreement on the relationship between SC and innovation within a network (Martıńez-Canãs, et al.,

2011). Also, this study is in line with the fact that while current research is heading in the direction of

assessing the adaption of innovation. So, future research can focus on how ideas are generated to

create new services and practices (Länsisalmi, et al., 2006). Finally, there are several poorly

understood facets of innovation where researchers can assess the relation between SC and innovation

(Rijn, et al., 2012). From an academic perspective, little research has investigated innovations in the

service and manufacturing industry since such research is fragmented. Also research lacks to assess

the relationship between innovation types, management style and innovation performance (Oke,

2007).

Even furthermore, considering the fact that organizational (1) innovation is knowledge concentrated

activity to attain competitive advantage and (2) knowledge is an on-going sharable resource in the SC

(Martıńez-Canãs, et al., 2011); this study proposes a viable relation between a firm’s (1) SC of

relationship; (2) knowledge sharing and (3) innovation. Such relationships are possible since ample

discussions have been published with regards to innovation, economic and technical determinants

while in the past SC has been also discussed as a determinant of innovation where knowledge is no

longer dependent on hierarchy or market but SC, which is also needed within a learning network. SC

is attained through the promotion of liquidated information for acquiring resources. SC is an existing

or a potential resources through a network of relationships to mine, collect and allocate resources such

as information to stimulate innovative behaviour. SC is embedded within the corporate relationships

in order to promote innovation an organizational SC is the embedded resources within an

organizational network (Wu & Hsu, 2012).

2 METHODOLOGY:

Based on the just-mentioned argument, i.e. a prior literature review, this study initiated with an

assumption that there is a relation between SC, knowledge sharing, KM processes and innovation,

such that, SC can support innovation. Such a relation can be mediated by knowledge sharing in a VC

environment. Henceforth, the aim of this study is to critique reviewed literature to establish the just-

mentioned relations so that such relations will be driven by literature to propose a conceptual model

depicted in Figure 1.


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All literature review was extracted from journal articles, especially from databases, e.g. ProQuest,

Science Direct, Emerald, etc. Such a research contribution is significant since no research yet has

critiqued the current published literature to theoretically understand the relationship between SC,

knowledge sharing and innovation, even though ample research has stressed the need through the lack

of empirical evidence to prove a viable relationship between:

(1) SC and knowledge sharing,

(2) Knowledge sharing and innovation and

(3) SC and innovation; prominently in the HC sector.

3 LITERATURE REVIEW:

3.1 Influence of Innovation in the Healthcare sector:

Innovation is the introduction and application of a process, a product or an idea within an organization

or a group; benefiting that group, a person or an organization. Innovation is characterized by novelty,

a component for an application and a benefit. For example: in the HC sector, an innovation is made

possible by providing a new service or a technology to achieve better patient health and better

organizational efficiency (Länsisalmi, et al., 2006). An innovation is the application and creation of

knowledge and a technology to produce a new service, process, product or technology for a

sustainable HC. Innovation is produced when current knowledge and technology is developed and

applied in the form of new knowledge and technology (Janssen & Moors, 2013). Innovation is not just

some fluke but a systematic discipline.

Organizations that hold innovative characteristics facilitate innovation by introducing new products

that strip out the relevance of old competing products (Dombrowski, et al., 2007). In the HC sector, an

innovation pertains to a new form of work, new service or new technology, in order to improve HC

quality or reduce the illness or suffering of a patient. A HC related innovation balances HC cost and

HC quality (Rijn, et al., 2012). In the HC sector, the innovations, related to medicine and technology,

spur various incremental innovations and radical innovations. Technology has revolutionized the HC

sector since the past 50 years. Technological innovations occur through interactions between research,

clinical practices, HC professionals and clinicians. Radical innovations are technological

breakthroughs through feedback loops. This leads to incremental innovations reflected through

improved efficiencies and lower HC costs (Coccia, 2012).

On the other hand, innovation performance, in the service sector, is quite similar to innovation in the

manufacturing sector. However, the drivers of innovation in these two industries are different. For

example the service sector fosters innovation due to its communication infrastructure while the

manufacturing sector relies more on its local competencies (Petrou & Daskalopoulou, 2013).

Technological innovation facilitates: (1) product innovation, i.e. introduction of new goods and

services and (2) process innovation, i.e. improvement of internal goods and services process to

improve quality, etc. Furthermore, an innovation is an implementation of an invention/design of new

or modified product, service, process, system or model for creating new organization, customer’s

returns or customer’s value. There are four types of innovations (Omachonu & Einspruch, 2010):

(1) Product innovation (Oke, 2007), i.e. introducing a new product/service,

(2) Process innovation, i.e. introducing a new delivery/product methodology,

(3) Market innovation, i.e. introducing a new marketing methodology and

(4) Organizational innovation, i.e. introducing a new organizational methodology for improving

exterior relations (Omachonu & Einspruch, 2010).

While there is ample literature in economics of innovation; there is lacking research in technological

innovations in the area of HC medicine (Coccia, 2012). An innovation can be characterized through

five factors:

(1) Ideas,

(2) People,

(3) Transactions,

(4) Context and


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(5) Outcomes (Escalfoni, et al., 2011).

Old applied ideas in newer contexts bring about new ideas. The synergy among people drives the

organizational practices. People relate through interaction based relationships between units,

departments, groups and between organizations. The context is external events that influence the

development of an innovation. The outcomes are peoples' judgment of successes or failures of the end

result of an innovation (Escalfoni, et al.,2011).

3.2 Relation between Virtual Community and its Social Capital of Relations:

The HC sector is facing times of change, i.e. the HC sector wants to: (1) keep up with constantly

changing relationships between HC information systems and IT, (2) reduce cost while maintaining

quality and (3) tackling the predicted shortage in skilled HC staff, like nurses. While the HC sector, in

the US, is facing changes pertaining to structure and regulations, European HC sector is facing

structural changes. The HC professionals are relying on networks to improve HC service quality

(Länsisalmi, et al., 2006). Future research is still needed to narrow the gap between scientific evidence

and practice during this time of changing medical care. Hence, HC innovation is critical (Länsisalmi,

et al., 2006). SC can facilitate innovation since innovation requires the conversion of different sorts of

knowledge, SC can facilitate innovation in this way (Martı´nez-Can˜as, et al., 2011). Since the last

decade the idea of innovation has changed dramatically. No longer do innovators work liked lone

scientists. Innovators collaborate within a network of trust, reciprocity and norms, i.e. a community

based concept referred as SC, since theoretically members within a community have the higher SC to

produce innovation (Florida, Cusbing, & Gates, 2002). SC has three dimensions:

(1) Structural dimension,

(2) Relational dimension and

(3) Cognitive dimension.

All these dimensions are highly dependent upon one another (Wu & Hsu, 2012). Such a theory is a

social study characteristic for communities and is based on trust, reciprocity and norms of a

community to share resources within a society (Rijn , et al., 2012). SC is a summed up resources, in,

and available from, relationships within a network. Here, the structural dimension, i.e. participants’

connections patterns - reaching whom and how (Pérez-Luño et al., 2011). The term network is a

popular phenomenon of a virtual network, which refers to a network residing on the World Wide

Web. This was possible after the rise of the Internet, which is when the idea of a community shifted to

the idea of a VC. VCs are group interactions, within a family, friends or organization, bonded by a

common interest, craving or value. VCs, as a research area, also caught the attention of academic

scholars who initially started researching on VCs in knowledge based topics and this passion led to

researchers’ interest in the innovative capabilities of VCs. There is ample literature discussing

building and maintaining of VCs as well as innovativeness within VCs. However, there is lacking

literature discussing the relationship between communities and the organization to innovate (Schröder

& Hölzle, 2010). Hence, the relationship between VCs and innovation should be empirical assessed.

The structural dimension refers to the links of the SCT of participants such that the network of

relationships is aware are whom to contact and how the relation can be contacted. This dimension

facilitates innovation behaviour since such a dimension eases participants to acquire resources

through the close relations to support knowledge in return to support innovation behaviour (Wu &

Hsu, 2012). The relational dimension is the personal relationships built on interactions history, i.e.

trust, respect, etc. This dimension highlights inter-organizational relationships (Pérez-Luño et al.,

2011) and the internal relations that anchor an organization’s position within a network for an

organization to access resources from and between its business units (Wu & Hsu, 2012). This idea is

similar to what another study stated when it reported that this dimension better explains innovation

since network structure and count of partners are not the only reasons why new innovation is

generated but also due to trust and commitment levels (Pérez-Luño et al., 2011) etc. The SCT’s

cognitive dimension provides common language and shared point of view between networks of

relations, which is an aid to reducing barriers in communication. Such a positive environment aids the

increase of knowledge shared resources. The shared vision embedded in shared goals and members’


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aspirations makes teams cooperate during the benefitting resource sharing. This also improves

organizational innovative behaviour (Wu & Hsu, 2012). There is lacking research assessing the effect

inter-organizational relations on innovation (Pérez-Luño et al., 2011).

3.3 Relation between Social Capital, Knowledge sharing and Innovation:

There is also the need to incorporate other topics like types of knowledge. SC is important in this

scenario especially when tacit knowledge is in concern. Such a knowledge type holds personal quality

that defines it to be difficult to communicate between the knowledge seekers and the ones who share

knowledge. This paper assesses the effect of tacit knowledge on innovation. In conclusion, knowledge

positively influences innovation even though research lacks to assess the effect of different types of

knowledge on innovation. Thus, the tacit nature of knowledge positively effects radical innovation.

The radical innovation is based on face-to-face collaborative interaction to transfer tacit knowledge

within closely related participants. Trust is not necessary to share explicit knowledge but tacit

knowledge is intuition and beliefs of a knowledge sharing person; hence subjective and articulate and

hence requires commitment and trust to successfully transfer knowledge, in the presence of higher

levels of SC. This is in order to achieve radical innovations (Pérez-Luño et al., 2011). Various studies

have interpreted SC from various perspectives. I.e.: (1) bridging perspective of SC bridges external

relationships and (2) bonding of SC relates collectiveness between participants. This is the reason why

SC links members to carve out a strategy which is an output of internal and external relationships

within the SC of relationships (Wu & Hsu, 2012). Internally speaking, SC facilitates intellectual

capital (Gallego, 2010; Wu & Hsu, 2012), i.e. internal to an organization. On the other hand, while

externally SC supports the improvement of supplier relationships, etc, the innovation behaviour of a

subsidiary organizational is divided into internal market, local market and global market. The external

organizational links facilitate source development and hence accumulates innovation for subsidiaries.

The entrepreneurs can attain venture capital and critical information through the network of SC

network. In such a network, knowledge is embedded within a community’s network, making SC

important to appreciate innovation behavior for benefits e.g. reducing cost of transactions (Wu & Hsu,

2012). There has been an established positive relationship between SC and innovation when

participants share and transfer knowledge (Gallego, 2010). However, another study provided

contradicting empirical findings. The regression analysis results of Rijn, et al. (2012) prove that SC

has a positive and significant effect on innovation, i.e. adaption of agricultural technologies in Africa.

At another point in their study they also reported that the structural dimension of SC is positively

associated with innovation while the cognitive dimension of SC is negatively associated with

innovation since resource sharing in the structural dimension facilitates innovation but the inward

norm based behaviours within a community discourages innovation (Rijn, Bulte, & Adekunle, 2012).

Even though innovation is an individual outcome and not through a group, as well as a sequence of

events (Escalfoni, et al., 2011); future research still seeks to look into how the HC industry can

collaborate with research institutions to continue being innovative (Länsisalmi, et al., 2006).

Considering that in a study, not related to the HC sector, it was reported that one way an organization

can become innovative when time and patients are bestowed on employees to follow their projects

without supervisory approval, e.g. 3M (Escalfoni, et al., 2011). Another way an organization can

foster innovation is by collaborating with outside sources for attaining innovative ideas (Dombrowski,

et al., 2007). Innovation is a practice based on techniques for improving product or process to attain

competitive advantage by diffusing knowledge and skills through effective communication.

Innovation occurs when all three elements work together: (1) (ideas, (2) perceived new and

implementable practices or artefacts and (3) outcome (Escalfoni, et al., 2011). E.g. Proctor & Gamble

connect with commercial and universities researchers with an aim to develop new products. Such

organizations are innovative due to their employees who, due to their leadership support, experiment

and champion their idea to get support for it and aim to succeed in their innovation (Dombrowski, et

al., 2007). Recently, management has worked on relating inter-organizational relations and

innovation. This is still an under-researched area (Gallego, 2010). In such a case, collaboration is the

key considering that the success of any rests on how innovatively it was sold or executed, where a

scientific innovation is very prosperous for a community. Currently, scientific innovations have


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introduced a ―global scientific culture‖ the need to collaborate in projects across countries in order to

globally and collaborative solve problems (Mukherjee, 2014).

Considering that this study critiqued an association between collaboration, SC and innovation since

firms are revolving on external collaboration to enhance their innovation and attain a competitive

advantage to beat their global competition (Pérez-Luño et al., 2011). Service oriented organizations

require technology, knowledge and networks, which are three important factors important for

supporting innovation (Petrou & Daskalopoulou, 2013). Innovation is socially interactive where

various stake holders are involved in shared learning. Innovation is caused by resource sharing and

knowledge transfer (Pérez-Luño et al., 2011) since innovation is a product of of a firm’s knowledge

base via human capital within networks. The SC within such networks accommodates innovation

through the network of resources. Networks facilitate to create knowledge and a knowledge base,

along with a network of participants, determines the capacity of innovation that an organization can

produce. Informal and tacit social networks of relations create SC, thus articulate value to facilitate in

resources and knowledge sharing (Petrou & Daskalopoulou, 2013).

SC explains the effect of relationships between organizations on innovations. Ample literature

discusses the positive relationship between inter-organizational collaborative relationships and

innovation facilitating general and radical innovation with a benefit to attain information and

equitation of knowledge. A new product innovation is introduced quicker when alliances are

established between organizations since SC enhances general and radical innovations. The idea of

having links between individuals within a group is necessary to facilitate radical innovation. The

strength of ties also facilitates innovation (i.e. relational dimension of SCT. On the other hand, there is

a dark side to the relationship between SCT and innovation since inspiration is locked within a small

number of sources (Pérez-Luño et al., 2011). Similarly, an assessment of provincial innovation and

economic growth, i.e. cities with high SC, has evidenced low innovation. However cities with low SC

have displayed high innovation. The rationale behind this is such that communities with strong ties

get so content that such communities get isolated from other communities. Hence, such a community

starts undermining innovation. A community with weak ties will promote sharing if knowledge and

new ideas (Florida, et al., 2002).

From the perspective of the management based research area, ample empirical work assessed SC and

innovation and has stressed the importance of SC on innovation from the point of view of improving

individual, firm and departmental performance (Gallego, 2010). However, it was observed from

literature that there is, yet, no such empirical evidence in relation to the medicating role of knowledge

sharing within the context of the HC sector. This view was assured by (Oke, 2007) who reported that

research lacks to assess the relationship between innovation types, management style and innovation

performance since little research investigates on the service and the manufacturing sector innovations

since such research are fragmented. Furthermore, another study supported the just-mentioned opinion,

which stated that the diffusion of information, as in information or knowledge sharing, deems an

important moderating variable for reducing market uncertainty to make management decisions by

improving innovation (van Riel,, Lemmink, & Ouwersloot, 2004). Hence, as depicted in Figure 1’s

proposed solution, SC supports knowledge sharing and in turn knowledge sharing synergized with

technology, in turn, facilitates innovation within a VC environment. This is considering that research

still lacks to understand the effectiveness of networks in the HC sector (Cunningham et al., 2011;

Länsisalmi, Kivimäki, et al., 2006). Also, Figure 1 expresses the need for VCs in relation with SC to

assess innovation, as stated by (Schröder & Hölzle, 2010).

3.4 Proposed Solution of this research:

As depicted in Figure 1, from a managerial research perspective, the SC is supported through the three

key factors, i.e. structural dimension, relational dimension and cognitive dimension. These three

factors define the knowledge management (KM) infrastructure, i.e. organizational technology,

organizational structure and organizational culture, where technology is crucial for SC to create new

knowledge. Henceforth, the technology reflects the organizational technological ties facilitated by the

KM processes being: knowledge acquiring, knowledge conversing, knowledge application and


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knowledge protection (Gold, et al., 2001). As a result, knowledge sharing, i.e. one of the KM

processes, encourages innovative behaviour of members within a VC (Schröder & Hölzle, 2010).

Figure 1. Social capital, knowledge sharing, technology and innovation within a virtual community

environment.

4 DISCUSSION AND CONCLUSION:

HC service quality can be improved through innovation s related to ICT (van Riel, Lemmink, &

Ouwersloot, 2004). Even though such innovations have been observed in HC since a century

(Omachonu & Einspruch, 2010), the 21st century HC sector is still in the 19th century. As a result,

innovations like EHR have proved promising even though expensive (Jha, 2011). Also, HC

innovations are complex to adapt ((Länsisalmi, Kivimäki, Aalto, & Ruoranen, 2006). Some quickly

adapted innovations could pose as a threat to HC’s service quality ((Dixon-Woods et al., 2011). On

the other hand, disruptive innovations are unwelcomed within the HC sector even though they could

be solutions to HC suffering service quality (Christensen, Bohmer, & Kenagy, 2000). This study

proposed that if VCs and EHR were utilized together, collectively and collaboratively they can form a

solution to improve HC service quality. One reason was that, while EHRs facilitate the HC sector

anywhere (Omachonu & Einspruch, 2010), SC of relations facilitate a VC to promote innovation (Wu

& Hsu, 2012; Cusbing, & Gates, 2002). First, since there is lacking research in the area of

technological innovations (Coccia, 2012) and there is still no defined relationship between SC and

innovation (Martıńez-Canãs, Saéz-Martıńez, & Ruiz-Palomino, 2011), hence an attractive relations

in need for future empirical assessment, in the service sector (Länsisalmi, Kivimäki, Aalto, &

Ruoranen, 2006). IT can bring revolution to HC through four means:

(1) Greater number of offshore service, e.g. x-rays, specialists’ consultation,

(2) Integrating HC information systems for ready available HC information so EHRs can travel with

patients,

(3) Global monitoring of drug consumption where still no such information is shared between

countries and

(4) Greater information quality for patients and physicians, e.g. VCs like WebMD for medical

resources (Omachonu & Einspruch, 2010).

One limitation of this study is that this research could have conducted an even deeper literature

review. The authors of this paper anticipate deepening their analysis of the current literature review

for a journal publication. Furthermore, pertaining to the adaption issues of innovation I in the HC

sector as demonstrated by Christensen, et al. (2000); future research should assess:

Virtual community environment

Resource sharing through

Outcome of

knowledge sharing

and technology

Knowledge sharing

Technology

Innovation

Structural Dimension

Relational Dimension

Cognitive Dimension

Social Capital Theory


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(1) The dark role of innovation, i.e. stressful role of innovators when they question current

organizational states; hence, rocking the boat and resistance when adapting innovation and

(2) Organizational change, which is an under researched area in the HC sector. Future research can

also assess longitudinally assess innovation as a dependant and independent variable (Länsisalmi,

et al., 2006).

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