Celebrating Success – Josephine Go Jefferies
Congratulations to Josephine Go Jefferies and her co authors whose research has been featured in the second Transformative Topics Newsletter for May 2024, focusing on the dynamic relationship between “technology and consumer well-being.” This issue highlights the work of Josephine Go Jefferies, Simon Bishop, and Sally Hibbert, titled “Service Innovation through Resource Integration: An Empirical Examination of Co-Created Value Using Telehealth Services.” Their qualitative study of telehealth users explores how and why public service beneficiaries co-create value.
In the spirit of our Transformative Topics Newsletter and its ‘behind the scenes’ storytelling, Josephine provides insights into what motivated this research, the impact of the work, and how this impact was achieved:
This paper was from my PhD researching how people with severely compromised health used telehealth to self-manage complex chronic conditions. It started with the problem facing most healthcare systems: how to efficiently treat a rise in chronic conditions when most healthcare systems are modelled around treating acute care needs. The paper was written for an audience of public policy and management scholars whose work narrowly conceived open governance and public service co-production concepts.
At the time I was conducting this research (pre-COVID-19) the UK strategy for introducing NHS telehealth services was to enable chronically ill patients to stay safely at home and reduce the rate that chronic patients, often described in the literature as ‘difficult’, ‘blocked’ hospital beds that were needed for urgent care. Through ethnographic interviews in patients’ homes and observing their use of telehealth machines, I was able to witness the creative ways that typically resource-constrained healthcare consumers use telehealth in ways that transcend their original design. For while they seemed to get on with the technology, they also deployed telehealth for deflecting the ‘difficult patient’ persona, and denied and delayed need for treatment (a) because hospital care was unpleasant, but also (b) to conserve limited healthcare resources for others. Telehealth was used to ‘fix’ and reconfigure many aspects of the multi-actor healthcare service experience. When I presented my findings to the telehealth service’s governance and procurement team, what struck me was the fact that they were more concerned with mitigating against the possibility that remote services enable ‘risky’ patient behaviours, than seeing how enabling co-creativity can speed innovation necessary for improving well-being.
How marginalized consumers identify and exploit contextual affordances for improving their own and others’ well-being from the bottom-up continues to fascinate me. It certainly characterizes my neurodiversity research projects. I am currently focusing on the role of technology in service ecosystem innovation for neuroinclusive social change. Meredith Thomas and I are leading a new Neurodiversity Think Tank to be launched at the Marketing and Public Policy Conference in June, where we are assembling interdisciplinary experts to discuss similar issues with other interested scholars, practitioners and policymakers. I warmly encourage TCR scholars to participate!
Abstract: Scholars, policymakers and practitioners recognise the potential to improve public services through active citizen involvement and much research has examined the formal opportunities to ‘co-produce’ changes in the structures and cultures of public services. Yet scholars have devoted little attention to the opportunities for service and social innovation that emerge from the everyday activities of service users and their phenomenological experiences of realising value from service interactions. This qualitative study of telehealth users explores how and why public service beneficiaries co-create value. It argues that understanding citizens’ approaches to co-create phenomenological value is a vital component of the collaborative processes that generate social benefit.