Customer Driven Service Development – Technology-based Care and Services for the Elderly

The objective of this master’s thesis was to examine technology-based smart home devices and services. Topic was approached through basic theories, transaction cost theory and resource-based view in order to build basis for this thesis. Conceptual framework was discussed by means of networks, value networks and service systems which provide a useful framework for service development. The needs of the elderly living at home were discussed in order to find out which technology-based services could be used to satisfy the needs. Segmentation and need data collected previously during proactive home visits was exploited and additionally a survey targeted to experts and professionals of social and health care sector was done to verify the needs. Finally, the results of the survey were analyzed using quality function deployment method to figure out the most important and suitable service offerings for the elderly. As a conclusion of analysis, social media and monitoring services are the most useful technology-based services. However, traditional home services will still maintain their necessity too.

Observations on the Pharmacokinetics and Pharmacodynamics of Dexmedetomidine. Clinical Studies on Healthy Volunteers and Intensive Care Patients

Patients treated in intensive care units require sedation and analgesia. However, sedative drugs also have potential adverse effects, and there is no single ideal sedativeanalgesic drug for these patients. Dexmedetomidine is an apha2-adrenoceptor agonist licenced for sedation of intensive care patients and patients undergoing surgery and other invasive procedures. Several routes of parenteral administration (intravenous, intramuscular, subcutaneous and intranasal) have been utilized. In the present series of studies, the pharmacokinetics and pharmacodynamics of intranasally administered dexmedetomidine as well as the gastrointestinal effects of intravenous dexmedetomidine were determined in healthy volunteers. Pharmacokinetics of dexmedetomidine during long lasting, high-dose infusions were characterized in intensive care patients. The bioavailability of intranasal dexmedetomidine was relatively good (65%), but interindividual variation was large. Dexmedetomidine significantly inhibited gastric emptying and gastrointestinal transit. In intensive care patients, the elimination half-life of dexmedetomidine was somewhat longer than reported for infusions of shorter duration and in less ill patients or healthy volunteers. Dexmedetomidine appeared to have linear pharmacokinetics up to the studied dose rate of 2.5 μg/kg/h. Dexmedetomidine clearance was decreasing with age and its volume of distribution was increased in hypoalbuminaemic patients, resulting in a longer elimination half-life and context-sensitive half-time. Intranasally administered dexmedetomidine was efficacious and well tolerated, making it appropriate for clinical situations requiring light sedation. The clinical significance of the gastrointestinal inhibitory effects of dexmedetomidine should be further evaluated in intensive care patients. The possibility of potentially altered potency and effect duration should be taken into account when administering dexmedetomidine to elderly or hypoalbuminaemic patients.

Private Home Care in Municipal Service Systems – A Case Study among Finnish and Swedish Municipalities

The aim of this study is to assess the current and future preconditions for conducting private business in municipal service systems for home care in Lahti and Hyvinkää in Finland, and in Uppsala and Huddinge in Sweden. This study also aims to assess the implications of quality related issues on the preconditions for conducting private business in the service systems in question. The theories and the research methodologies of the study are based on the Business Model Generation and the Business Model Canvas -concepts. Also a couple of frameworks on implications of quality are applied and integrated into the study. The study is completed as a case study – with structured and identical approaches for all four municipalities. The analyses and assessments of the study are primarily qualitative, but supported by simple quantitative methodologies. The data of the study consists primarily of publicly available information, and secondarily of answers provided by the case-municipalities to multiple choice questions. The results of the study show that the service systems for home care among the case-municipalities are, from perspective of private companies, diverse with local characteristics. Both the premises for conducting private business and the quality-issues are in many respects different in the Finnish and the Swedish case-municipalities. This is partly due to differences in the national service systems; the service voucher system versus the system of choice. Still, it appears that the current preconditions for conducting private business in the service systems for home care, including the implications of quality, would be more favorable in Uppsala and Huddinge than in Lahti and Hyvinkää. On the other hand, the service systems are subject to changes, and the most positive and significant development is here forecasted for a Finnish case-municipality (Lahti). Communication of quality is clearly more advanced in the Swedish case-municipalities. The results of this study can be utilized in several ways, for instance by private companies interested in entering into service systems for home care, either in some of the case-municipalities, or in some other Finnish or Swedish municipalities. Also municipalities can apply the analyses of the study when designing, developing or evaluating their own service systems for home care.

Exploring Customer-Oriented Service Offerings in Public Health: Developing Integrated Health Care Services for Rural Areas

Väestön ikääntyminen pakottaa yhteiskunnan ja julkisen terveydenhuollon muutoksiin. Jotta ikääntyvien ihmisten kotona asuminen voidaan mahdollistaa, palvelujärjestelmän pitää mukautua muuttuvaan tilanteeseen. Tämän diplomityön tarkoituksena on tunnistaa asiakaslähtöisiä lähellä asiakasta tarjottavia palvelukokonaisuuksia. Tutkimuksen teoreettinen viitekehys muodostuu asiakasarvon luomisesta ja palvelutarjoamista. Tarkasteluryhmänä on Etelä-Karjalan alueen 60–90-vuotiaat ja käytetty aineisto on kerätty vastaajilta postitse lähetetyllä kyselyllä. Tutkimus on eksploratiivinen ja tulosten tulkinnassa on hyödynnetty määrällisen tutkimuksen ja verkostoanalyysin menetelmiä. Työn keskeisimmät tulokset ovat tunnistetut asiakassegmentit ja heidän tarpeidensa pohjalta muodostetut palvelupaketit. Tulokset indikoivat asiakkaiden tarpeita ja tuloksia on analysoitu myös tuottajan näkökulmasta. Empiiristen tulosten lisäksi teoriaviitekehystä on kehitetty eteenpäin, jotta palvelukeskeiset teoriat voidaan ymmärtää yritysten näkökulman lisäksi asiakkaan näkökulmasta.

Productivity and Services – Safety Telephone Services for the Elderly

Previous research on productivity is often associated with manufacturing or uses manufacturing definitions of productivity. Marketing research on services has not been satisfied with the manufacturing definitions. No universal definition for service productivity exists. The lack of a universal definition highlights the complexity entailed in the concept of productivity. The objective of this study was to investigate service productivity in situations, where traditional ways are in some cases even not possible or are not enough. In one definition of the productivity of service organisations there is the efficiency of the organisation on the input side and on the output side the customers’ perceived quality or value-in-use. To learn about value-in-use, many methods have been developed. A common practice is to make customer opinion surveys in the form of customer questionnaires and interviews. However, customers cannot always be asked directly, for example, because of impaired cognitive abilities. Such cases include the elderly and children. Furthermore, customer opinion surveys are time consuming. In addition, customers do not always know what kind of services they would benefit from. For the empirical part of the study, a business area was identified where traditional ways of measuring value-in-use are difficult or in some cases even not possible. This business area is safety telephone services. These services are most often used by the elderly. The way to define value-in-use here was to assess how well the services offered met customer expectations. Comparing the services customers asked for and the services provided to them indicated whether customer expectations were met. This study showed that customers had their ideas concerning the contents of the services but many times the services provided did not meet these expectations. Organisational efficiency aspirations can decrease customers’ value-in-use. This study found a solution, in which increasing organisational efficiency would go hand-in-hand with increasing customers’ value-in-use; the result being that the organisations’ needs and the service users’ expectations were in line. Value creation for customers produced organisational efficiency and thus increased productivity. In this study, customer expectations were observed by means of wellness technology. With the help of modern technology, customer expectations can be followed quickly and easily and customers can co-create with the organisation. This type of an approach could be useful even in the development of other services for other ages and in different contexts. If a service organisation decreases the number of personnel and, at the same time, tries to offer services to the same or a larger clientele, customers easily notice the change, which is often negative. To avoid harmful decrease in value-in-use, limitations to the aspiration of efficiency should be implemented – one of such is that the organisation is required to meet certain quality standards defined by experts. The aim is to secure that, as a result of efficiency aspirations in the organisation, the quality of the service offerings does not diminish below mutually agreed standards. Traditionally, when productivity in services has been estimated, organisational efficiency has not been combined with both customer expectations and an expert assessment of quality. This study contributes with novel thinking entitled ‘Relationship Management of the Elderly’. This study handles productivity, expert defined quality and value-in-use in an organisational context, which is practically untouched in previous research studies.

Exploring business models for medical games: Key components and challenges

The costs of health care are going up in many countries. In order to provide affordable and effective health care solutions, new technologies and approaches are constantly being developed. In this research, video games are presented as a possible solution to the problem. Video games are fun, and nowadays most people like to spend time on them. In addition, recent studies have pointed out that video games can have notable health benefits. Health games have already been developed, used in practice, and researched. However, the bulk of health game studies have been concerned with the design or the effectiveness of the games; no actual business studies have been conducted on the subject, even though health games often lack commercial success despite their health benefits. This thesis seeks to fill this gap. The specific aim of this thesis is to develop a conceptual business model framework and empirically use it in explorative medical game business model research. In the first stage of this research, a literature review was conducted and the existing literature analyzed and synthesized into a conceptual business model framework consisting of six dimensions. The motivation behind the synthesis is the ongoing ambiguity around the business model concept. In the second stage, 22 semi-structured interviews were conducted with different professionals within the value network for medical games. The business model framework was present in all stages of the empirical research: First, in the data collection stage, the framework acted as a guiding instrument, focusing the interview process. Then, the interviews were coded and analyzed using the framework as a structure. The results were then reported following the structure of the framework. In the results, the interviewees highlighted several important considerations and issues for medical games concerning the six dimensions of the business model framework. Based on the key findings of this research, several key components of business models for medical games were identified and illustrated in a single figure. Furthermore, five notable challenges for business models for medical games were presented, and possible solutions for the challenges were postulated. Theoretically, these findings provide pioneering information on the untouched subject of business models for medical games. Moreover, the conceptual business model framework and its use in the novel context of medical games provide a contribution to the business model literature. Regarding practice, this thesis further accentuates that medical games can offer notable benefits to several stakeholder groups and offers advice to companies seeking to commercialize these games.

Capital investments planning and life cycle simulations for the new valves manufacturing facility in Russia

The focus of the research is on the derivation of the valid and reliable performance results regarding establishment and launching of the new full-scale industrial facility, considering the overall current conditions for the project realization in and out of Russia. The study demonstrates the process of the new facility concept development, with following perfor-mance calculation, comparative analyzes conduction, life-cycle simulations, performance indicators derivation and project`s sustainability evaluation. To unite and process the entire input parameters complexity, regards the interlacing between the project`s internal technical and commercial sides on the one hand, and consider all the specifics of the Russian conditions for doing business on the other hand, was developed the unique model for the project`s performance calculation, simulations and results representation. The complete research incorporates all corresponding data to substantiate the assigned facility`s design, sizing and output capacity for high quality and cost efficient ferrous pipe-line accessories manufacturing, as well as, demonstrates that this project could be suc-cessfully realized in current conditions in Russia and highlights the room for significant performance and sustainability improvements based on the indexes of the derived KPIs.

Survival competencies in SMEs in changing business environments

The thesis examines the competencies that enable business survival in changing business environments from the perspective of Russian and Finnish micro, small, and medium-sized enterprises in the field of forest industry. Additionally, it studies the competence transformation necessary in SMEs for successful continuation of business operations when a firm considers transferring its business to another industry. The dissertation builds a holistic firm-level view of survival competencies for SMEs facing changes in their business environments. The holistic firm-level view of competencies includes both the individual-level and the firm-level perspectives, regardless of the position of the person in a firm. The findings highlight the importance of high-level individual competencies and the ability to perform versatile tasks in a firm. In addition, continuous business environment scanning, self-evaluation of personal competencies, willingness to renew and change, open-mindedness, and a readiness to network, are competencies that belong to and need to be taken care of by everybody – employees and employers - in a firm. In addition to previous competencies, an ability to manage every-day business also needs to be embedded in SME owners/managers. Furthermore, Russian SMEs seem to be more proactive in change situations, when compared with Finnish SMEs, which are used to operate in a more stable business environment. In conclusion, it can be said that the thesis adds to SME literature by introducing the concept of ‘SME-level competencies’, a combination of previously discussed organisational and networking competencies which are needed in order to survive through change. Furthermore, the thesis concludes with new competence classifications, such as operational and change competencies, which offer new information concerning the required competencies by which a firm may reduce the resistance to change that can hinder business renewal. For SME practitioners, the study suggests proper preparation and proactive operations in their business to reduce the influence of endless changes, and reminds SME owners/managers that changes are, however, a significant source of new business opportunities. For educational players, the study suggests upgrading educational and training systems by improving the training as regards attitudes towards work, and especially training in the comprehensive working abilities needed in SMEs to master diverse tasks. Finally, for public actors the study suggests providing stronger support to entrepreneurs by boosting SMEs entrepreneurial conditions and the existing business possibilities in change situations. This can be done by encouraging a legislative and entrepreneurial climate that responds better to the demands of SMEs.

Linguistic skills and trust creation in international business relationships

Today’s international business in highly related to crossing national, cultural and linguistic borders making communication and linguistic skills a vital part of the trade. The purpose of the study is to understand the role of linguistic skills in trust creation in international business relationships. Subobjectives are to discuss the importance of linguistic skills in international business context, to evaluate the strategic value of trust in business relationships and to analyze the extent to which linguistic skills affect trust formation. The scope is restricted to business-to-business markets. The theoretical background consists of different theories and previous studies related to trust and linguistic skills. Based on the theory a new LTS-framework is created to demonstrate a process model of linguistic skills affecting trust creation in international B2B relationships. This study is qualitative using interviews as a data collection method. Altogether eleven interviews were conducted between October 2014 and February 2015. All of the interviewees worked for organizations operating in the field of international business in B2B markets, spoke multiple languages and had a lot of experience in sales and negotiations. This study confirms that linguistic skills are an important part of international business. In many organizations English is used as lingua franca. However, there are several benefits of speaking the mother tongue of the customer. It makes people feel more relaxed and it makes the relationship more intimate and allows to continue developing it at a more personal level. From the strategic point of view trust creates competitive advantage to a company adding strategic value to the business. The data also supported the view that linguistic skills definitely impact the trust formation process. Quickness and easiness could be stated as the main benefits. It was seen that trust forms faster because both parties understand each other better and they become more open about information sharing within a shorter period of time. These findings and the importance of linguistic skills in trust creation should be acknowledged by organizations, especially regarding the human resource management. Boundary spanners are in key positions so special attention should be put into hiring and educating employees which then take care of company’s relationships. Eventually, these benefits are economical and affect to the profitability of the organization

A Business Incubator, Accelerator, or Coworking Space? Case Health Innovation Village at GE

Health Innovation Village at GE is one of the new communities targeted for startup and growth-oriented companies. It has been established at the premises of a multinational conglomerate that will promote networking and growth of startup companies. The concept combines features from traditional business incubators, accelerators, and coworking spaces. This research compares Health Innovation Village to these concepts regarding its goals, target clients, source of income, organization, facilities, management, and success factors. In addition, a new incubator classification model is introduced. On the other hand, Health Innovation Village is examined from its tenants’ perspective and improvements are suggested. The work was implemented as a qualitative case study by interviewing GE staff with connections to Health Innovation Village as well as startup entrepreneurs and employees’ working there. The most evident features of Health Innovation Village correspond to those of business incubators although it is atypical as a non-profit corporate business incubator. Strong network orientation and connections to venture capitalists are common characteristics of these new types of accelerators. The design of the premises conforms to the principles of coworking spaces, but the services provided to the startup companies are considerably more versatile than the services offered by coworking spaces. The advantages of Health Innovation Village are that there are first-class premises and exceptionally good networking possibilities that other types of incubators or accelerators are not able to offer. A conglomerate can also provide multifaceted special knowledge for young firms. In addition, both GE and the startups gained considerable publicity through their cooperation, indeed a characteristic that benefits both parties. Most of the expectations of the entrepreneurs were exceeded. However, communication and the scope of cooperation remain challenges. Micro companies spend their time developing and marketing their products and acquiring financing. Therefore, communication should be as clear as possible and accessible everywhere. The startups would prefer to cooperate significantly more, but few have the time available to assume the responsibility of leadership. The entrepreneurs also expected to have more possibilities for cooperation with GE. Wider collaboration might be accomplished by curation in the same way as it is used in the well-functioning coworking spaces where curators take care of practicalities and promote cooperation. Communication issues could be alleviated if the community had its own Intranet pages where all information could be concentrated. In particular, a common calendar and a room reservation system could be useful. In addition, it could be beneficial to have a section of the Intranet open for both the GE staff and the startups so that those willing to share their knowledge and those having project offers could use it for advertising.