The Dutch first-line healthcare domain faces challenges arising from an ageing population and resource limitations, accentuating the need for an effective IT domain. Inadequate interoperability and data portability between information systems used by healthcare organisations in daily processes hinder patient treatment and innovation. This study explores a platform-based information system as a solution to enhance innovation and interoperability. Previous research focused on the IS supplier perspectives, but this research aimed to examine patients and healthcare professionals' needs considering the development of a platform-based information system. The study is conducted within a socio-technical context, guided by the Design Science Research Methodology (DSRM). This study centers around five sub-research questions distributed across design cycles within DSRM. The preliminary research (including a focus group, semi-structured interviews and expert talks) revealed inefficiencies in communication regarding care around the medication process. The statements gathered during this research phase were validated on a bigger scale by conducting a survey. The statements resulted in a number of requirements, which were formalised and categorised using a System Requirement Structure (SRS) design. The SRS resulted in five main areas: supporting healthcare professional participation, regulating access, enabling clear and concise content, supporting agreements, and supporting patient participation. The low-level requirements of each of these areas were used to construct the platform modules and platform architecture, using a layered approach (showing the business, information and technology layer). The platform architecture was developed through iterative evaluations with domain experts, enhancing quality and detail. The evaluations also resulted in a new perspective on the platform-based information system, rather seeing it as a platform-based ecosystem solution. The practical contribution of this research lies in two areas. Firstly, the designed platform addresses the need to improve communication within the healthcare domain, offering a communication service that can significantly enhance efficiency and collaboration among healthcare providers and patients. The insights and requirements from various perspectives can also be applied to enhance communication practices in other healthcare lines and countries. Secondly, the platform-based ecosystem design provides valuable insights into the roles, responsibilities, and interactions among different stakeholders, serving as a blueprint for developing similar ecosystems in other domains. The design also aligns with the Communication Platform as a Service (CPaaS) concept, offering the potential for further exploration in other industries. Additionally, the research contributes to the scientific literature by addressing the research agenda on digital platforms by providing a comprehensive overview of how platform-based ecosystems can be conceptualised and designed in the healthcare sector. The findings can guide further research on feasibility, financial implications, and governance in platform-based ecosystems. The study’s value also extends to other domains, such as education and government, where ISs play a crucial role. Moreover, this study found that the interoperability layers can be applied and adapted within the healthcare context and potentially in other IS ecosystems, providing strong guidance and support for designing platforms and services. The research design demonstrates the relevance and applicability of interoperability layers, and with further experimentation, these layers may have broader applicability across different domains. Overall, the study’s positioning in Design Science Research (DSR) places it as an improvement for communication and an exaptation for the platform-based ecosystem, with potential for reuse and further research in various domains and contexts. The academic contribution also entails identifying knowledge gaps that must be explored in the future: the next steps. Several areas need further research to enhance the development of the platform-based ecosystem and communication service. Firstly, understanding the patient’s perspective through focus groups or interviews can provide valuable insights into communication preferences and platforms. Secondly, detailed research on communication variety in healthcare and specifying platform content and user details will ensure successful implementation. Thirdly, following the Architecture Development Method (ADM) cycle can optimise the business, information, and technology architecture, cost-sharing decisions and stakeholder governance. Additionally, exploring governance frameworks like the Institutional Analysis and Development (IAD) framework will facilitate feasible implementation. Lastly, developing new design principles and guidelines for digital platform (ecosystem) design will better support the platform-based ecosystem’s growth and refinement.

The AEC industry has shown a slower development when compared to other industries, this has aroused interest among researchers to help the industry achieve its objectives. As a result, one important contribution to the industry has been proven to be the encouragement of effective collaboration among project team members, which in fact, is considered as a central element of success in construction projects. Additionally, the birth of new technologies like BIM has facilitated these collaborative practices among team members. Researchers have focused on the technical aspects of BIM itself, and not enough attention has been given to the collaborative aspects of its use. Consequently, this research has focused on studying the collaborative aspects of the use of BIM in construction projects, with the objective of enriching current literature about the topic. More specifically, on the identification of perspectives that members of project teams have on the most important features of BIM collaboration, with the intention of understanding the feeling of members in order to approach to them in a more accurate way, which will more likely engage members in a collaborative environment. In order to identify the perspectives, Q-methodology has been used. A list of 29 statements were sorted by 15 selected participants from different organizations in The Netherlands, which are currently involved in the execution of construction projects. The analysis of the collected data was performed, which gave sufficient information to identify the existence of three perspectives among fourteen participants, while one participant was considered as a non-loader since his perspective did not show any link to the other perspectives. The identified perspectives were named as follows: Protocol Sticklers, Team-Oriented and Task-Oriented. The analysis of each perspective led to propose a framework that consists of: first, the performance of a thorough analysis to identify the perspectives of each member of a project team. Secondly, the strategy adopted to engage team members in a collaborative environment, should consider a combination of the suggested actions in order to guarantee the existence of the necessary antecedents for effective collaboration in BIM-based projects. However, the use of the framework will depend on the perspective that each member has, trying to make use of their perceived importance of a certain aspect of collaboration to share with the rest of the team, as well as working on the aspects they believe to be of less importance, in order to highlight the benefits of its implementation and engage them to promote a collaborative environment.

The rise in urban stresses has prompted the need for preparedness of urban areas to face precarious circumstances. Consequently, the concept of urban resilience has grown in popularity not only to tackle sudden shocks but also to face long-lasting socio-economic tensions. To implement the arrangements for resilience policy, literature suggests that social factors govern the resilience of urban areas. Communities in which the residents work together and have common goals have a stronger willingness to cooperate. To this end, social cohesion has been proven to be significant for subsistence in the event of a catastrophe. Cohesive communities protect residents against threats, care of others during hardships, and ultimately promote community resilience. Balanced neighbourhood policies aim to strengthen the cohesion between citizens, communities, and social institutions departing from the assumption that social mix fosters social cohesion. Their goal is to increase the social mix of specific areas to avoid the clustering and segregation of disadvantaged households to, as a result, promote resilient actions. There is, however, literature that suggests that the anticipated effects are rather inconclusive and usually not achieved. Instead, balanced neighbourhood policies would promote segregation by forcing the displacement of groups of residents. The issue arises whether balanced neighbourhoods trigger resilient actions that are pivotal in resilient communities. In other words, does neighbourhood balance increase resilient action of neighbourhood residents? We took a cross-sectional confirmatory approach to understand the social mechanism that triggers resilient action in balanced neighbourhoods based on Partial Least Squares—Structural Equation Modelling (PLS-SEM) and spatial econometrics. To this end, the research tests the assumptions on which the municipality of Rotterdam grounds their Resilience Strategy's balanced neighbourhood policy, the Woonvisie, using a 2019 public survey on social development. Rotterdam's definition of a balanced neighbourhood is defined from a set of conditions for the amount of houses in different house price segments. Therefore, the tested model is based on the grounds that geographically connected people become affected by their neighbourhood's balance to promote resilient action. As such, we use the willingness to help friends and neighbours to characterise informal support as resilient action. Here we show that balanced neighbourhoods are associated with less informal support: the higher the balance, the fewer residents are willing to help their friends and neighbours. The results indicate that social cohesion is the social mechanism that triggers help between friends and relatives and fully acts as the mechanism for resilient actions triggered by the balance in a neighbourhood. From the multiple combinations of houses in different house price segments that the definition of balanced neighbourhoods allows, we distinguish two associations. On one hand, house price distributions which foment a reduction in polarisation (more middle-priced houses) are negatively associated with social cohesion. On the other hand, balanced neighbourhoods which foment polarisation (more low- and high-priced houses) are positively associated with social cohesion. This indicates that our results are in line with Putnam’s homophily principle, i.e. ‘birds of a feather flock together’. This outcome is opposite to the policy discourse of governments in favour of balanced neighbourhoods, including the municipality of Rotterdam, that mixed neighbourhoods foster social cohesion and therefore resilient action. The testing of the theory is complemented in two ways. First, we show that social cohesion and informal support are not constrained by administrative boundaries, so the social perceptions and actions in nearby neighbourhoods affects the level of the other neighbourhoods. Second, we found no moderating effect of factors related to the demographics and the built environment that can promote or deter social interactions, and thus are aspects of what can be considered a resilient neighbourhood. The analysis also shows that Rotterdam's definition of balance allows multiple and dispersed combinations of the amount of houses in each price segment, which can result in counterintuitive conceptions of balance. In addition, the results show apparently contradicting results of the relationship between balance and social cohesion depending on whether the distribution foments house price polarisation. As a result, we argue that the definition is under-specified and can be misleading. Finally, only 2.1% of the possible balance distributions yielded an acceptable goodness-of-fit of our model. This could be indicative that the model needs to be reevaluated. We found that neighbourhood ethnic heterogeneity and house type heterogeneity are directly associated to social cohesion and informal support, respectively. Future research should elaborate on the theory on which the model is grounded and create coherence to the empirical relationships identified. In contrast, the few fitting distributions could otherwise indicate that that social cohesion and informal support cannot be explained by the balance in a neighbourhood and that the policy should be reevaluated. Under this second interpretation, the study has uncovered which are the balance distributions for the city that can actually show the alleged effects of balance. Based on these findings, a policy advice is formulated. If the objective is to increase social cohesion and resilient actions, we discourage the municipality of Rotterdam to approach this by building balanced neighbourhoods. Nevertheless, we have seen that building social cohesion is a way to build social resilience, so recently developed city programs focused on the development of neighbourhood organisations, which not only provide a space for social cohesion but also to collect and share resources directly, are a step forward from the Woonvisie.

This open access book is a unique resource for health professionals who are interested in understanding the philosophical foundations of their daily practice. It provides tools for untangling the motivations and rationality behind the way medicine and healthcare is studied, evaluated and practiced. In particular, it illustrates the impact that thinking about causation, complexity and evidence has on the clinical encounter. The book shows how medicine is grounded in philosophical assumptions that could at least be challenged. By engaging with ideas that have shaped the medical profession, clinicians are empowered to actively take part in setting the premises for their own practice and knowledge development. Written in an engaging and accessible style, with contributions from experienced clinicians, this book presents a new philosophical framework that takes causal complexity, individual variation and medical uniqueness as default expectations for health and illness.@en

This open access book is a unique resource for health professionals who are interested in understanding the philosophical foundations of their daily practice. It provides tools for untangling the motivations and rationality behind the way medicine and healthcare is studied, evaluated and practiced. In particular, it illustrates the impact that thinking about causation, complexity and evidence has on the clinical encounter. The book shows how medicine is grounded in philosophical assumptions that could at least be challenged. By engaging with ideas that have shaped the medical profession, clinicians are empowered to actively take part in setting the premises for their own practice and knowledge development. Written in an engaging and accessible style, with contributions from experienced clinicians, this book presents a new philosophical framework that takes causal complexity, individual variation and medical uniqueness as default expectations for health and illness.@en

This research provides a performance measurement framework for Reverse Innovation (RI) within the healthcare sector. In order to design this performance measurement framework, literature analysis was combined with data from current practices that was obtained by interviewing product managers from multination companies (MNCs) in the healthcare sector that have produced RIs. Within the performance measurement framework four categories are used: financial performance, product innovation performance, sustainability performance and customer satisfaction performance. This performance measurement framework can be used to assess the performance of RIs and MNCs pursuing RIs which can help managers in their decision making and daily business management.

Developed market multinational enterprises (DMNEs) and emerging market multinational enterprises (EMNEs) can serve developed and emerging markets via a strategic alliance, encouraging reverse innovation. The objective of this study is to identify an alliance strategy and alliance dynamics that encourage innovation of low-cost medical devices which have the potential to become reverse innovations. The main research question is therefore as follows: ‘What kind of collaboration framework can ensure collaboration between a DMNE and an EMNE in the context of reverse innovation of medical devices?’ The study found that a joint venture is an appropriate type of alliance strategy and that the alliance dynamics that can be used by managers to stimulate collaboration are: strategic positioning, value alignment, balanced loyalty and bilateral learning. Symmetry is considered as a context dependent alliance dynamic as it is considered important in the scientific literature but was less important in the two analyzed cases. A key means of continuously aligning the values and strategic positioning of the enterprises is the relationships at the senior level of the enterprises and the joint venture. A key means of balancing the loyalty to the joint venture and to the parent companies is to hire people from the enterprise whose organizational culture is in minority in the joint venture or hire people with no history at one of the enterprises.

The aim of this research is to gain an understanding of the balance between guideline standardisation and professional autonomy. This includes its impact on the safety and quality of healthcare. These are crucial aspects of providing good care as they can contribute to an overall healthcare system that is effective, reliable, and patient-centered. The reason for performing this research is the difficulty of finding a balance between guideline standardisation and professional autonomy. While guideline standardisation is crucial to ensure a structured approach to uniform care of high quality, professional autonomy is necessary to individualise this care for each patient. At times, the tension between these aspects arises as medical practitioners feel limited in their professional autonomy, but healthcare organisations require a structural set-up of healthcare systems to provide equal care. By performing interviews with guideline developers, doctors, and patients, this tension and possible contributing factors were explored through a technical, human, and organisational perspective. The identification of a need for the inclusion of the psychosocial elements, research regarding sensitivity around professional autonomy, and structural changes is beneficial to get to a point where it is possible to identify a balance between guideline standardisation and professional autonomy and its impact on the safety and quality of care. While multiple points for further research are indicated in this study, these three factors contribute to improving the situation of both the tension itself and the discussions around it.