UNDERSTANDING BUSINESS PROCESS TRANSFORMATION: AN INSTITUTIONALISATION PERSPECTIVE

This study aims to understand how a health insurance organisation undertake business process transformation to stimulate innovation. A growing interest in digital transformation raises questions about how this can lead to business process transformation in delivering health insurance. This study seeks to understand one of the most relevant phenomena today, digital transformation, which implies fundamental changes in the activities of organisations based on the use of digital technologies and the implication for business process management. This paper, therefore, applies a sociotechnical approach using institutional theory as the analytical lens and qualitative interpretive case study as the methodology. It depicts how various institutions influence the outcome of business process transformation. The findings have implications for research, practice, and polic

THE ROLE OF CONTRADICTIONS AND NORMS IN HEALTH INSURANCE CLAIMS PLATFORMISATION: AN INTER-ORGANISATIONAL PERSPECTIVE

This study aims to understand the role of contradictions and norms in health insurance claims platformisation from an inter-organisation system perspective. The study is situated in a developing country context of Ghana. A growing body of information systems research on digital platforms as a vehicle to organise public healthcare exists and continues to evolve; however, the inter-organisational perspective has received little attention. Even less is the focus on the complex relationship between the health insurance sector and health care providers. This paper, therefore, applies a sociotechnical approach using activity theory as the analytical lens and qualitative interpretive case study as the methodology. It depicts how contradictions between the various levels of the activity system influence platformisation between organisations in the health system. The findings have implications for policy research and practice

Understanding Digital Innovation in National Health Insurance: The Case of Ghana

The purpose of this study is to understand how institutional environment influences digital innovation in national health insurance. A growing body of information systems research on health insurance exists; however, these have focused more on performance and management with less attention on institutional influences. This study employs institutional theory as the analytical lens and qualitative, interpretive case study as the methodology to understand digital innovation and institutional challenges to address the research gap. The findings show that digital innovation can help improve national health insurance service delivery. The critical barriers identified for limiting health insurance include (1) error-prone manual system; (2) silo information system that failed to offer healthcare access portability; (3) absence of national identity system and (4) digital divide across accredited health providers. The findings have implication for research, practice, and policy

SERVICE INNOVATION THROUGH PLATFORMISATION OF A PRIVATE HEALTH INSURANCE: AN ACTIVITY THEORY PERSPECTIVE OF THE CASE OF GHANA

This study aims to understand how a private health insurance organisation achieves service innovation through platformisation from a developing country perspective of Ghana. A growing body of information systems research on digital platforms as a vehicle for service innovation exists and continues to evolve; however, to a large extent, focuses on commercial platforms. Even less is the focus on the health insurance sector and private health insurance in particular. This paper, therefore, applies a socio-technical approach using activity theory as the analytical lens and qualitative interpretive case study as the methodology. It depicts how contradictions in the initial primarily manual and paper-based work environment were addressed through platformisation. The study provides insights on how emerging contradictions in tools and rules can be used as an avenue for delivering service improvement. It also offers insight into how private health insurance organisations can evolve their work environment through platformisation. Based on the research findings, this paper recommends that to stimulate service innovation, the deployment of digital platforms should help address contradictions in the existing activity system

Institutionalisation of Health Insurance Digital Claims Platform

This study aims to understand how institutionalisation of health insurance digital claims platform gets facilitated or constrained. The study is situated in a developing country context of Ghana. A growing body of information systems research on digital platforms to organise public health care exists and continues to evolve; however, the facilitators and constraints to institutionalisation of digital platform in health insurance have received little attention. This paper, therefore, applies a sociotechnical approach using institutional theory as the analytical lens and qualitative interpretive case study as the methodology. The findings show that institutionalisation of digital platforms is not linear and incremental, but goes through several iterations, sudden and non-linear disruptions. The critical barriers identified limiting institutionalisation of digital platform include; (1) Heterogeneous health care provider environment. (2) political change and leadership; and, (3) Management of the innovation process