Leadership of healthcare commissioning networks in England : a mixed-methods study on clinical commissioning groups

Objective: To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation. Design: Mixed-method, multisite and case study research. Setting: Six clinical commissioning groups and local clusters in the East of England area, covering in total 208 GPs and 1 662 000 population. Methods: Semistructured interviews with 56 lead GPs, practice managers and staff from the local health authorities (primary care trusts, PCT) as well as various healthcare professionals; 21 observations of clinical commissioning group (CCG) board and executive meetings; electronic survey of 58 CCG board members (these included GPs, practice managers, PCT employees, nurses and patient representatives) and subsequent social network analysis. Main outcome measures: Collaborative relationships between CCG board members and stakeholders from their healthcare network; clarifying the role of GPs as network leaders; strengths and areas for development of CCGs. Results: Drawing upon innovation network theory provides unique insights of the CCG leaders’ activities in establishing best practices and introducing new clinical pathways. In this context we identified three network leadership roles: managing knowledge flows, managing network coherence and managing network stability. Knowledge sharing and effective collaboration among GPs enable network stability and the alignment of CCG objectives with those of the wider health system (network coherence). Even though activities varied between commissioning groups, collaborative initiatives were common. However, there was significant variation among CCGs around the level of engagement with providers, patients and local authorities. Locality (sub) groups played an important role because they linked commissioning decisions with patient needs and brought the leaders closer to frontline stakeholders. Conclusions: With the new commissioning arrangements, the leaders should seek to move away from dyadic and transactional relationships to a network structure, thereby emphasising on the emerging relational focus of their roles. Managing knowledge mobility, healthcare network coherence and network stability are the three clinical leadership processes that CCG leaders need to consider in coordinating their network and facilitating the development of good clinical commissioning decisions, best practices and innovative services. To successfully manage these processes, CCG leaders need to leverage the relational capabilities of their network as well as their clinical expertise to establish appropriate collaborations that may improve the healthcare services in England. Lack of local GP engagement adds uncertainty to the system and increases the risk of commissioning decisions being irrelevant and inefficient from patient and provider perspectives

The Impact of the Diffusion of a Financial Innovation on Company Performance: An Analysis of SWIFT Adoption

How does a major financial network innovation influence firm performance? Despite much speculation we have little hard quantitative evidence about the impact of technology diffusion in financial services. In this paper we use the entire adoption history for SWIFT (the Society for Worldwide Interbank Financial Telecommunication - standards provider and messaging carrier) matched to bank-level panel data for the US, Canada and 27 European countries. Our dataset covers almost 7,000 banks (including 1,689 SWIFT adopters) between 1998 and 2005. We find that adoption appears to have large effects on profitability, but it takes several years before any positive return is discernible, consistent with the idea of significant complementarities between new technologies and firm organization. The profitability effect operates by both raising sales and decreasing operating costs and is greater for smaller firms than larger firms. Although the long-run effects are similar, US and UK banks appear to reap the benefits from adoption more quickly than their Continental European counterparts. This is consistent with the idea that the impact of information and communication technologies is stronger in the US than Europe due to lower adjustment costs.Diffusion, profitability, banks, SWIFT

Verticalization of data sharing and the difficult path to eunnovation

Data sharing has been offered as a useful tool to open up impregnable markets to competition. EU law has a rich tradition in enabling business-to-business data sharing in a sector-specific (or vertical) fashion, which has formed the basis of the quest for an internal market where data flows freely. Two recent legislative instruments, the Digital Markets Act and the Data Act, contain industry- and actor-specific data sharing provisions. By unleashing troves of data hoarded by large incumbents, the Acts aspire to empower small and medium-sized enterprises, unlocking organic innovation. Notwithstanding the normative desirability of such a goal, it is unclear whether verticalized rules on data sharing can foster innovation by entrants and smaller undertakings. This Article legally and economically appraises the Acts to shed light on this issue. Read together, the data sharing provisions under the Digital Markets Act and the Data Act pursue the common aim of spurring disruptive (market creating) and complementary innovation. However, the Acts suffer from legal uncertainty and are liable to produce unintended economic consequences, such as diminishing the ability of complementors to satisfy consumers whilst simultaneously strengthening incumbent platform operators. The conclusions cast doubt on whether the vertical data sharing rules of the Acts can achieve their intended objectives, that is, ensuring the contestability of digital markets by promoting organic innovation by smaller scale firms

COUNTING ON GUANXI WHEN TRANSACTING MILLIONS? HYBRID GUANXI AND THE BEAUTY OF BRICOLAGE

This paper presents a new type of guanxi: hybrid guanxi. We study the informal market in China’s Commercial Paper market, where there is no official infrastructure for online paper transactions. We conducted 33 interviews, a two-month observation, and collected a set of screenshots, to understand how informal financiers trade papers online. We discovered that these actors perform network and technology bricolage, which cultivate and maintain hybrid guanxi through computer-mediated technologies, offline interactions, and transitive ties. Our work enriches the literature of guanxi. Unlike a large body of literature, our work does not assume two prerequisites for online transactions: 1) the existence of transactional infrastructure is prior to the occurrence of transactions, 2) such infrastructure safeguards economic exchanges. Thus, hybrid guanxi offers a lens to understand how social relations purely support economic transactions in the digital era, which is prevalent in both developing and underdeveloped countries

The long-term effect of digital innovation on bank performance: An empirical study of SWIFT adoption in financial services

We examine the impact on bank performance of the adoption of SWIFT, a network-based technological infrastructure for worldwide interbank telecommunication. We construct a new longitudinal dataset of 6,848 banks in 29 countries in Europe and the Americas with the full history of adoption since SWIFT’s initial operations in 1977. Our results suggest that the adoption of SWIFT (i) has large effects on profitability in the long-term; (ii) is greater for small than for large banks; and (iii) exhibits significant network effects on performance. We use an in-depth field study to better understand the mechanisms underlying the effects on profitability

Reliability and security at the dawn of electronic bank transfers in the 1970s-1980s

From a historical perspective, the concept of reliability and computing security in the early 1970s, when electronic data transfer processes were in infancy, is especially interesting in terms of their implications in technological change and the business of banking. The cases of Japan, Spain and Germany, in terms of their national banking networks, provide an interesting field of analysis in terms of the implications that the online data transfer systems had for banking institutions. Concerns about the reliability of the computing processes and digital security were the key factors. These innovations laid the foundation for the advancement of networks and new banking services that would open up unprecedented horizons in what was to become known as service banking

The Covid-19 impact on fintech: now is the time to boost investment

Fintechs may be uniquely positioned to facilitate credit to businesses and monetary aid to individuals, write Markos Zachariadis, Pinar Ozcan, and Dize Dinçko

Desafios do comércio eletrónico no Brasil: integração vertical entre fornecedores e meios de pagamentos, proteção de dados pessoais e cooperação regulatória internacional

O artigo trata do problema emergente da integração vertical dos meios de pagamento com a oferta dos serviços de venda no comércio eletrónico contemporáneo. É descrito o aumento do comércio eletrónico e são indicados três tipos de riscos aos consumidores: diretos, indiretos e sociais. É indicado que a integração vertical pode oferecer benefícios. Todavia, que essas vantagens potenciais são difíceis de mensurar em face dos riscos. É produzido um modelo de comércio remoto com uma evolução da tipologia de relações de troca, para evidenciar a automatização contemporânea dos processos comerciais. Depois, é indicado que o risco de vazamento de dados pessoais e bancários figura como um problema grave, em razão da integração vertical dos modelos de comércio eletrónico. Para evidenciar o problema, são descritos dois casos internacionais, para demonstrar a dificuldade de combate dos vários países em razão da centralização dos dados pelas empresas. Após isso, é realizada uma avaliação da legislação brasileira para evidenciar a sua limitação em razão da sua falta integração com outros campos da regulação, bem como pela inexistência de previsão de meios de cooperação internacional e sua efetividade. Por fim, a conclusão do artigo indica a necessidade de discutir o panorama do comércio eletrónico integrado com o olhar dirigido para experiências internacionais de proteção de dados pessoais e bancários, bem como dos riscos da internacionalização e da integração vertical.This article focuses on the trending issues about vertical integration between payment systems and the electronic commerce platforms from a Brazilian perspective. It describes the increasing international electronic commerce and it indicates three kinds of potential risks to consumers: direct, indirect and social. It shows that vertical integration can bring some benefits, which are very difficult to measure due to the related risks. The article creates a model of the remote commerce based on an evolution of a typology of typical trade relations to shed some light over the current automatization. Afterwards, the article states that the leakage of personal information coupled with vertical integration is a major threat to electronic businesses. It describes two international cases of mass data leakage to demonstrate the difficulties faced by the national systems in regulating transnational electronic commerce and data protection. Then, the article performs an assessment of the Brazilian legal system to conclude that there is a grave lack of integration of the electronic commerce regulations and that there is an absence of international cooperation provisions designed for electronic commerce. It concludes that Brazilian law may benefit from international experiences of personal data protection, and that the new legal provisions must take in account the risks associated with internationalization and vertical integration

Productivity spreads, market power spreads and trade

Much of recent Trade theory focuses on heterogeneity of firms and the differential impacttrade policy might have on firms with different levels of productivity. A common problem isthat most firm level dataset do not contain information on output prices of firms which makesit difficult to distinguish between productivity differences and differences in market powerbetween firms. This paper develops a new econometric framework that allows estimatingboth firm specific productivity and market power in a semi-parametric way based on acontrol function approach. The framework is applied to Chilean firm level data from the early1980, shortly after the country underwent wide ranging trade reforms. The finding is that inall sectors of the economy market power declined and productivity increased. In sectors withhigher import penetration productivity particularly at the bottom end of the distributionincreased faster. At the same time market power declined particularly so at the top end of themarket power distribution. We also show, that ignoring the effect on market power leads toan underestimation of the positive effects of increased import penetration on productivity