Tip of the Week: Broaden Your View of Value Creation for Services

During ever-tightening budgets and in an era of greater accountability in health care, it is important that pharmacists demonstrate their value. Sometimes it is important, however, to step back and see value creation for services from a broader and more fundamental perspective than the individual, daily tasks in the pharmacy.

Pharmacists create value for themselves and other stakeholders by improving patients’ medication adherence, triaging patients to see another provider, or by saving them money on their prescription or OTC medication purchases. Pharmacists often create value simply by showing that they care, by helping to solve problems, or brightening others’ days, whether it be a coworker, patient, colleague, prescriber, or even a friend or family member. Pharmacists who read the literature will come across many studies demonstrating the effectiveness of a particular service.

Eriksson and Nordgren examined how the concept of value creation during the provision of services has evolved over time.¹ The authors explain that health care management formerly took its cues from manufacturing; that is, the so-called “value chain” was conceptualized as having predefined and sequential steps. This resulted in the treatment of illnesses in a linear fashion through standardized processes. It relegated patients to the status of passive receiver of value at the end of the chain rather than acknowledging patients’ active contributions and has often resulted in an overarching goal of treating everyone the same.¹

A recent shift involves focusing on value creation by putting the individual patient at the crux of service implementation. The authors frame value creation in the context of social constructionism, which includes both the actor (i.e., the patient or user) and the structure (i.e., the provider or the health care system) concurrently rather than one or the other. This leads to a concept called “service logic,” which implies that the logic in health care focuses on health, not the actor receiving it or the structure providing it.¹

Eriksson and Nordgren suggest, however, that the pendulum might have recently swung too far; that focusing on just the patient may be unwise or unproductive. Emerging from the individualized perspective are group and public-level perspectives. The group level focuses on creating value for patients’ families and for local communities, which makes sense given that the health of the individual patient has an impact on their job, their family, and their friends. The effective actuation and continuation of a service take these into account.¹ The public level goes a step further, characterizing concepts within the broader context of health equity and contributions of populations. This perspective understands, for example, that certain vulnerable populations might be more susceptible to disease due to issues of access, education, and health literacy.¹

With a more individual perspective, we focus on aspects of the service such as empathy, care, courtesy, and friendliness. These are not unimportant. However, the social constructionist view suggests that these are not enough to guarantee the success of a service, or that value has been created. It is not unlike a restaurant that has good food or friendly servers yet still ends up shutting its doors. The restaurant will have more likely created value by creating a brand in the community, addressing deficiencies in the local food scene, and creating a culture that invites large swaths of people to engage in the service interaction.

The most successful pharmacy leaders and managers understand the interconnectedness of various individuals and stakeholders in the medication use process. They realize that value is created from interactions with individual patients and with various other groups. Effective leaders and managers implement services based upon need and will engage entire populations and clients representing broad swaths of patients to create value that transcends individual levels of satisfaction with components of a service such as friendliness of the staff and convenient hours of operation.

Additional information about Creating and Managing Value can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.

About the Author

Shane P. Desselle, RPh, PhD, FAPhA, is a professor of social and behavioral pharmacy at the Touro University California College of Pharmacy.

Reference

Eriksson EM, Nordgren L. From one-sized to over-individualized? Service logic’s value creation. J Health Org Manage. 2018;32(4):572-586.