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“Co-Creation”and“Experience Co-Creation”
in Health Care
- introduction -
!
Rob Halkes
May 2014
Starting points of “Co-Creation” and 

“Experience Co-Creation” are optimally fit to
create Value to Patients:	

!
!
!
!
!
Surely, creating health care is too complicated
to “work together”.
• Working with a multi stakeholder environment:

patients, health care professionals, industry, institutions, payor organizations, authorities;

!
• Personalization of health care, 

with regard to objectives, therapy, medication, life style, behavior, attitude, emotion,
knowledge, etc.;

!
• Multidisciplinary medical activity: 

physicians, nurses, pharmacists, physiotherapist, dietitians, psychologists, etc.

!
• Involvement of related persons, impacted by the process: family, employers, a.o.	

Each, with particular interests, wishes and demands
Co-Creation is the kind of cooperation in which all
participants are enabled to influence process and result,	

like a plan, routine, advice, or product.	

Characteristics of co-creation are dialogue,'common ground',
enthusiasm, vigor and focus on results.	

Conditions to successful co-creation are: equivalence of the
participants, reciprocity, openness and trust.	

Experience co-creation breaks down the process through
which customers create their own interactions with
companies.
Health CareValue to Patients is Co-Created when it is
individualized. 	

That is: if and when a patient is able to personalize his or her
experience with the given health care services and products,

to a level that is best suited to get his or her therapy
effectively done. 



It allows the health care providers to derive greater value
from their product-service investment in the form of new
knowledge, higher revenues/profitability and/or superior
brand value/loyalty.
Co-Creation as the Basis forValue
The personal meaning derived from
the co-creation experience is what
determines the value to the individual
Experience networks comprise nonlinear,

non sequential inter-actions among
companies, institutions and customers.
The network creates an experience environment 

with which each consumer has a unique interaction. 	

The consumer actively co-creates his or her personalized experience.
4 Principles of Co-Creation
Stakeholders will participate in co-creation, if
it produces value for them too
!
The best way to co-create is to focus on the
experiences of all stakeholders
!
Stakeholders must be able to directly interact
with one another
!
Platforms that allow stakeholders to
interact and share their experiences
are crucial
Experience Co-Creation in Care!
A method of development!
to reach a common understanding!
between all parties !
based on !
insights into each others’ interest!
Experience Co-Creation is not just working together!
Traditional Strategy ! Co-Creative Strategy !
Values!
Goals!
Focus!
Advantage!
Creates value by delivering defined
customer experience to targeted
customer set !
Creates value by constantly
enhancing experiences for all
stakeholders!
Establishes strategic goals at
the outset and doesn’t
significantly change them !
Uses the initial strategic goal as a
starting point and lets the full
strategy emerge over time !
On the interests of the firm: that is, how
the firm can maximize its share of the
created value relative to the shares of its
industry competitors !
Focuses on the interests of all
stakeholders and how the
ecosystem can maximize the !
size of the pie; !
Achieves advantage through realizing
economies of scale before competitors do
and making big, bold moves !
Achieves advantage through the
increased engagement of stakeholders
and by continually building new
interactions and experiences, which lead
to higher productivity, higher creativity,
and lower costs and risks !


The Co-Creation Approach to Process Design

aims to serve the interests of all stakeholders
It focuses on their experience and how they interact with one another:	

!
Identify all stakeholders touched by the process	

• patients, health care professionals, industry, institutions, payor organizations, authorities;	

!
Understand and map out current interactions among stakeholders	

!
Organize Workshops in which stakeholders share 

experiences, elaborate meaning and imagine ways to improve them	

!
Build platforms to implement ideas 

for new interactions and to continue the dialogue 

among stakeholders to generate further ideas	

!
Perpetuate innovation upon understandings and evaluations	

Sustainable partnerships may foster health care innovation

to better outcomes and cost savings
Using specific methods in
a step wise process, 

Experience Co-Creation
leads often to surprising
insights between
stakeholders,

and to straightforward,
often surprising, results
!
The method involves a stepwise procedure in which
stakeholders learn to understand each other’s
perspectives, particular ways of reasoning, their
priorities in specific situations, and ambitions.	

!
!
Next, analyze and learn together the how and why of
current routines, involvement of different persons and
background information to unintended, unexpected
and adverse responses.	

!
!
Will think of options and create together optimal
actions and processes to reach better result and
health outcome in a collective endorsement.	

!
!
!
Then, finally will search for optimizations through on
line features to compensate for difficult,
uncomfortable or not feasible interactions, sharing or
communication.	

!
!
By doing so, one will understand the partners’
orientation and will be enabled to experiment in
trust.
The resulting platform functions as 	

ehealth ecosystem to the patient
Patient
Communication
Interaction
Nurse
Support
Information
Support
Data Storage
& Registration
EHR
PHR
Medication
Compliance
Support
Monitoring
Devices
Mobile
Apps
Daily Diary
Etc.
Experience Co-Creation originates from 

other branches than health care, like:
When it is
applied to health
care, then

know how,
experiences,
research,
technology, 

on line facilities,
will get
integrated with
individualized
personal
engagement to
effectiveness
The health care
industry may
specifically 

add value to
their customers
through
partnership in
Experience 

Co-Creation of
Health Care
Competition
General
Differentiated
Market
Pricing
Top value
Clientneeds
Not relevant
Relevant to
Commodities
Innovative products
Services
Experiences
Not to go where the prices of their products go, 

the industry could redesign their business of delivery
from this traditional value chain, ..
.. to value creation in a Co-Creative Enterprise
research industry
patients
physicians
pharmacists
clinical staff
Co-Creation could then be about:
Leading together
• Commitment
• Information
• Management
Caring together
• Integrated Care
• Functional

Differentiation
• Self Management
Developing together
• Effectiveness

& Quality
• Process & Structure
• Information support
• Business Case
• Business Exploitation
• Performance Evaluation
Earning together
Definition
Nuances
• Co-creation is an active, creative and social
process, based on collaboration between
producers and users, that is initiated by the firm
to generate value for customers 



But also: 	

• Co-creation is an active, creative and social
process, based on collaboration between users,
that is initiated by users 

to generate value for users
Also, one could state:	

Experience co-creation is what happens when individuals,
groups and/or organizations, committed to a challenge
perceived as complex, create solutions collaboratively that
satisfy a specific collective or societal interest.	

It is a facilitated process of authentic and respectful
interactions of people striving for a shared vision on a desired
situation and/or outcome with commonly endorsed actions to
realize them.
To choose an experience co-creative approach gets the
more relevant if:	

1. Current approaches or action routines are less than
sufficient, or satisfying;	

2. The parties of interest acknowledge the situation as
challenging;	

3. Persons involved have no clue yet as how to get to a
result, or even define the situation and its expected
outcomes
• Access to a large spectrum of knowledge,
experiences and data 

- one doesn’t need to invent the wheel, and
is enabled to continuous innovation	

• (brand) loyalty from end-users, partners and
customers	

• strong and sustainable commitment	

• customers become advocates 	

• Fresh insights into customer and end-user
development	

• Reduction of R&D Costs 	

• Customer Satisfaction
Benefits of Co-Creation

from a providers’ 	

perspective
EHR
PHR
Medicine
Data Storage
registration
Mobile
Apps
Nursing
support
1.
Patiënt
Monitoring
Devices
Information
support
Compliance
facilities
Daily diary
Etc.
Communication
Interaction
Co Creation in regional/local Health Care
Collaborative - Engaged - Connected - Care
Cooperation between all necessary providers and other
stakeholders	

!
Facilitate integrated, easily accessible, transparent and
clear care, specifically in chronic conditions	

!
New and reorganized structures of care processes are
easier to establish	

!
Framing care paths in comprehensive health economic
cost models will facilitate performance modeling
References
Beardsley, Scott C., Johnson, Bradford C. and Manyika,
James M.
Competitive advantage from better interactions. The McKinsey Quaterly, 1006,
2, 53- 63 Mckinsey and Company, 2006
Bughin, Jacques, Manyika, James M. and Miller, Andy. Building the Web20 Enterprise, McKinsey Global Survey results Mckinsey and Company, 2008, July
Gouillart, Francis,
Top ten list of excuses not to engage in co-creation. Francis Gouilart’s blog on
co-creation. http://francisgouillart.com/wordpress/?p=488 2009, October 17
Gouillart, Francis, McKenna, Andy and Ryan Cahill Sr. Value Co-Creation. Partnering with customers in a new energy enterprise Fortnightly Public Utilities 2013, May 30
Herzlinger, Regina, E. (ed)
Consumer-Driven Health Care. Implications for providers, payers, and
policymakers
Harvard Business School, Jossey Bass. San
Francisco 2004
Kim, W. Chan en Mauborgne, Renée
Blue Ocean Strategy. How to create uncontested market space and make the
competition irrelevant
Harvard Business School Press, Boston
Massachusetts 2005.
Kodner Dennis L. en Spreeuwenberg, Cor
Integrated care: meaning, logic, applications and implicatoins - a discussion
paper.
International Journal of Integrated Care - Vol. 2,
14,1 - 6 2002, November
Lawer, Chris
Eight Styles of Firm-Customer Knowledge Co-Creation. OMC Group insight,
no.4 in Series of Short papers on new perspectives in customer strategy and
innovation. OMC Group Insight, UK
Middleton, S., Barnett J., en Reeves, R. What is an integrated pathway?
Published by Hayward Medical Communications,
a division of Hayward Group pl. Aventis 2003, web publicatie
Pine, Joseph II and Gilmore, James H. The Experience Economy, Work is theatre and every business a stage.
Harvard Business School Press, Boston
Massachusetts 1999
Porter, Michael, E. and Teisberg, Elizabeth Olmsted Redefining Health Care. Creating Value-Based Competition on Results.
Harvard Business School Press, Boston
Massachusetts 2006
Prahalad C.K. and Krishnan, M.S. The new age of innovation. Driving Co-created value through global networks. McGraw Hill New York 2008
Prahalad, C.K. and Ramaswamy, Venkat
Co-Creation Experiences: The next practice in Value Creation. Journal of
interactive Marketing, 18, 3, 5-14. Wiley Interscience 2004, Summer
Prahalad, C.K. and Ramaswamy, Venkat The Co-Creation Connection. In: Strategy Business, Issue 27, 1-12
Prahalad, C.K. and Ramaswamy, Venkat The New Frontier of Experience Innovation. MIT Sloan Management Review, Massachusetts Institute of Technology, 2003, Summer
Prahalad, C.K. and Ramaswamy, Venkat The Future of Competition, co-creating unique value with customers.
Harvard Business School Press, Boston
Massachusetts 2004
Ramaswamy, Venkat Co-Creating Strategy with Experience Co-Creation. Management Synergies, 2008, July/August
Ramaswamy, Venkat and Gouillart, Francis Building the Co-Creative Experience. In: Harvard Business Review Harvard Business School Press, Boston Massachusetts2010, October
Ramaswamy, Venkat and Gouillart, Francis
The Power of Co-Creation. Build i with them, to boost growth, Productivity and
Profits. Free Press, London 2010
Romero, David and Molina, Arturo
Value Co-creation & Co-Innovation: Linking Networked Organizations &
Customer Communities. Production Planning & Control, 22: 5, 447 — 472, Taylor and Francis, London 2011, March
Vandermerwe, Sandra
How increasing value to customers improves business results. In: Sloan
Management review
Massachusetts Institute of Technology, Vol 42,
1,27-37. Fall 200
All thinking originates from authors listed below.

The synthesis and application towards the business of health is my own
Drs.A.R.J. Halkes MHA	

rob.halkes@healthbusinessconsult.com	

!
P.O. Box 292	

5050 AG Goirle	

The Netherlands	

!
M +31 6 31 66 2595	

T http://www.twitter.com/rohal	

F http://www.facebook.com/rob.halkes 	

L http://nl.linkedin.com/in/arjhalkes 	

W www.healthbusinessconsult.com 	

 

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"Co-creation" and "Experience Co-Creation" in Health Care

  • 1. “Co-Creation”and“Experience Co-Creation” in Health Care - introduction - ! Rob Halkes May 2014
  • 2. Starting points of “Co-Creation” and 
 “Experience Co-Creation” are optimally fit to create Value to Patients: ! ! ! ! ! Surely, creating health care is too complicated to “work together”. • Working with a multi stakeholder environment:
 patients, health care professionals, industry, institutions, payor organizations, authorities;
 ! • Personalization of health care, 
 with regard to objectives, therapy, medication, life style, behavior, attitude, emotion, knowledge, etc.;
 ! • Multidisciplinary medical activity: 
 physicians, nurses, pharmacists, physiotherapist, dietitians, psychologists, etc.
 ! • Involvement of related persons, impacted by the process: family, employers, a.o. Each, with particular interests, wishes and demands
  • 3. Co-Creation is the kind of cooperation in which all participants are enabled to influence process and result, like a plan, routine, advice, or product. Characteristics of co-creation are dialogue,'common ground', enthusiasm, vigor and focus on results. Conditions to successful co-creation are: equivalence of the participants, reciprocity, openness and trust. Experience co-creation breaks down the process through which customers create their own interactions with companies. Health CareValue to Patients is Co-Created when it is individualized. That is: if and when a patient is able to personalize his or her experience with the given health care services and products,
 to a level that is best suited to get his or her therapy effectively done. 
 
 It allows the health care providers to derive greater value from their product-service investment in the form of new knowledge, higher revenues/profitability and/or superior brand value/loyalty.
  • 4. Co-Creation as the Basis forValue The personal meaning derived from the co-creation experience is what determines the value to the individual Experience networks comprise nonlinear,
 non sequential inter-actions among companies, institutions and customers. The network creates an experience environment 
 with which each consumer has a unique interaction. The consumer actively co-creates his or her personalized experience.
  • 5. 4 Principles of Co-Creation Stakeholders will participate in co-creation, if it produces value for them too ! The best way to co-create is to focus on the experiences of all stakeholders ! Stakeholders must be able to directly interact with one another ! Platforms that allow stakeholders to interact and share their experiences are crucial
  • 6. Experience Co-Creation in Care! A method of development! to reach a common understanding! between all parties ! based on ! insights into each others’ interest!
  • 7. Experience Co-Creation is not just working together! Traditional Strategy ! Co-Creative Strategy ! Values! Goals! Focus! Advantage! Creates value by delivering defined customer experience to targeted customer set ! Creates value by constantly enhancing experiences for all stakeholders! Establishes strategic goals at the outset and doesn’t significantly change them ! Uses the initial strategic goal as a starting point and lets the full strategy emerge over time ! On the interests of the firm: that is, how the firm can maximize its share of the created value relative to the shares of its industry competitors ! Focuses on the interests of all stakeholders and how the ecosystem can maximize the ! size of the pie; ! Achieves advantage through realizing economies of scale before competitors do and making big, bold moves ! Achieves advantage through the increased engagement of stakeholders and by continually building new interactions and experiences, which lead to higher productivity, higher creativity, and lower costs and risks !
  • 8. 
 The Co-Creation Approach to Process Design
 aims to serve the interests of all stakeholders It focuses on their experience and how they interact with one another: ! Identify all stakeholders touched by the process • patients, health care professionals, industry, institutions, payor organizations, authorities; ! Understand and map out current interactions among stakeholders ! Organize Workshops in which stakeholders share 
 experiences, elaborate meaning and imagine ways to improve them ! Build platforms to implement ideas 
 for new interactions and to continue the dialogue 
 among stakeholders to generate further ideas ! Perpetuate innovation upon understandings and evaluations Sustainable partnerships may foster health care innovation
 to better outcomes and cost savings
  • 9. Using specific methods in a step wise process, 
 Experience Co-Creation leads often to surprising insights between stakeholders,
 and to straightforward, often surprising, results ! The method involves a stepwise procedure in which stakeholders learn to understand each other’s perspectives, particular ways of reasoning, their priorities in specific situations, and ambitions. ! ! Next, analyze and learn together the how and why of current routines, involvement of different persons and background information to unintended, unexpected and adverse responses. ! ! Will think of options and create together optimal actions and processes to reach better result and health outcome in a collective endorsement. ! ! ! Then, finally will search for optimizations through on line features to compensate for difficult, uncomfortable or not feasible interactions, sharing or communication. ! ! By doing so, one will understand the partners’ orientation and will be enabled to experiment in trust.
  • 10. The resulting platform functions as ehealth ecosystem to the patient Patient Communication Interaction Nurse Support Information Support Data Storage & Registration EHR PHR Medication Compliance Support Monitoring Devices Mobile Apps Daily Diary Etc.
  • 11. Experience Co-Creation originates from 
 other branches than health care, like:
  • 12. When it is applied to health care, then
 know how, experiences, research, technology, 
 on line facilities, will get integrated with individualized personal engagement to effectiveness
  • 13. The health care industry may specifically 
 add value to their customers through partnership in Experience 
 Co-Creation of Health Care Competition General Differentiated Market Pricing Top value Clientneeds Not relevant Relevant to Commodities Innovative products Services Experiences
  • 14. Not to go where the prices of their products go, 
 the industry could redesign their business of delivery from this traditional value chain, ..
  • 15. .. to value creation in a Co-Creative Enterprise research industry patients physicians pharmacists clinical staff
  • 16. Co-Creation could then be about: Leading together • Commitment • Information • Management Caring together • Integrated Care • Functional
 Differentiation • Self Management Developing together • Effectiveness
 & Quality • Process & Structure • Information support • Business Case • Business Exploitation • Performance Evaluation Earning together
  • 17. Definition Nuances • Co-creation is an active, creative and social process, based on collaboration between producers and users, that is initiated by the firm to generate value for customers 
 
 But also: • Co-creation is an active, creative and social process, based on collaboration between users, that is initiated by users 
 to generate value for users
  • 18. Also, one could state: Experience co-creation is what happens when individuals, groups and/or organizations, committed to a challenge perceived as complex, create solutions collaboratively that satisfy a specific collective or societal interest. It is a facilitated process of authentic and respectful interactions of people striving for a shared vision on a desired situation and/or outcome with commonly endorsed actions to realize them. To choose an experience co-creative approach gets the more relevant if: 1. Current approaches or action routines are less than sufficient, or satisfying; 2. The parties of interest acknowledge the situation as challenging; 3. Persons involved have no clue yet as how to get to a result, or even define the situation and its expected outcomes
  • 19. • Access to a large spectrum of knowledge, experiences and data 
 - one doesn’t need to invent the wheel, and is enabled to continuous innovation • (brand) loyalty from end-users, partners and customers • strong and sustainable commitment • customers become advocates • Fresh insights into customer and end-user development • Reduction of R&D Costs • Customer Satisfaction Benefits of Co-Creation
 from a providers’ perspective EHR PHR Medicine Data Storage registration Mobile Apps Nursing support 1. Patiënt Monitoring Devices Information support Compliance facilities Daily diary Etc. Communication Interaction
  • 20. Co Creation in regional/local Health Care Collaborative - Engaged - Connected - Care Cooperation between all necessary providers and other stakeholders ! Facilitate integrated, easily accessible, transparent and clear care, specifically in chronic conditions ! New and reorganized structures of care processes are easier to establish ! Framing care paths in comprehensive health economic cost models will facilitate performance modeling
  • 21. References Beardsley, Scott C., Johnson, Bradford C. and Manyika, James M. Competitive advantage from better interactions. The McKinsey Quaterly, 1006, 2, 53- 63 Mckinsey and Company, 2006 Bughin, Jacques, Manyika, James M. and Miller, Andy. Building the Web20 Enterprise, McKinsey Global Survey results Mckinsey and Company, 2008, July Gouillart, Francis, Top ten list of excuses not to engage in co-creation. Francis Gouilart’s blog on co-creation. http://francisgouillart.com/wordpress/?p=488 2009, October 17 Gouillart, Francis, McKenna, Andy and Ryan Cahill Sr. Value Co-Creation. Partnering with customers in a new energy enterprise Fortnightly Public Utilities 2013, May 30 Herzlinger, Regina, E. (ed) Consumer-Driven Health Care. Implications for providers, payers, and policymakers Harvard Business School, Jossey Bass. San Francisco 2004 Kim, W. Chan en Mauborgne, Renée Blue Ocean Strategy. How to create uncontested market space and make the competition irrelevant Harvard Business School Press, Boston Massachusetts 2005. Kodner Dennis L. en Spreeuwenberg, Cor Integrated care: meaning, logic, applications and implicatoins - a discussion paper. International Journal of Integrated Care - Vol. 2, 14,1 - 6 2002, November Lawer, Chris Eight Styles of Firm-Customer Knowledge Co-Creation. OMC Group insight, no.4 in Series of Short papers on new perspectives in customer strategy and innovation. OMC Group Insight, UK Middleton, S., Barnett J., en Reeves, R. What is an integrated pathway? Published by Hayward Medical Communications, a division of Hayward Group pl. Aventis 2003, web publicatie Pine, Joseph II and Gilmore, James H. The Experience Economy, Work is theatre and every business a stage. Harvard Business School Press, Boston Massachusetts 1999 Porter, Michael, E. and Teisberg, Elizabeth Olmsted Redefining Health Care. Creating Value-Based Competition on Results. Harvard Business School Press, Boston Massachusetts 2006 Prahalad C.K. and Krishnan, M.S. The new age of innovation. Driving Co-created value through global networks. McGraw Hill New York 2008 Prahalad, C.K. and Ramaswamy, Venkat Co-Creation Experiences: The next practice in Value Creation. Journal of interactive Marketing, 18, 3, 5-14. Wiley Interscience 2004, Summer Prahalad, C.K. and Ramaswamy, Venkat The Co-Creation Connection. In: Strategy Business, Issue 27, 1-12 Prahalad, C.K. and Ramaswamy, Venkat The New Frontier of Experience Innovation. MIT Sloan Management Review, Massachusetts Institute of Technology, 2003, Summer Prahalad, C.K. and Ramaswamy, Venkat The Future of Competition, co-creating unique value with customers. Harvard Business School Press, Boston Massachusetts 2004 Ramaswamy, Venkat Co-Creating Strategy with Experience Co-Creation. Management Synergies, 2008, July/August Ramaswamy, Venkat and Gouillart, Francis Building the Co-Creative Experience. In: Harvard Business Review Harvard Business School Press, Boston Massachusetts2010, October Ramaswamy, Venkat and Gouillart, Francis The Power of Co-Creation. Build i with them, to boost growth, Productivity and Profits. Free Press, London 2010 Romero, David and Molina, Arturo Value Co-creation & Co-Innovation: Linking Networked Organizations & Customer Communities. Production Planning & Control, 22: 5, 447 — 472, Taylor and Francis, London 2011, March Vandermerwe, Sandra How increasing value to customers improves business results. In: Sloan Management review Massachusetts Institute of Technology, Vol 42, 1,27-37. Fall 200 All thinking originates from authors listed below.
 The synthesis and application towards the business of health is my own
  • 22. Drs.A.R.J. Halkes MHA rob.halkes@healthbusinessconsult.com ! P.O. Box 292 5050 AG Goirle The Netherlands ! M +31 6 31 66 2595 T http://www.twitter.com/rohal F http://www.facebook.com/rob.halkes  L http://nl.linkedin.com/in/arjhalkes  W www.healthbusinessconsult.com