Sustainability, as well as the sustainable use of resources and related issues, has inspired a long-lasting and lively debate among scholars of different disciplines. Due to under-investigation of several of the sustainability-related challenges, this paper aims to better understand the system dynamics that, supported by some digital enablers (e.g., digital technologies and platforms), boost the sustainability of complex service systems such as healthcare. To this end, the theoretical meta-model of interaction types, which inspired the prototype digital platform dedicated to the online delivery of health-related services, is presented. Moreover, some healthcare usage scenarios, based on the prototype’s functions, are analysed and discussed. This allows understanding of how important the role of technologies and, in particular, digital platforms, are in empowering actors and in making them willing to interact, and share their own resources in continually new ways. This paves the way for ongoing value co-creation, which is essential for healthcare system sustainability.

Purpose: Service ecosystems are gaining credence among management scholars. However, there is still little agreement about the distinguishing attributes of service ecosystems in both the public and the private sectors. The purpose of this paper is to focus on the health care service system, suggesting a “recipe” for the implementation of a sustainable and innovative health care service ecosystem. Design/methodology/approach: A mixed methodology was used. First, a critical literature review was conducted to lay the conceptual foundations of this study. Then a theory about the institutional, organizational and managerial requisites for the implementation of a health care service ecosystem was developed. Findings: The health care sector is appropriate for the core tenets of the service ecosystem perspective. Tailored interventions aimed at improving the functioning of the health care service ecosystem should be implemented at the micro, meso, macro and mega levels. Patient empowerment, patient-centered care and integrated care are the fundamental ingredients of the recipe for effective health care service ecosystems. Practical implications: The ecosystem approach provides health policy makers with interesting insights to help shape the health care service system of the future. The paper also contributes to the innovation of managerial practices emphasizing the role of patient involvement in the design and delivery of health care. Originality/value: This is one of the first attempts to systematize scientific knowledge about service ecosystems in the health care sector. An agenda for further research is suggested, in order to further advance the establishment of an effective and innovative health care service ecosystem.

Purpose: In line with the current literature, the purpose of this paper is to contribute to a better understanding of whistleblowing procedures and their influence on overall organisational quality. To this end, institutional, organisational, and cultural barriers to whistleblowing implementation have been investigated. Design/methodology/approach: A qualitative analysis based on three explorative case studies investigates and compares different whistleblowing practices implemented in health care organisations, operating within the Italian National Health Service (INHS). Findings: INHS organisations have implemented whistleblowing procedures in different ways, despite the fact that the procedures are laid down by law. These differences are mainly due to cultural, administrative, organisational, and process barriers, which have a deep impact on whistleblowing integration in managerial practices and their influence on the overall quality of health processes and services. Research limitations/implications: This research paper was limited by the analysis of three Italian public health care organisations, which did not allow the generalisability of findings. Therefore, the study offers interesting insights on the way effective whistleblowing systems should be implemented in order to support managers to improve organisation’s management and service quality. Originality/value: The paper represents one of the first attempts to structurally analyse the practice of whistleblowing in an Italian healthcare system. Therefore the study has mainly focussed not only on the analysis of whistleblowing practices, but also on their impacts on the improvement of organisational processes’ quality and, subsequently, on social well-being.

In the service economy, scholars and practitioners are even more focused on the development and appliance of innovative services. The importance of service innovation is rising in many sectors and among different organizations. Several disciplines (e.g., marketing, management, operations research, etc.) deal with this innovation, a concept widely used, but with different definitions. In this paper, service innovation has been analyzed according to the Service Dominant Logic (S-D Logic) and a service ecosystem perspective. The literature still calls for a greater understanding of how a new or renewed combination of resources affects the shaping of service ecosystems. To contribute to filling this gap, this study explores the practices that different actors, enact to co-create value in novel ways; i.e., service innovation. The paper is structured as follows. In the first section, the main academic contributions on service research have been reviewed, focusing on healthcare service innovation. This is followed by the research method and discussion of the research findings. Finally, the theoretical and managerial implications have been detailed and an agenda for future research suggested. The paper offers interesting insights to develop new or renewed practices that foster the reshaping and maintaining of a healthcare service ecosystem. Some recommendations are included to support managers in the development of service innovation strategies.

Purpose: The ecosystem view is a fascinating perspective which provides management scholars with innovative conceptual tools to investigate the functioning of complex service systems. The purpose of this paper is to focus on the “mega” level of the education service ecosystem in an attempt to explain the relationships between education attainments and income disparities across Europe. Design/methodology/approach: Data were collected from the European Union Statistics on Income and Living Conditions. Data trends over the time period (2007-2010) were investigated, involving 27 European countries. Unobserved time-invariant heterogeneity was controlled and dynamics over time were investigated. A random effects model was estimated for each country. The semi-log functional form is informed by Mincer’s (1974) human capital models. Findings: Education levels were found to be a predictor of income inequality in all the countries included in this research, i.e. higher education level leads to higher income and vice versa. However, the effect of education attainments on individual earnings was irregular. Eastern European countries, inter alia, revealed a strong relationship between education attainments and individual earnings, whereas Scandinavian countries showed a weak link between education levels and income. Practical implications: Education has the potential to affect income inequalities in Europe. Policy makers should develop tailored strategies to deal with the consequences of education levels on individual earnings. Both education services’ quality and the interaction between education and moderating socio-demographic variables may influence income inequality in European countries. Originality/value: This is one of the first attempts to investigate the relationship between education and income inequalities drawing on the service ecosystem perspective. Further conceptual and practical developments are needed to better explain the effects of education attainments on income inequality.

The aim of the paper is to contribute to the literature on the conceptualization of technology as an operant resource and the role of Artificial Intelligence (AI) in value co-creation processes. Resource integration and interaction determine such cocreation, however the issue pivots on whether AI is effectively able to co-create value as an operant resource. With an integrated framework based on the Service Science (SS), the Viable Systems Approach (VSA) & the Variety Information Model (VIM), the Authors show how to the various kinds of AI technology corresponds a diverse level of co-creation. Our (conceptual) study, highlights how AI (e.g. chatbot) with its client profiling capacity achieves consonance in a luxury goods context, thus interpreting customer expectations. At the same time, the man-machine virtuous circuit qualifies the shift from AI (a combination of various technologies with cognitive abilities-listening, comprehending, acting, learning and at times speaking-capable of matching human intelligence) to the more potent IA Intelligence Augmentation.