| Healthcare is one of the most important aspects of people's lives;however,the healthcare system is facing global challenges,with the inability of traditional medical systems to cope with broader societal needs arising from aging populations,chronic disease explosion and healthcare awareness.Information and communication technologies(ICTs),e.g.,online healthcare communities(OHCs),are regarded as important solutions for this problem and is hoped to open new avenues for doctor-patient interaction.Under the background,this thesis raises the research of what affects the doctor-patient social exchange in OHCs and how to make sustainable doctor-patient exchange.Although researchers have examined the benefits of OHCs from different perspectives,such as information delivery,knowledge sharing and emotional support,research on online healthcare communities is still in a preliminary phase and more research is thus warranted to contribute to both theory and practice.This thesis is based on the literature of doctor-patient communication and online healthcare community and driven by the theories of social exchange and healthcare capital.From both separate and holistic perspective,empirical and conceptual studies have been done to explore how healthcare capital affects the social exchange between doctors and patients in OHCs.(1)This study examines the determinants of social and economic returns of doctors at OHCs by extending the social exchange theory into the professional domain.The notion of professional capital as a kind of embodied state of healthcare capital is introduced to understand the unique resources available to doctors for social exchange.Specifically,this study examines the effects of status capital and decisional capital(two dimensions of professional capital)on doctors' social and economic returns.Further,this study explores how such effects differ across different doctor groups.The results show that the embodied healthcare capital of doctors has significant influence on their returns of interactions with patients in OHCs,and the exchange trajectories can be heterogeneous among different doctor-patient interactions.(2)This exploratory study examines the institutionalized state healthcare capital between doctors and patients by measuring the strength of the doctor-patient relationship and exploring its impacts on physicians' individual outcomes in an OHC.Guided by the social ties theories and using a structural equation modeling SEM approach,this study has found that weak ties can result in social exchange returns,i.e.,economic and social returns for doctors.H owever,further analysis has indicated that strong ties mediate the effect of weak ties,thus encouraging doctors to convert weak ties into strong ties by mobilizing their website settings to strengthen their patient relationships and to be better rewarded subsequently.(3)This study explores how offline objectified healthcare capital affects the interactions of doctors and patients in OHCs and,additionally,how OHCs can lead to a better objectified healthcare capital distribution offline.Even though OHCs are proposed to deliver embodied and institutionalized healthcare capital(e.g.,professional capital and doctor-patient relationship)by social exchange between doctors and patients in OHCs(as the two studies above),it is difficult to transport objectified healthcare capital through the Internet.Based on both online and offline data,this study sheds light on how offline objectified healthcare capital Impacts online social exchanges between doctors and patients,and provides recommendations for applying online and offline channels for better resource allocation.Further,the results can help creatively allocate and use objectified healthcare resources across a widespread population.Combined with the studies above from separate perspective,this study offers a holistic view of the healthcare ecosystem and discuss how to obtain a sustainable doctor-patient social exchange.Grounded in healthcare capital logic,this study builds on the core principles of complex healthcare ecosystem,the conceptual framework of the new complex healthcare ecosystem is based on three meta-theoretical foundations: self-adaptation,external interaction and capital co-evolution.Furthermore,this study considers the role of digital IT,both as an enabler(creating variety for healthcare capital co-evolution)and a catalyst(leading positive direction of healthcare capital co-evolution).An IT artifact,intelligent online healthcare community,is proposed via design science approach to keep a sustainable social exchange between doctors and patients in OHCs and help demonstrate potential interpretations and implications of the framework in exploring the nature of the complex healthcare ecosystem. |
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