User-defined ecosystems in health and social care

Karl-Jacob Mickelsson*, Ulla Särkikangas, Tore Strandvik, Kristina Heinonen

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

6 Citations (Scopus)


Purpose – People with complex health conditions must often navigate landscapes of uncoordinated public, private and voluntary health-care
providers to obtain the care they need. Complex health conditions frequently transcend the scope of typical health-care service systems. The purpose
of this paper is to explore and characterize such unique assemblages of actors and services as “user-defined ecosystems”.
Design/methodology/approach – Building on literature on customer ecosystems, this paper introduces the concept of the user-defined ecosystem
(UDE). Using an abductive approach, the authors apply the concept in an interpretive, qualitative study of ten families with special needs children.
Findings – This study uncovers complex UDEs, where families actively combine a broad range of services. These ecosystems are unique for each
family and extend beyond the scope of designed service ecosystems. Thus, the families are forced to assume an active, coordinating role.
Research limitations/implications – This paper shows how to identify ecosystems from the user’s point of view, based on the selected user unit
(such as a family) and the focal value-creating function of the ecosystem for the user.
Social implications – This paper highlights how service providers can support and adapt to UDEs and, thus, contribute to user value and wellbeing.
This can be used to understand users’ perspectives on service and systems in health and social care.
Originality/value – This study develops the concept of the UDE, which represents a customer-focused perspective on actor ecosystems and
contrasts it with a provider-focused and a distributed perspective on ecosystems. This study demonstrates the practical usefulness of the
conceptualization and provides a foundation for further research on the user’s perspective on ecosystems.
Original languageEnglish
Peer-reviewed scientific journalJournal of Services Marketing
Issue number9
Pages (from-to)41-56
Publication statusPublished - 24.05.2022
MoE publication typeA1 Journal article - refereed


  • 512 Business and Management
  • user-defined ecosystem
  • health care
  • social care
  • user unit
  • customer-dominant logic
  • health services
  • Customers and Relations
  • Customer value
  • ecosystem

Areas of Strength and Areas of High Potential (AoS and AoHP)

  • AoS: Competition economics and service strategy - Service and customer-oriented management


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