At the Frontline of Healthcare: Understanding the Impact of Frontline Service Technologies

Abstract

Frontline service technology (FST), defined as any combination of hardware, software, information systems, and networks that facilitates value co-creation between a healthcare provider and healthcare customer by optimizing processes and outcomes across the healthcare frontline, is rapidly transforming the frontline of healthcare. These technologies hold significant potential to address the mounting challenges faced by the healthcare industry, yet they also reshape the roles and experiences of both healthcare customers and providers. Although research on FSTs is expanding, much of it lacks service-related insights. This dissertation broadens the lens through which FSTs are evaluated by investigating their effectiveness in reaching healthcare objectives and their impact on healthcare customers and providers, through a service-oriented lens. Each of the six chapters contributes to these objectives through distinct methodological approaches.

Chapter 1 outlines the transformation of the organizational frontline and introduces FSTs in the context of healthcare services. It also details the structure of the dissertation and its intended contributions. Chapter 2 investigates the effectiveness of FSTs in advancing the Quintuple Aim of healthcare: improving health outcomes, reducing costs of care, enhancing healthcare customer and provider experiences, and promoting health equity. A systematic literature review reveals that while FSTs improve health outcomes, reduce costs of care, and enhance healthcare customer experience, their impacts on provider experience and health equity are neglected. Existing research adopts a predominantly clinical lens, underutilizing service-related insights. The chapter concludes with a research agenda identifying five key areas where service researchers can contribute.

Chapters 3 and 4 shift the focus to the impacts on FST users. Grounded in the Job Demands–Resources (JD-R) theory, both chapters examine how FSTs reshape users’ roles by influencing the demands they encounter and the resources they can draw on. Chapter 3 uses a qualitative study to explore the bright and dark sides of FSTs. Two remote monitoring FSTs are studied: Pregnancy Remote Monitoring and Elderly Remote Monitoring, considering perspectives from both customers and providers. Findings reveal distinct role demands and role resources during FST usage, and psychological capital (PsyCap) emerges as a critical personal resource. The chapter emphasizes shared patterns and differences across user groups, highlighting the need for tailored support strategies.

Chapter 4 extends these insights through scenario-based studies that empirically test the JD-R theory. Using partial least squares structural equation modeling, it investigates how role demands, role resources, and PsyCap influence users’ well-being, satisfaction, and word-of-mouth intentions. The results show that PsyCap significantly enhances motivation, satisfaction, and word-of-mouth; role demands increase strain but have no impact on motivation; and role resources are strongly linked to key outcomes in several user groups. Furthermore, well-being emerges as a key driver of satisfaction and word-of-mouth.

Chapter 5 introduces WATCH (Well-Being Assessment of Technology Concerning Healthcare), a research-driven application developed to help organizations monitor and optimize the impact of FSTs. Drawing on Importance-Performance Analysis, the tool provides actionable insights for improving user well-being and organizational outcomes.

Chapter 6 concludes the dissertation by reflecting on key lessons, acknowledging limitations, and offering directions for future research.