Serving specialized patient segments in a diversified context : A knowledge perspective on the case of Karolinska University Laboratory

Fragmentation in healthcare has led to a desire to align and integrate care processes horizontally. The concept of value-based healthcare has been introduced, suggesting a maximized value creation to occur when optimal conditions are created for selected patient segments, integrating all activities that jointly determine the success in meeting a set of patient needs. While targeting specialized segments has been shown to be beneficial, theories of diversification suggests that an increased scope may be an even more efficient approach to improve performance. By sharing resources and capabilities across several specialized units, coordination and knowledge sharing of a hospital’s ancillary services becomes important. In this study, we examine how an ancillary service function, providing resources and capabilities that are shared across specialized units, can be organized to ensure contribution to the overarching goal of maximizing value for patients. This is done through a qualitative case study of the Karolinska University Laboratory – an ancillary service function of the Karolinska University Hospital. It is concluded that an ancillary service function can, in a diversified context, facilitate and support the value creation around medical conditions by developing a comprehensive structure for knowledge management and sharing, both externally towards medical conditions and internally within the ancillary service function. If structured properly, clear benefits, such as economies of scale, scope and knowledge spillovers, can be achieved by separating sharable resources from the patient flows