Home > Research > Publications & Outputs > Technology Push without a Patient Pull

Electronic data

  • Attached standard file (002)

    Rights statement: This article is (c) Emerald Group Publishing and permission has been granted for this version to appear here. Emerald does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Emerald Group Publishing Limited.

    Accepted author manuscript, 584 KB, PDF document

    Available under license: CC BY-ND: Creative Commons Attribution-NoDerivatives 4.0 International License

Links

Text available via DOI:

View graph of relations

Technology Push without a Patient Pull: Examining Digital Unengagement (DU) with Online Health Services

Research output: Contribution to journalJournal article

Published
<mark>Journal publication date</mark>9/09/2019
<mark>Journal</mark>European Journal of Marketing
Issue number9
Volume53
Number of pages32
Pages (from-to)1701-1732
Publication statusPublished
Early online date25/02/19
Original languageEnglish

Abstract

Purpose: Policymakers push online health services delivery, relying on consumers to independently engage with online services. Yet, a growing cluster of vulnerable patients do not engage with or disengage from these innovative services. There is a need to understand how to resolve the tension between the push of online health service provision and unengagement by a contingent of health-care consumers. Thus, this study aims to explore the issue of digital unengagement (DU) (i.e. the active or passive choice to engage or disengage) with online health services to better inform service design aligned to actual consumer need. Design/methodology/approach: Adopting a survey methodology, a group of 486 health services consumers with a self-declared (acute or chronic) condition were identified. Of this group, 110 consumers were classified as digitally unengaged and invited to write open-ended narratives about their unengagement with online health services. As a robustness check, these drivers were contrasted with the drivers identified by a group of digitally engaged consumers with a self-declared condition (n = 376). Findings: DU is conceptualized, and four levels of DU drivers are identified. These levels represent families of interrelated drivers that in combination shape DU: subjective incompatibility (misalignment of online services with need, lifestyle and alternative services); enactment vulnerability (personal vulnerabilities around control, comprehension and emotional management of online services); sharing essentiality (centrality of face-to-face co-creation opportunities plus conflicting social dependencies); and strategic scepticism (scepticism of the strategic value of online services). Identified challenges at each level are the mechanisms through which drivers impact on DU. These DU drivers are distinct from those of the digitally engaged group. Research limitations/implications: Adding to a nascent but growing literature on consumer unengagement, and complementing the engagement literature, the authors conceptualize DU, positioning it as distinct from, not simply a lack of, consumer engagement. The authors explore the drivers of DU to provide insight into how DU occurs. Encapsulating the dynamic nature of DU, these drivers map the building blocks that could help to address the issue of aligning the push of online service provision with the pull from consumers. Practical implications: This paper offers insights on how to encourage consumers to engage with online health services by uncovering the drivers of DU that, typically, are hidden from service designers and providers impacting provision and uptake. Social implications: There is a concern that there will be an unintentional disenfranchisement of vulnerable segments of society with a generic policy emphasis on pushing online services. The paper sheds light on the unforeseen personal and social issues that lead to disenfranchisement by giving voice to digitally unengaged consumers with online health services. Originality/value: Offering a novel view from a hard-to-reach digitally unengaged group, the conceptualization of DU, identified drivers and challenges inform policymakers and practitioners on how to facilitate online health service (re)engagement and prevent marginalization of segments of society.

Bibliographic note

This article is (c) Emerald Group Publishing and permission has been granted for this version to appear here. Emerald does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Emerald Group Publishing Limited.