Management of Open Innovation in Healthcare for Cost Accounting Using EHR
Round 1
Reviewer 1 Report
The paper was radically changed/improved during the review carried out by the authors. The main problems were addressed.
I think the title should report the word EHR and not HER.
Author Response
Authors answer
Dear Reviewer 1,
thank you for your effort to improve our paper.
We have rechecked the article from a linguistic point of view and hoped that it will now be more
comprehensible.
We apologize for the problem in the title which has now been corrected.
The authors
Author Response File: 
Author Response.pdf
Reviewer 2 Report
I do appreciate the authors’ effort to revise the manuscript, but I think that the article is still a draft. First of all, I don’t understand the idea behind the conceptual model which is supposed to be a combination of the innovation cycle theory and the micro-costing theory. The authors formulate the research questions in the introduction, i.e. “This paper addresses the following research questions: Can the theory of microcosting close the theoretical gap link to the knowledge innovation cycle? Does the union of the two theories increase the added value in the knowledge cycle?” (lines 52-54), but they don’t explain what they mean by “theoretical gap link” and don’t provide any answer to the question how this gap can be closed by the micro-costing theory. I believe that the authors have concepts that they wish to explore, but they need to be clearer so that the reader follows what they are trying to accomplish. Moreover, it is unclear for me how the case study, presented by the authors, can “illustrate the incremental value of the innovation cycle theory with microcosting theory” (line 154). From the methodological point of view, it is right that case studies may be means for testing theories, but it requires specific elements of a research design and setting up the analytical framework. Unfortunately, the research methodology and data collection section doesn’t explain how the research was designed in the context of the verification of the conceptual model. Finally, the results of the study don’t refer directly to the research questions. Indeed, the authors provide some basic information on the qualitative and quantitative benefits of the EHR implementation, but without any reference to the validation of their conceptual model.
Author Response
thank you for your comments.
We believe your vision may have been to the benefit of the paper.
First of all, our team has tried to make it easier to understand the idea behind the union of the two
theories, especially of the theoretical GAP that we have seen exist in literature. The changes are
shown in line 57.
Besides, concerning line 154 (now modified) we have made some changes which aim to explain
better how the case study can explain the gap and above all identify those elements that we then
analyzed in the context of reference.
Furthermore, another problem referred to the discussion of results and validation in the conceptual
model. We tried to add some evidence from line 391.
Finally, we have rechecked the article from a linguistic point of view and hoped that it will now be
more comprehensible.
Please consider that in the second review we have added the reference theory on social open
innovation, in agreement with the associate editor.
The authors
Author Response File: Author Response.pdf
Reviewer 3 Report
I want to thank the author for submitting the paper “Management of innovation in healthcare for cost accounting using HER ”. I find the research idea and the topic interesting and relevant, I have some minor concerns that should be addressed. I will outline these concerns along the paper.
You probably mean EHR not HER in the title The idea of this article is good, but it has a major shortcoming – you seem to have very rich case study materials but you rush through it Materials and Methods – Why did you select “City of Turin – Service for Drug-addictions"? What is reasoning behind it? You should explain these in your paper. Could you possibly elaborate more what data have you taken into consideration (part 4), as now it is slightly ambiguous. You mention before that “The validity of the collected data is confirmed by the triangulation of different sources of data, intervies (…)” but fail to continue this underlying thread. How many interviews ?What about timeframe of your research? What analytical approach was selected? What about the research strategy you employ? Could you please specify and elaborate on arguments for your decision? Definitely, methodology part as well as research results should be more elaborated in the article in order to remove the doubts. Additionally, research limitations and future research avenues are not addressed at all.
I hope the author will find my comments constructive and helpful
Author Response
Dear Reviewer 3,
thank you for your comments.
We apologize first for the title, EHR is the correct abbreviation for Health Electronic Record.
We have tried to explain in the method how the Addiction Service can be a good case study to
analyze. You will find the explanation in lines 278 to 284.
More general, we have created a section entitled research design that has the objective of putting
together:
1) the method and the data collection;
2) information about the context of the case study.
Besides, we have better specified the method of the interviews and the timeframe you refer to for
analysis in the same section.
Finally, the research limitations and future indications were not present. Thank you for indicating to
us to implement also this part that is now present at the end of the paper from line 541.
Last but not least, we have rechecked the article from a linguistic point of view and hoped that it
will now be more comprehensible.
Please consider that in the second review, we have added the reference theory on social open
innovation, in agreement with the associate editor.
The authors
Author Response File: Author Response.pdf
Round 2
Reviewer 2 Report
The authors addressed most my concerns.
This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.
Round 1
Reviewer 1 Report
Abstract
There are references in the abstract, please remove them. It lacks the aim of the study, methods and results
In addition, the style of referencing should be revised; there are references in different styles all over the text.
Introduction:
It is not comprehensible. It is incredible difficult to read and it seems a collage of different paragraphs, not related to each other. It fails to set the stage: it fails to explain the background of the study, why it is important and what main research questions were addressed
It states the research aim “to explore the methods and dynamics with which healthcare professionals, use information tools, with particular reference to the case study of HTH regional software.” Nothing related to HTH is explained previously. Some explanation is found in the methods section though.
Methods:
It seems that this is a case study. However, the methodology is not conveniently explained. It seems that there were several stages, but how these interconnect is unknown. There is a figure 1 that appears but does not add to the methodology.
There is some explanation of the setting, which is good, but one wonders if some of this information belongs in the introduction section.
Results:
What are the results in figure 3? How were they obtained?
In line 160 to 163, authors write about failures. Do these relate do the EHR that supposedly is under study?
Discussion and conclusion:
As the results are incomprehensible, these sections fail to weight on the results and fail to present future studies’ direction.
Reviewer 2 Report
The review is reported in a separate file.
Comments for author File: Comments.pdf
Reviewer 3 Report
The topic discussed is of interest and current, with potential implications at both the academic and the managerial levels. Nevertheless, after reading the paper, I feel the paper is unsuitable for publication in Journal of Open Innovation: Technology, Market, and Complexity. There are some minor problems with the paper and some major drawbacks that prevent it for being published.
First of all, the article title doesn’t correspond with the aim of the paper. As stated by the authors, “The research aims to explore the methods and dynamics with which healthcare professionals use information tools, with particular reference to the case study of HTH regional software” (lines: 73-74). On the other hand, the title suggests that the paper deals with the issue of the implementation of innovation (i.e. a new way of medical recording) in the healthcare sector. Moreover, the paper is not well developed.The theoretical background is really poor. Unfortunately, the authors refer to the papers which are not included in the reference section (for example: Lerro, 2012; Guertler, Wiedemann and Lindemann, 2015). As such, it is hard to get familiar with theoretical foundations of the authors’ reasoning. There are some statement in the text that are stripped of all context. For example, “This section is not mandatory but can be added to the manuscript if the discussion is unusually long or complex.” (lines: 220-221). Finally, the authors mention about the verification of research hypotheses, i.e. “The clinical record of the ASL "Città di Torino" case study is analyzed to identify the information that most affects the organization to confirm the research hypotheses” (lines: 85-86), but they do not formulate them.
As regards methodological issues, I am unclear how the research has been conducted. The section 3. Case study and sample does not provide any information on the research process. The results are not presented clearly. I think this paper is still a draft.
