How to Reach the Goal of Quadruple Aim Today in Healthcare Service Ecosystem: Nudges from the A4A Approach

¹ Higher Institute for Public Health, Université Saint-Joseph, Beirut
² University of Salerno, Dept. of Business Science – Management & Innovation Systems

^* Corresponding author: nabil@itvaluepartner.com

Abstract

The pandemic has uncovered hidden, latent or unknown misalignments in healthcare worldwide. Difficulties, friction, disturbances, misunderstandings, underestimations, carelessness and other issues have ensued quickly, upsetting the ecosystem value creation mechanisms and influencing all actor’s behavior within every country’s Healthcare Service Ecosystems (H-SES). The expected health system impacts are those demarcated by the quadruple aims that include all the actors in the health ecosystem. Such aims address improving patient and caregiver experience; improving the health of populations; reducing per capita cost; and improving the work life of providers. This warranted a search for deeper understanding of the on-going dynamics and relative insights to foster actor engagement, provide a good global service in Healthcare, and fully reach the well-known quadruple aim. By referring to the cyclical model of the actor for actor model (A4A), we consider and review their shared intentionality and finality alignment, to investigate how resource integration work here and what happen in case of contingences (as in the case of a pandemic). It is a theoretical work, but entails many practical issues in Healthcare in terms of patient empowerment, improving population health, lowering cost of care, and maintaining the wellbeing of the care team.