Journal of Health Organization and Management最新文献

{"title":"Strategic resilience in healthcare: towards a digitalised and regenerative balanced scorecard framework.","authors":"Paula Cristina Almeida Marques","doi":"10.1108/JHOM-09-2025-0595","DOIUrl":"https://doi.org/10.1108/JHOM-09-2025-0595","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to examine how integrating regenerative principles into a digitalised balanced scorecard (BSC) can support hospital resilience, sustainability and governance in contexts characterised by systemic complexity, recurrent crises and accelerated digital transformation. While sustainability initiatives in healthcare have traditionally emphasised harm reduction and operational efficiency, a regenerative perspective extends beyond mitigation by fostering net-positive environmental, social and organisational (ESG) outcomes. In this study, regenerative governance refers to practices that reinforce ecosystem stewardship, workforce well-being, organisational learning and adaptive capacity, thereby supporting long-term resilience and more integrated strategic decision-making.</p><p><strong>Design/methodology/approach: </strong>A comparative multiple-case study was conducted across three Portuguese public hospitals. Data collection combined semi-structured interviews conducted between April 2024 and January 2025 with senior executives and key functional managers, documentary analysis of strategic and sustainability reports and longitudinal performance indicators covering the period 2018-2023. This comparative and longitudinal design enabled identification of patterns in digitalisation practices, governance approaches and resilience-related capabilities, supporting interpretation of the BSC as a governance framework rather than solely a static performance measurement tool.</p><p><strong>Findings: </strong>Hospitals incorporating regenerative principles within digitalised BSC architectures appeared to exhibit comparatively stronger adaptive capacity, more structured ESG reporting practices and more consistent continuity of care during periods of disruption. Implementation challenges remain evident, including cultural resistance to change, fragmented information systems, resource constraints and uneven levels of digital maturity. Overall, findings indicate that hospital resilience is influenced not only by structural efficiency but also by governance capabilities that integrate sustainability principles, organisational learning and data-informed decision-making processes. The integration of digital data infrastructures with sustainability-oriented governance practices appears to be associated with stronger cross-departmental coordination, enhanced organisational learning and more structured crisis-response mechanisms.</p><p><strong>Research limitations/implications: </strong>The study focuses on three hospitals operating within the same national healthcare system, which may limit transferability to institutional environments characterised by different regulatory structures, governance arrangements or funding conditions. Although the comparative design provides analytically rich insights, findings should be interpreted as theoretically informative rather than statistically generalisable. Future research may extend the e","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":"1-24"},"PeriodicalIF":2.2,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why diversity climate alone does not drive innovation in healthcare: evidence from an emerging economy.","authors":"Minh Hoang Dao, Thi Thuc Anh Phan, Tram-Anh H Nguyen, Van Kien Pham","doi":"10.1108/JHOM-11-2025-0801","DOIUrl":"https://doi.org/10.1108/JHOM-11-2025-0801","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines why diversity climate may fail to stimulate innovation in healthcare organizations operating in an emerging economy and identifies the organizational capabilities that convert internal resources into performance outcomes.</p><p><strong>Design/methodology/approach: </strong>Survey data were collected from 311 managers in Vietnamese hospitals and pharmaceutical firms. Partial least squares structural equation modelling was used to assess reliability, validity, direct effects, predictive relevance and mediation through firm innovativeness.</p><p><strong>Findings: </strong>R and D effectiveness positively predicts both firm innovativeness and firm performance. Diversity climate improves firm performance directly but does not significantly predict innovativeness. Participative leadership does not show a significant direct association with either firm performance or innovativeness in the reported structural model. Firm innovativeness positively predicts firm performance.</p><p><strong>Research limitations/implications: </strong>Cross-sectional and self-reported data limit causal claims. Future research should use longitudinal designs and objective performance indicators.</p><p><strong>Practical implications: </strong>Healthcare managers should complement diversity initiatives with interdisciplinary work routines, R and D partnerships, psychological safety practices and innovation governance systems.</p><p><strong>Social implications: </strong>The findings extend resource-based and dynamic capability perspectives by specifying an emerging-market healthcare boundary condition: inclusive climates do not automatically become innovation capability when professional silos, hierarchical norms and weak knowledge-integration mechanisms restrict voice and experimentation.</p><p><strong>Originality/value: </strong>The study challenges the universal assumption that diversity climate naturally drives innovation and shows that leadership, R and D systems and institutional context shape whether inclusion becomes innovation.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":"1-25"},"PeriodicalIF":2.2,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-performance work systems, organizational identification, trust in leader, perceived organizational support and healthcare professionals' turnover intention.","authors":"Ismaheel Adewumi Raji, Abdussalaam Iyanda Ismail, Muhammad Abdus Salam","doi":"10.1108/JHOM-06-2025-0366","DOIUrl":"10.1108/JHOM-06-2025-0366","url":null,"abstract":"<p><strong>Purpose: </strong>Drawing on social exchange theory (SET) and social identity theory (SIT), this study investigates how the high-performance work systems (HPWS)-turnover intention () link is mediated by organizational identification (OID) and moderated by trust in leader (TIL) and perceived organizational support (POS).</p><p><strong>Design/methodology/approach: </strong>A two-wave time-lagged survey research was conducted on healthcare professionals in Nigeria, comprising medical doctors, nurses and midwives, and 387 valid responses were received.</p><p><strong>Findings: </strong>The results indicated that HPWS significantly and negatively predicted TI and significantly and positively predicted OID. In turn, OID significantly and negatively predicted TI. OID partially mediated the relationship between HPWS and TI. While the moderating effect of TIL on the relationship between HPWS and OID was not significant, POS was found to significantly strengthen the negative relationship between OID and TI.</p><p><strong>Originality/value: </strong>Despite a considerable body of research on the outcomes of HPWS, its underlying mechanisms and boundary conditions remain elusive. This study therefore offers valuable theoretical contributions to advancing the literature on how and when HPWS influence employee outcomes.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":"785-810"},"PeriodicalIF":2.2,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contextual factors affecting learning-oriented leadership in healthcare: a case study.","authors":"Rachel Margrethe Lørum, Henrik Eriksson, Frida Smith","doi":"10.1108/JHOM-03-2025-0151","DOIUrl":"10.1108/JHOM-03-2025-0151","url":null,"abstract":"<p><strong>Purpose: </strong>To explore how contextual factors affect the practice of learning-oriented leadership in fragmented healthcare systems.</p><p><strong>Design/methodology/approach: </strong>A qualitative case study using a participatory approach. Data were collected through semi-structured focus groups and interviews with leaders across hospital levels. Thematic analysis was applied.</p><p><strong>Findings: </strong>Four contextual factors were identified: (1) multiple external drivers (why), (2) diverse actors and perspectives (who), (3) emergent, unpredictable change (how) and (4) organizational resources and support (what). The study refines the learning-oriented leadership framework in fragmented healthcare systems by emphasizing (1) cross-boundary leadership, (2) contradiction management, (3) leading for organizational learning under resource constraints and (4) differentiated leadership roles across levels.</p><p><strong>Originality/value: </strong>By integrating empirical insights with expansive learning theory, the study advances the learning-oriented leadership framework and offers strategies for leadership and policy in complex healthcare systems.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":"684-704"},"PeriodicalIF":2.2,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical realist theory of emotions and older people's challenges in technology adoption: a case study of Lindsay Leg Club volunteers.","authors":"Anna Milena Galazka","doi":"10.1108/JHOM-04-2024-0134","DOIUrl":"10.1108/JHOM-04-2024-0134","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines the challenges in digital technology adoption among older volunteers in an organisation addressing social isolation. Using Margaret Archer's critical realist theory of emotions as causal commentaries on wider concerns, it investigates why older individuals might reject or need to adapt to digital technology adoption.</p><p><strong>Design/methodology/approach: </strong>The paper examines a qualitative case study of Lindsay Leg Club (LLC) volunteers through two sequential projects: assessing attitudes towards digital communication technology and understanding motivations for in-person social interactions. In total, 27 interviews were conducted with volunteers in three Leg Clubs to analyse these aspects of the volunteer experience.</p><p><strong>Findings: </strong>Volunteers' emotional reactions to technology revealed two wider concerns: leaving the role of the Leg Club volunteer, fundamentally grounded in face-to-face social relationships and reflexivity about technology adaptation, underpinned by evaluative decisions about the extent of willingness to engage with change.</p><p><strong>Research limitations/implications: </strong>The sequential design meant that there was not a complete overlap between participants in both studies. Exact age and sex demographics were not recorded.</p><p><strong>Practical implications: </strong>The study suggests that technology can be relationally oppressive, so its introduction in organisations focused on in-person support for older people must consider the risks of technological appropriation of social relationships.</p><p><strong>Originality/value: </strong>Rather than presenting technology introduction as a technical process and emotions as its subjective by-product, the paper uses critical realism to show emotions can represent commentaries on technology's risks to transforming the context of human relationality.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":"650-665"},"PeriodicalIF":2.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The appropriation dynamics of the norm LHAS: the oscillation between open and closed modes of management tools.","authors":"Mohamad Medawar, Corinne Grenier","doi":"10.1108/JHOM-01-2025-0052","DOIUrl":"10.1108/JHOM-01-2025-0052","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Research on management tool appropriation examines either the components of the tool or its nature (open or closed) separately. This article aims to enhance understanding by combining both research streams.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/methodology/approach: &lt;/strong&gt;We combine two analytical frameworks: the four-dimensional model of tool appropriation (instrumental, political, cognitive, symbolic) and the concept of open and closed tools. Using a qualitative case study design, we examine the implementation of the Lebanese Hospital Accreditation System (LHAS) in a private hospital in Beirut from 2019 to 2020. Data were collected through 63 semi-structured interviews with 21 participants across three time periods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The study reveals that the successful appropriation of LHAS depends on alternating between open and closed tool modes. The symbolic and instrumental dimensions are primarily closed to ensure legitimacy and consistency, while the political and cognitive dimensions remain open to promote contextual adaptation and participation. This oscillation is guided by the dissemination of an organizing vision, actively shaped by the hospital's CEO and communicated by empowered middle managers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research limitations/implications: &lt;/strong&gt;Our study addresses a significant research gap by combining two distinct yet complementary approaches to tool appropriation that are often treated separately. Our findings reveal a unique relationship between the four dimensions of the tool appropriation process and offer a more nuanced understanding of malleable tools. Our findings enhance appropriation guided by a deliberate organizing vision and offer insights for overcoming the paradoxes of openness and closure and avoiding inconsistencies and tensions that could lead to inertia or weak arrangements when tool appropriation is deployed in pluralistic organizations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical implications: &lt;/strong&gt;The findings offer valuable insights for healthcare managers regarding the management of accreditation by maintaining consistency in core values while allowing flexibility in implementation. Transparent communication and empowering middle management are critical enablers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Social implications: &lt;/strong&gt;Our case allows us to suggest managerial implications that address the societal challenge of improving patient service quality. First, CEO leadership is essential for envisioning changes through daily activities. Second, CEOs should appoint and support middle managers in both spreading the vision and facilitating negotiations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Originality/value: &lt;/strong&gt;The study introduces the concept of a \"selectively open\" management tool and highlights the dynamic interplay among various dimensions of appropriation. It contributes to the literature by bridging rationalist and constructivist perspectives while offering a nuanced view of organizational change in pluralistic context","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":"633-649"},"PeriodicalIF":2.2,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the dentist-chair coupling constraint in high-volume dental operations: a system dynamics-based decision support approach.","authors":"Jiakun Fang, Min Yao, Yannan Sun","doi":"10.1108/JHOM-01-2026-0100","DOIUrl":"https://doi.org/10.1108/JHOM-01-2026-0100","url":null,"abstract":"<p><strong>Purpose: </strong>High-volume dental healthcare settings face capacity challenges governed by the rigid coupling constraint between dentists and dental chairs. This study aims to analyze these complex resource interdependencies and evaluate the long-term impacts of capacity management strategies on medical revenue, resource investment, dentist workload and service quality.</p><p><strong>Design/methodology/approach: </strong>A system dynamics modeling approach was applied to capture the non-linear dynamics and feedback delays. The model was constructed integrating qualitative causal loop diagrams with quantitative stock-flow modeling based on operational data from 2023 to 2025 collected at a large-scale stomatological center in China. Validation was conducted using historical data, achieving a mean absolute percentage error of 2.19% for outpatient visits and 3.09% for medical revenue.</p><p><strong>Findings: </strong>Simulation results reveal that capacity expansion alone is insufficient to resolve the supply-demand gap. Aggressive expansion leads to diminishing financial returns and underutilized assets due to high fixed costs. In contrast, an internal optimization strategy satisfies demand earlier, generates the highest net surplus and stabilizes workforce stress more effectively.</p><p><strong>Practical implications: </strong>The study provides a practical decision-support tool enabling healthcare administrators to transition from experience-based static planning to data-driven dynamic management. It suggests that improving coordination efficiency of coupled resources yields a higher return on investment than simple scale expansion.</p><p><strong>Originality/value: </strong>This research conceptualizes dentist-chair coupling as a dynamic binding constraint within a system dynamics framework and models the interplay between resource constraints and operational feedback loops that drive the long-term capacity, financial performance, and workforce sustainability of dental healthcare organizations.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of task-based and values-based performance measurement on employee commitment and rewarding in hospitals.","authors":"Yasin Aras, Oğuz Işık","doi":"10.1108/JHOM-10-2025-0658","DOIUrl":"https://doi.org/10.1108/JHOM-10-2025-0658","url":null,"abstract":"<p><strong>Purpose: </strong>In the 20th century, performance measurement evolved to assess both goal achievement (task-based) and ethical values (values-based) in employees. The aim of this study was to evaluate the task-based and values-based performance of healthcare employees according to different variables.</p><p><strong>Design/methodology/approach: </strong>The study included 498 healthcare employees working in three different healthcare organizations. Data were collected using the Values and Task-Based Performance Evaluation Questionnaire. In the first stage, employees completed the questionnaire for self-assessment; in the second stage, managers evaluated the performance of the same employees. Descriptive and inferential statistical analyses were applied.</p><p><strong>Findings: </strong>The results revealed that values-based and task-based performance differed significantly according to tenure and hospital ownership (p < 0.05). Furthermore, both values-based and task-based performance had a significant positive relationship with employee commitment and rewarding (p < 0.05). These findings suggest that combining task-based and values-based criteria provides a more holistic and effective framework for performance evaluation in healthcare organizations.</p><p><strong>Originality/value: </strong>This study contributes to the literature by integrating both task-based and values-based dimensions of performance into a single evaluation framework and applying it empirically in healthcare organizations. While previous studies have largely focused on either task performance or ethical values separately, this research demonstrates their combined effect on employee commitment and rewarding. The dual approach not only addresses the multidimensional nature of healthcare work but also offers a transferable model that can be applied in other sectors, filling a gap in performance measurement practices.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":"1-19"},"PeriodicalIF":2.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient value creation and implications for financial and market performance: insights from Moroccan clinics.","authors":"Chafik Echine, Ridouan Nejjari, Jawad Kibou, Abdellatif Taghzouti","doi":"10.1108/JHOM-11-2025-0781","DOIUrl":"https://doi.org/10.1108/JHOM-11-2025-0781","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines the impact of patient value creation on clinics' performances. Patient value is conceptualized as a multi-stage, multi-actor process that involves the participation of healthcare professionals while integrating the perspectives of clinics' directors and of patients. The study also assesses both financial performance (FP) and market performance (MP).</p><p><strong>Design/methodology/approach: </strong>In order to explore the three perspectives, data were collected through 81 clinic directors, 324 healthcare professionals or service healthcare providers (doctors and nurses) and 324 patients. Hypotheses were tested through partial least squares structural equation modelling (PLS-SEM) using SmartPLS4 software.</p><p><strong>Findings: </strong>The findings revealed that patient value had a positive and significant effect on both clinics' FP and MP. The results revealed a series of relationships in which each stakeholder contributes to subsequent phases, leading to improvements in performance outcomes of healthcare organizations. In addition, significant mediation effects are observed within this patient value phases and performance outcomes.</p><p><strong>Originality/value: </strong>Previous research on patient value creation has primarily focused either on the perspective of healthcare institutions or on that of patients. This theoretical dichotomy prevents researchers from exploring potential discrepancies between the value offered by healthcare organizations and the value perceived by patients. Furthermore, no study has incorporated the perspective of healthcare professionals, despite their crucial role in providing care-value to patients. This study fills this gap by incorporating three perspectives of patient value creation to explain the clinics' performance outcomes.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":"1-24"},"PeriodicalIF":2.2,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient intention to use and recommend teleconsultation platforms: the role of perceived platform governance and design.","authors":"Gustavo Perri Galegale, Luis Hernan Contreras Pinochet, Cesar Alexandre de Souza, Violeta Sun","doi":"10.1108/JHOM-01-2026-0026","DOIUrl":"https://doi.org/10.1108/JHOM-01-2026-0026","url":null,"abstract":"<p><strong>Purpose: </strong>This study reframes teleconsultation adoption as a platform governance and design problem rather than treating it exclusively as an individual technology acceptance issue. It examines how patients' perceptions of multisided platform governance and design shape their behavioral intentions to use and recommend teleconsultation platforms.</p><p><strong>Design/methodology/approach: </strong>A quantitative study was conducted with 503 teleconsultation users. The research integrates behavioral intention constructs with multisided platform governance dimensions and governance-derived patient perceptions. Data were analyzed using partial least squares structural equation modeling (PLS-SEM) to assess sufficiency relationships and necessary condition analysis (NCA) to identify minimum conditions required for high levels of patient recommendation.</p><p><strong>Findings: </strong>The results show that while perceived usefulness and ease of use remain important, governance-related dimensions such as platform-side diversity and monetization logic play differentiated constraining and enabling roles in shaping patient behavior. Some platform attributes do not directly increase intention to recommend but emerge as necessary conditions that must be met before high recommendation can occur, highlighting the distinction between enabling and constraining factors in teleconsultation platforms.</p><p><strong>Practical implications: </strong>The findings show that patient engagement and recommendation rely on essential governance and design conditions. Beyond feature improvement, platform sustainability depends on meeting minimum governance thresholds perceived by patients.</p><p><strong>Originality/value: </strong>This study advances digital health and teleconsultation research through a governance-first lens. It reframes perceived usefulness, ease of use, and technology risk as patient-facing evaluations of platform governance and design. By combining sufficiency and necessity logics, it provides a more nuanced explanation of how multisided teleconsultation platforms shape patient use and recommendation intentions.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":"1-27"},"PeriodicalIF":2.2,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}