Anatomy of Successful Business Models for Complex Services: Insights from the Telemedicine Field

Figures & data

Table 1. An Overview of Business Model Elements and Purposes

Authors	Business model elements				Business model purpose
	Value proposition	Value co-creation	Value communication and transfer	Value capture
Afuah and Tucci [2]	Customer value Scope	Connected activities Implementation Capabilities Sustainability	—	Pricing Revenue source	Description
Ansorge et al. [5]	Value proposition	Key resources Key activities Key partnerships	Channels Customer relationship	Revenue streams Cost structure	Description
Bieger and Reinhold [10]	Value proposition	Value creation Value development	Value communication and transfer	Value capture Value dissemination	Description
Björkdahl [11]	Customer value Customer segment	Offering Sourcing	Distribution/selling	Revenue model	Analysis
Chesbrough [16]	Value proposition Market segment	Value Network Competitive Strategy	Distribution	Revenue mechanism Cost structure and profit potential	Description
Gersch and Hewing [25]	Value proposition	Key resources Key activities Key partnerships	Channels Customer Relationship	Revenue streams Cost structure	Description and analysis
Schultz et al. [56]	Value model	Internal value creation model	—	External value creation model	Analysis and communication
Gemünden et al. [24]	Value model	Internal value creation model	—	External value creation model	Analysis and communication
Hamel [28]	Customer benefits	Core strategy Strategic resources Value network Configuration Company boundaries	Customer interface	—	Description
Maglio and Spohrer [37]	Value proposition	Access to resources Physical symbols systems	—	—
Mahadevan [39]	Value stream	Logistical stream	—	Revenue stream	Description
Osterwalder and Pigneur [47]	Value proposition	Key resources Key activities Key partnerships	Channels Customer relationship	Revenue stream Cost structure	Analysis and communication
Osl et al. [46]	Customer offering	Service offering Value creation	Marketing Model	Paying entity Revenues	Description
Valeri et al. [58]	Value proposition	Key resources Key activities Key partnerships	Channels Customer relationship	Revenue stream Cost structure	Analysis and communication
Weill and Vitale [64]	Strategic objective and value proposition Customer segments	Critical success factors Core competencies IT infrastructure	Channels	Sources of revenues	Analysis and communication
Wirtz [66]	Service offering model	Organization/ cooperation model Goods and services model	Market model Procurement/ distribution model	Capital model	Analysis and communication
Wirtz et al. [67]	Market offering Customers	Strategy Resources Network Procurement		Revenues Finances	Description

Source: Adapted from [10, 67].

Figure 1. Design Science Research Setting

Source: Adapted in part from Hevner [29].

Table 2. Overview of Performed Relevance, Design, and Rigor Cycles

Iteration	Relevance cycle	Design cycle (result)	Rigor cycle
1	Elicitation of needs from the field, integration of domain-specific parameters	Four dimensions and parameters with single characteristics	Existing business model frameworks from literature as input; extending the knowledge base by business model framework knowledge for telemedicine services
2	Sixteen existing telemedicine business models as input; parameter-by-parameter assessment using initial framework; identification of business model patterns	Morphological box as CompBizMod framework plus first versions of the three business model patterns	Continued knowledge extension regarding business model frameworks for telemedicine services and complex services general; analytic generalization of identified business model patterns against business model literature
3	Evaluation of CompBizMod framework and business model patterns with eleven expert interviews	Refined CompBizMod framework and refined business model patterns; revelation of the underlying roles of information systems	Continued knowledge extension regarding business model frameworks for telemedicine services and complex services general; specification in regard to the varying roles of information systems

Table 3. Overview of Interview Partners

No.	Function	Organization	Developed telemedicine service/business model
1	CEO and founder	Telemedicine start-up	Telemedicine service that enables individuals to individually track and improve their health status
2	Project manager	Technology consultancy	Telemedicine service that enables patients with amyotrophic lateral sclerosis to weekly document their medical conditions by using a standardized questionnaire
3	Project manager	Health-care association	Home-monitoring service that enables patients with hypertension to check their blood pressure by using wearables
4	Head of research and development	Regional telemedicine research center	Telemedicine software service that supports communication between rescue service and hospital
5	CEO and founder	Regional telemedicine association	Telemedicine service in the field of mobile eye care in nursing homes
6	Project manager	Research transfer institute	Telemedicine service in the field of ambient assisted living
7	Research scientist	Multinational software corporation	Various telemedicine service in the field of IT-facilitated health-care service
8	Founder and rechnology consultant	Technology consultancy	Telemonitoring platform for smart medication that enables patients to treat hemophilia at home under the supervision of a physician
9	Project manager	Regional telemedicine association	Telemedicine service in the field of mobile eye care in nursing homes
10	Project manager	Regional telemedicine association	Telemedicine service in the field of business management software for hospitals
11	Research scientist	University	Product-related telemedicine services in the field of medical technology

Figure 2. The CompBizMod Framework

Figure 3. Application Process for the CompBizMod Framework

Table 4. Advantages and Disadvantages of the Identified Business Model Patterns

Pattern	Advantages	Disadvantages
“Enablement”	+ Revenues follow because of service and maintenance	– In order to profit, customers (health-care providers) must develop their own ideas for telemedicine service applications
“Support”	+ Medical know-how is not necessary + Outsourcing specific functions of value creation, for example, acquisition of customers or patients, and reimbursement issues	– Being highly dependent on external service providers; a service provider influences a service’s quality significantly
“Empowerment”	+ Keeping in touch with recipients directly; there is no health-care provider between the telemedicine service provider and the patient; service quality is influenced by the telemedicine service providers (suppliers) themselves + The patients probably have to pay out-of-pocket	– Developing a clientele; cooperation with health-care providers is necessary in order to get access to a client’s data (patient data)

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