Social Capital Theory as a Framework for Stakeholder Connectivity Within an eHealth Innovation Ecosystem: a Case Study of the EPIC Project

Innovation ecosystems can be described as inter-organizational, political, economic, environmental, and technological systems of innovation that are conducive to business growth. eHealth or digital health is the use of apps, websites, internet of things, robotics etc. in health and care. Numerous cities and regions around the world are trying to establish eHealth ecosystems where stakeholders on the demand side (clinicians, patients, carers etc.) can work with providers (SMEs, digital companies, services etc.) and education and research to provide innovation ecosystems in eHealth (Figure 1.). These eHealth ecosystems can be thought of as networks, where interconnected actors work together in order to fund, develop, usability test, evaluate or adopt health technologies. EPIC (eHealth Productivity and Innovation in Cornwall and the Isles of Scilly (CIoS)) is a European Regional Development Fund project that is developing one such eHealth innovation ecosystem. Based on a number of scholarly interpretations, social capital can be understood as a “metaphor about advantage in which social structure is a kind of capital that can create, for certain individuals or groups, a competitive advantage in pursuing their ends” (Burt 2017: 31). From a social capital perspective, societies can be viewed as a market in which people exchange all variety of goods and ideas in pursuit of their interests. The social capital metaphor postulates that better connected actors enjoy higher “returns”, however disagreements exist between social capital scholars when determining how and when actors are considered better connected. From a network’s perspective, two historically conflicting theories underpin one’s ability to achieve increased social capital, the structural holes argument (Burt: 1992) and the closure argument (Coleman, 1988, 1990). Despite these two previously distinct theories of social theory within network research, Burt recently suggests (2017: 52) that based on the latest empirical evidence “structural holes and network closure can be brought together in a productive way”. Although the mechanisms remain distinct and the empirical evidence supports the hole argument over closure, Burt comments “while brokerage across structural holes is the source of added value, closure can be critical to realizing the value buried in the structural holes”. Based on Burt’s (2017) developments in social capital theory, this paper will discuss our approach to increasing the capacity, capability and productivity of the ecosystem. Firstly we will outline our methods of longitudinally mapping connectivity within the ecosystem using an online network survey, alongside our approach to facilitating targeted and monitored networking activities between relevant stakeholders. Secondly, we will discuss our attempts to increase network closure within pre-established groups, whilst maintaining structural holes throughout the network to prevent increasing tie redundancy. Finally, we will discuss 249 the challenges we faced in mapping the development of the ecosystem and will highlight the benefits and limitations of the social capital approach we have adopted in order to develop a vibrant, productive and sustainable eHealth ecosystem.