Rønn Camille, Wieland Andreas, Lehrer Christiane, Márton Attila, LaRoche Jason, Specker Adrien, Leroy Pascal, Fürstenau Daniel
Department of Business IT, IT University of Copenhagen, Copenhagen, Denmark.
Department of Operations Management, Copenhagen Business School, Copenhagen, Denmark.
JMIR Res Protoc. 2023 Nov 24;12:e47874. doi: 10.2196/47874.
The circular economy reshapes the linear "take, make, and dispose" approach and evolves around minimizing waste and recapturing resources in a closed-loop system. The health sector accounts for 4.6% of global greenhouse gas emissions and has, over the decades, been built to rely on single-use devices and deal with high volumes of medical waste. With the increase in the adoption of digital health solutions in the health care industry, leading the industry into a new paradigm of how we provide health care, a focus must be put on the amount of waste that will follow. Digital health solutions will shape health care through the use of technology and lead to improved patient care, but they will also make medical waste more complex to deal with due to the e-waste component. Therefore, a transformation of the health care industry to a circular economy is a crucial cornerstone in decreasing the impact on the environment.
This study aims to address the lack of direction in the current literature on circular business models. It will consider micro, meso, and macro factors that would impact the operational validity of circular models using the digital health solutions ePaper label (medical packaging), smart wearable sensor (health monitoring devices), smart pill box (medication management), and endo-cutter (surgical equipment) as examples.
The study will systematically perform a scoping review through a database and snowball search. We will analyze and classify the studies from a predetermined set of categories and then summarize them into an evidence map. Based on the review, the study will develop a 2D framework for businesses to follow or for future research to take a standpoint from.
Preliminarily, the review has analyzed 26 studies in total. The results are close to equally distributed among the micro (8/26, 31%), meso (10/26, 38%), and macro (8/26, 31%) levels. Circular economy studies emphasize several circular practices such as recycling (17/26, 65%), reusing (18/26, 69%), reducing (15/26, 58%), and remanufacturing (8/26, 31%). The value proposition in the examined business model is mostly dominated by stand-alone products (18/26, 69%) compared to product as a service (7/26, 27%), involving stakeholders such as health care professionals or hospitals (20/26, 77%), manufacturers (11/26, 42%), and consumers (9/26, 35%). All studies encompass societal (12/26, 46%), economic (23/26, 88%), and environmental (24/26, 92%) viewpoints.
The study argues that each digital health solution would have to be accessed individually to find the optimal business model to follow. This is due to their differing life cycles and complexity. The manufacturer will need a layered value proposition, implementing several business models dependent on their respective product portfolios. The need to incorporate several business models implies an ecosystem perspective that is relevant to consider.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/47874.
循环经济重塑了线性的“取、造、弃”模式，围绕在闭环系统中最大限度减少浪费和回收资源而发展。卫生部门占全球温室气体排放量的4.6%，几十年来，其建立依赖于一次性设备，并产生大量医疗废物。随着医疗行业对数字健康解决方案采用率的增加，引领行业进入我们提供医疗保健的新范式，必须关注随之产生的废物量。数字健康解决方案将通过技术应用塑造医疗保健，并带来更好的患者护理，但由于电子废物成分，它们也会使医疗废物的处理更加复杂。因此，医疗行业向循环经济转型是减少对环境影响的关键基石。
本研究旨在解决当前文献中循环商业模式缺乏指导方向的问题。它将以数字健康解决方案电子纸标签（医疗包装）、智能可穿戴传感器（健康监测设备）、智能药盒（药物管理）和内镜切割器（手术设备）为例，考虑会影响循环模式运营有效性的微观、中观和宏观因素。
本研究将通过数据库和滚雪球搜索系统地进行范围综述。我们将从一组预定类别中分析和分类研究，然后将它们总结成一个证据图。基于该综述，本研究将为企业制定一个二维框架以供遵循，或供未来研究参考。
初步来看，该综述总共分析了26项研究。结果在微观（8/26，31%）、中观（10/26，38%）和宏观（8/26，31%）层面上分布接近均匀。循环经济研究强调了几种循环实践，如回收利用（17/26，65%）、再利用（18/26，69%）、减少（15/26，58%）和再制造（8/26，31%）。在所研究的商业模式中，价值主张大多由独立产品主导（18/26，69%），相比之下产品即服务模式占比为7/26（27%），涉及医疗保健专业人员或医院（20/26，77%）、制造商（11/26，42%）和消费者（9/26，35%）等利益相关者。所有研究都涵盖社会（12/26，46%）、经济（23/26，88%）和环境（24/26，92%）观点。
该研究认为，必须分别审视每种数字健康解决方案，以找到要遵循的最佳商业模式。这是由于它们不同的生命周期和复杂性。制造商将需要分层的价值主张，根据各自的产品组合实施多种商业模式。纳入多种商业模式的必要性意味着需要考虑相关的生态系统视角。
国际注册报告识别号（IRRID）：DERR1-10.2196/47874。
