E-Thesis 20 views
Implementing Intelligence for Value: A Socio-Technical Framework for Business Intelligence Capability Development to Enable Value-Based Healthcare in NHS Wales / NAVJOT KALRA
Swansea University Author: NAVJOT KALRA
DOI (Published version): 10.23889/SUthesis.71959
Abstract
The world is experiencing increasing political, financial and demographic pressures that affect the sustainability, equity, and the overall quality of care provided by health systems. The paradigm of Value -based Healthcare (VBHC) has emerged in response to the increasing burden, wherein outcomes th...
| Published: |
Swansea
2026
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| Institution: | Swansea University |
| Degree level: | Doctoral |
| Degree name: | Professional Doctorate |
| Supervisor: | Rich, Nicholas ; Brooks, Simon |
| URI: | https://cronfa.swan.ac.uk/Record/cronfa71959 |
| Abstract: |
The world is experiencing increasing political, financial and demographic pressures that affect the sustainability, equity, and the overall quality of care provided by health systems. The paradigm of Value -based Healthcare (VBHC) has emerged in response to the increasing burden, wherein outcomes that are important to patients are evaluated in relation to the cost incurred to achieve them. In Wales (which is a country in the United Kingdom), VBHC is the preferred approach of healthcare delivery as set in the long -term strategy of the Welsh Government in the “A Healthier Wales “strategy and the Once for Wales digital strategy. Yet, the realisation of these ambitions remains largely unrealised. This research study examines how to implement the Intelligence for Value (IFV) framework in NHS Wales, which places business intelligence (BI) as a key enabler of VBHC based healthcare transformation. The research design was an interpretivist, abductive research which incorporated theory synthesis with the analysis of data. The interviews with senior executives, clinicians, as well as analysts of the Welsh health boards (n = 17) were conducted in semi -structured form. An integrated theoretical framework that included the Consolidated Framework for Implementation Research (CFIR), Socio-Technical Systems (STS) theory, the Unified Theory of Acceptance and Use of Technology (UTAUT), and typology of value as developed by Gray, and Complex Adaptive System (CAS)/ Learning Health System (LHS) guided the thematic analysis.The results indicated that although there is strong strategic support of VBHC there is however a variable maturity in its operationalisation. Patient outcome measurement continued to be fragmented, retrospective and weakly integrated especially in the area including of patient -reported outcome measures (PROMs) in the reporting of VBHC initiatives and design. The systematic use and adoption of BI is constrained by low maturity levels of interoperability, analytical capacity and weak governance. To improve clinical and financial enablers such as cross -functional governance structures, dual (clinical -digital or clinical -finance) sponsorship models, interpretive analytics, and co designed dashboards between clinical and analytic mindset were central.The research study was able to create two precise methodological frameworks through the series of synthesis, namely the Integrated IFV (F4) and the Validated IFV (F5). These frameworks are a demonstration of how the original IFV framework has evolved in terms of conceptual ground to empirically validated socio -technical construct to guide the operating model of VBHC informed service design. The frameworks describe eight interrelated domains (leadership, governance, digital integration, data strategy, analytics, workforce, collaboration, and outcome translation) which are connected by feedback loops that operationalise learning and adaptation in a complex adaptive healthcare system. The research study has shown both theoretical and practical contributions. It expands CFIR to a socio -technical BI -enabled context; provides a structured way on how healthcare organisations can use UTAUT; and offers a tested implementation framework towards VBHC in a devolved health care system in NHS Wales. In practice, it outlines specific actions on prioritising cross functional governance, interoperability, as well as data and analytics literacy. The research study concludes that IFV is an adaptive learning system that is alive and that its success depends on the integrated governance, cultural preparedness, and ability to convert analytics, intelligence and insights into value creation that is continuous and iterative. |
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| Keywords: |
Business Intelligence, healthcare, Value Based Healthcare, VBHC, Intelligence for Value, Management Information Systems |
| College: |
Faculty of Humanities and Social Sciences |
| Funders: |
Value Based Healthcare Academy/Welsh Government Intensive Learning Academies |