title: Knowledge structures of a health ecosystem.
abstract: OBJECTIVE
  This paper aims to hypothesize that modern health systems are transforming towards what has been called a health ecosystem in complexity-based health care literature. It has been argued that complexity arises from the interconnectedness, which in this paper is equated with knowledge flows between actors. The paper seeks to discuss the possible implications of a health ecosystem approach to health system management.
  
  
  METHODS
  The paper is conceptual in nature but the transition towards a health ecosystem is illustrated with an example of a regional health care system in Finland. The case description and related analysis presented are based on qualitative data gathered by interviewing leading office-holders, by process modeling and by observing management group meetings.
  
  
  RESULTS
  Conceptually, a health ecosystem seems to have potential for the system-level analysis of the health care system. The discussion concludes that management of knowledge flows should be a strategic management function for individual health organizations as well as for the wider health system.
  
  
  CONCLUSIONS
  This study focuses on a Finnish health care system. The operations and structures of health care services and systems vary in different areas and countries.
  
  
  CONCLUSIONS
  The practical illustration of the health ecosystem provides a reminder that health care systems are dynamic and largely based on interaction between different actors. The approach provides new strategic insights for the development of health care systems by concentrating on interrelationships and knowledge flows.
  
  
  CONCLUSIONS
  The literature has suggested that the ecosystem metaphor offers useful insights for the development of health care systems. Nevertheless, this approach has not been thoroughly studied so far. This paper makes a contribution by presenting a practical illustration of the framework and in light of this discusses the possible implications for health care management.
authors.affiliation: Department of Business Information Management and Logistics, Tampere University of Technology, Tampere, Finland. harri.laihonen@tut.fi
authors.forename: Harri
authors.initials: H
authors.lastname: Laihonen
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D005387:Finland; D058436:Knowledge Management; D008962:Models, Theoretical; D015279:Organizational Culture; D036301:Qualitative Research