Reducing information asymmetry and increasing health value co‐creation in a rural healthcare context

• Published date: 01 June 2022
• Author: Andrew J. Dahl,James W. Peltier,George R. Milne
• Date: 01 June 2022
• DOI: http://doi.org/10.1111/joca.12447

RESEARCH ARTICLE

Reducing information asymmetry and

increasing health value co-creation in a rural

healthcare context

Andrew J. Dahl

1

| James W. Peltier

1

| George R. Milne

2

1

College of Business and Economics,

Marketing, University of Wisconsin-

Whitewater, Whitewater,

Wisconsin, USA

2

Isenberg School of Management,

University of Massachusetts Amherst,

Amherst, Massachusetts, USA

Correspondence

George R. Milne, George R. Milne,

University of Massachusetts Amherst,

Isenberg School of Management,

121 Presidents Drive, Amherst,

MA 01003, USA.

Email: milne@isenberg.umass.edu

Abstract

Digital platforms offer emerging opportunities for dis-

seminating information to improve decision-making,

motivate behavior changes, and enhance outcomes.

However, consumer-physician asymmetry and tradi-

tional service delivery principles create resource

utilization conflicts that may hinder health value co-

creation efforts. We address how expert service con-

textswithhighlevelsofinformationasymmetrymay

maximize value co-creation by encouraging con-

sumers' digital information usage to close the

consumer-physician information gap. Structural equa-

tion modeling of rural consumer surveys demonstrates

the ancillary value created by supporting consumers'

digital resource integration. The results identify how

physicians may increase rural consumers' co-creation

of health outcomes by helping consumers utilize digi-

tal information to facilitate their activation in value

co-creation. However, physicians and consumers first

need to share value perceptions of the digital inputs to

maximize consumers' resource integration and co-

creation efforts.

KEYWORDS

digital health, information asymmetry, information seeking,

resource integration, service-dominant logic, value co-creation

Received: 3 June 2021 Revised: 5 February 2022 Accepted: 12 February 2022

DOI: 10.1111/joca.12447

© 2022 American Council on Consumer Interests.

512 J Consum Aff. 2022;56:512–535.

wileyonlinelibrary.com/journal/joca

1|INTRODUCTION

Expert services often result in consumers having less knowledge than the service provider,

resulting in conditions of information asymmetry (Barile et al., 2014). Broadly, information

asymmetry exists in a service relationship when an information imbalance exists whereby one

party has more or better information than another (Akerlof, 1970). An extensive review by

Bergh et al. (2019) shows that reducing the information imbalance between service providers

and consumers is a key mechanism for reducing information asymmetry. Within the context of

healthcare, information imbalances are often due to the fact that physicians are the primary or

even the sole source of needed health and wellness insights (Dahl et al., 2018). Consumer-

physician information imbalance leads to misinformation and consumer (patient) failure to

adhere to evidence-based guidelines, contributing to issues that make preventative healthcare

more difficult to co-create (Gallan et al., 2019). Because of this information imbalance, con-

sumers commonly feel challenged when understanding their health, increasing their reliance

on physicians for comprehending prescribed pro-health behaviors (Singh et al., 2004).

Consumers who actively seek information outside of the consumer-physician relationship

are often overwhelmed with the amount and conflicting nature of health-related information

(Anderson et al., 2016; Kareklas et al., 2015). It is thus not surprising that for many consumers,

this resource integration process is complex and may minimize value co-creation efforts (Chen

et al., 2021; Virlée et al., 2020). One of our research aims is to examine mechanisms through

which consumers may narrow the consumer-physician information imbalance (Edvardsson

et al., 2011), and specifically through digital health information usage. Information asymmetry

reduction has been found to occur with increased use of digital communications (Gutiérrez-

Barroso et al., 2021; Manes & Tchetchik, 2018; Peltier et al., 2020). By facilitating consumers'

resource integration, physicians may help co-create positive outcomes on consumer well-being

via motivating consumers to engage in value co-creation efforts such as information seeking,

sharing, and cooperative behaviors (McColl-Kennedy et al., 2017).

Marketing scholars are beginning to investigate consumers' digital resource and information

usage behaviors and the resulting impact on value co-creation efforts (Peltier et al., 2020). Con-

sumers' health information seeking increasingly occurs via digital platforms beyond the service

provider's control (Dahl et al., 2021). For example, more than 141 million visits to WebMD.com

occur monthly (SimilarWeb, 2021), and Google receives over 70,000 health-related searches per

minute (Murphy, 2019). Despite its promise for improving health outcomes, consumers' digital

health information usage is not without controversy (Nunan & Di Domenico, 2019; Robertson

et al., 2014). While many healthcare providers feel confident about internally created informa-

tion, they often question the credibility of resources created and shared externally, leading to

integration conflicts and consumer-physician information asymmetry (Anderson et al., 2016).

Consequently, a major aim of the current study is to examine the mechanisms that consumers

utilize to judge the credibility and value of externally created digital health information

resources, and particularly those with perceived physician support.

The service-dominant (S-D) logic perspective offers insights for addressing asymmetry and

value co-creation within expert service contexts. S-D logic argues that consumers play a central

role in co-creating and defining service value (Vargo & Lusch, 2016). Consumers' resource inte-

gration efforts are more likely to maximize value co-creation when both the consumer and ser-

vice provider have a greater understanding of the decision-making context (Davey &

Grönroos, 2019). Consistent with the S-D logic perspective, value co-creation in a health ser-

vices context is contingent on four elements: (1) physician–consumer collaboration (Storbacka

DAHL ET AL.513