Martina Pisarra
University of Milan, Italy

Abstract:

Digitalization is transforming service delivery and fostering greater citizen engagement. Building on the concepts of digital co-production and digital accountability, the study examines how digital public services shape data production and information use, ultimately influencing new forms of accountability. It develops a conceptual framework, which is empirically tested through an embedded case study of three multispecialty public hospitals in Sweden. The findings show that patient engagement extends beyond service delivery to the co-production of data. These data, collected via digital platforms, are multidimensional, encompassing quality of life and patient experience alongside clinical outcomes, resulting in the generation of high-volume, timely information. Digital engagement further manifests in the co-use of information, as patients participate in decision-making with doctors and become empowered actors in their care. This shift in responsibility and control challenges traditional hierarchical and vertical accountability models, which are primarily based on financial metrics, and opens opportunities for more horizontal and interactive approaches. The analysis also highlights potential obstacles to this transformation, including technical challenges such as skill requirements and social barriers, such as misalignments between institutional priorities and the value creation potential of digital services, which may undermine advances in digital accountability.

Martina Pisarra recently earned her PhD in Management and Innovation from the Università Cattolica del Sacro Cuore in Milan, with a thesis entitled “New Frontiers of Accountability in the Public Healthcare Sector: Exploring the Role of Non-Financial Reporting and Digitalization”. She is currently a research fellow at the University of Milan, where she has collaborated for eight years on research projects in healthcare management. Her works focus on performance management, non-financial reporting, and stakeholder engagement, with a particular interest in value co-creation and digitalization, in the public sector, especially healthcare. Martina has gained international experience, including as a visiting researcher at the Adam Smith Business School, University of Glasgow and at the Karolinska Institutet of Stockholm, and as seminar speaker hosted by the Edinburgh Business School.