Heidi Carin Dreyer

Background: There is a consensus among healthcare providers, academics, and policy-makers that spiraling demand and diminishing resources are threatening the sustainability of the current healthcare system. Different telemedicine services are seen as potential solutions to the current challenges in healthcare. This paper aims to identify how distance monitoring services rendered for patients with chronic conditions can affect the escalating demand for healthcare. First, we identify how distance monitoring service changes the care delivery process using the lens of service cocreation. Next, we analyze how these changes can impact healthcare demand using the literature on demand and capacity management. Method: In this qualitative study, we explore a distance monitoring service in a primary healthcare setting in Norway. We collected primary data from nurses and general physicians using the semi-structured interview technique. We used secondary patient data collected from a study conducted to evaluate the distance monitoring project. The deductive content analysis method was used to analyze the data. Result: This study shows that the application of distance monitoring services changes the care delivery process by creating new activities, new channels for interaction, and new roles for patients, general physicians, and nurses. We define patients’ roles as proactive providers of health information, general physicians’ roles as patient selectors, and nurses’ roles as technical coordinators, data workers, and empathetic listeners. Thus, the co-creation aspect of the service becomes more prominent demonstrating potential for better management of healthcare demand. However, these changes also render the management of demand and resources more complex. To reduce the complexities, we propose three mechanisms: foreseeing and managing new roles, developing capabilities, and adopting a system-wide perspective. Conclusion: The main contribution of the paper is that it demonstrates that, although distance monitoring services have the potential to have a positive impact on healthcare demand management, in the absence of adequate managerial mechanisms, they can also adversely affect healthcare demand management. This study provides a means for practitioners to reflect upon and refine the decisions that they make regarding telemedicine deployment and resource planning for delivering care.

Purpose: The purpose of this paper is to investigate the impact of sharing and utilizing remaining shelf life (RSL) information from grocery stores by the use of age-based replenishment policies for perishables. Design/methodology/approach: The performance is evaluated through a discrete event simulation model, which mirrors a part of one of Norway’s largest grocery retailer and uses their POS data to reflect a realistic demand pattern of 232 stores for one year. Findings: The findings indicate that a current age-based replenishment policy (EWA policy) provides a significant improvement of 17.7 percent increase in availability for perishables with a shelf life between 4 and 11 days, but suffers from high inventory levels and only reduces waste by 3.4 percent compared to a base stock policy. A proposed adjustment to the EWA policy, EWA_SS, provides a more balanced performance in the conducted study with a reduction of 10.7 percent waste and 10.3 percent increase in availability by keeping the same average inventory level. Practical implications: Sharing and utilizing RSL information for replenishment of perishables with a predetermined shelf life between 6 and 11 days can be beneficial, and could enable the replenishment processes to be automated. However, for products with longer shelf life, the benefits slowly diminish. Originality/value: The study proposes a new age-based replenishment policy which in the conducted study showed a more balanced performance improvement, in both waste and availability, compared with previous replenishment policies.

Purpose: The purpose of this paper is to investigate the application of Lean Six Sigma (LSS) in the continuous process industry, taking an insight into the food processing industry; and to evaluate the impact of LSS on environmental sustainability. The authors present observations and experiences from the application of LSS at a Norwegian dairy producer, with the aim of bringing out pertinent factors and useful insights that help us to understand how LSS can contribute toward greater environmental sustainability in this industry type, something that is so far lacking in the extant literature.Design/methodology/approach: The authors adopt a single, longitudinal field study approach as we observe an entire cycle of the VSM-DMAIC (value stream mapping-define, measure, analyze, improve and control) LSS process, which evolved over a six-month period at the dairy.Findings: The authors highlight some of the important elements that should be considered when using LSS as a contributor toward greater environmental sustainability in fresh-food supply chains. The authors also present some of the specific outcomes and key success criteria that became apparent to the implementation team following the deployment of the VSM-DMAIC approach.Originality/value: The authors demonstrate how LSS can be applied in the food processing industry as a contributor to greater environmental sustainability. The authors also make useful reflections regarding the success criteria that can be used by researchers and practitioners for the effective deployment of such an approach, particularly in the continuous process industry.

Despite strong market interest in speciality foods, producers find market access and distribution challenging. This exploratory research includes a literature review and five case studies of supply chains relating to shellfish, cheese, meat, potato and miscellaneous speciality foods in the mid-Norway region. The study identifies key supply chain configuration parameters from the extant literature, and these are used to analyse the cases. The study makes three main contributions to the literature: an analytical framework for analysing the supply chain characteristics of speciality foods; important supply chain factors for accessing the conventional food supply chain; and five propositions for improving market access. We argue that the speciality foods supply chain should be configured according to these propositions to ensure responsiveness to customer needs and to strengthen market access.