2564
Pricing Strategy of Online Knowledge Market
DQDOWHUQDWLYHWR¿QGLQJDQVZHUVE\WKHPVHOYHV
Therefore, the prices set by these consumers do
QRWSURSHUO\UHÀHFWWKHYDOXHRIWKHLUTXHVWLRQV
Nevertheless, for those consumers who utilize the
knowledge market to derive additional utilities,
their prices will be set according to Equation 5.
The more utility they expect to get, the higher
prices they will set. Following this rational, the
consumers on the knowledge market can be dif-
ferentiated into the following two categories:
• Spin-off information consumer: those who
are only interested in using the knowledge
PDUNHWDVDQDOWHUQDWLYHWR¿QGLQJLQIRUPD-
tion without value added to their utilities;
and
•
Mainstream knowledge consumer: those
who utilize the knowledge market to acquire
knowledge to derive additional utilities.
As we have assumed, the additional utility is
UHODWHGZLWKWKHGLI¿FXOW\q
m
of the question, so
DPRUHGLI¿FXOWTXHVWLRQZLOOJLYHDFRQVXPHU
more additional utility, which, however, is only
applicable to mainstream knowledge consumers,
but not to spin-off consumers, because there is no
additional utility attached to their questions no
PDWWHUKRZGLI¿FXOWWKH\DUH,QIDFWWKHKLJKHVW

price that a spin-off consumer with the skill level
s
j
is willing to pay for the answer of a question m
is just c(s
j
, q
m
), whereas a mainstream consumer
with the same skill level will be willing to pay
an amount higher than c(s
j
, q
m
) as long as he(she)
may derive additional utility from the answer of
his(her) question.
The existence of the spin-off consumers has
some negative effects on the knowledge market
EHFDXVHSULFHVGRQRWUHÀHFWWKHLUWUXHYDOXHVDV
they just post their questions by offering a very
low price. As a former researcher of Google An-
swers, West (2002) made the similar observations
DVIROORZV³2IWKHTXHVWLRQV,SLFNHGVRPHIHOO
in my areas of expertise—technical support is-
sues, historical facts, etc.—and some were just
plain odd. One person offered a few bucks for
someone to tell him a joke he hadn’t heard be-
fore. Another wanted psychic advice, or barring
that, a humorous reply. People used the service

as an impromptu temp agency, offering a few
dollars for someone to test drive a Web site or to
make business appointments for them. While the
service was intended to offer answers to factual
questions, people tried to push the envelope any
way they could.”
Although the group of spin-off consumers
seems to cause some problems to the knowledge
PDUNHW LW PD\ DOVR EHQH¿W WKH ¿UP WR UHWDLQ
some of them for several reasons. First of all,
spin-off consumers are usually those who keep
abreast of the state-of-art technologies and new
SKHQRPHQD7KH³ZRUGRIPRXWK´HIIHFWWKURXJK
spin-off consumers can bring more customers to
the market. Second, network effects require the
¿UPWRDWWUDFWPRUHTXHVWLRQVWRWKHNQRZOHGJH
market so that more consumers may be enticed
WR SDUWLFLSDWH LQ WKH ³DVNLQJDQGDQVZHULQJ´
process. Third, maintaining a certain volume of
questions on the knowledge market may alleviate
the malicious competition among researchers.
Therefore, it is also necessary to welcome some
spin-off consumers on the knowledge market.
Minimal and Maximal Posting Prices
In this subsection, we analyze the purpose of the
¿ U P V S HF L I \ LQ J WK H PL Q L PD OD QG P D[ L P DO S R VW LQ J
prices on the knowledge market.
First of all, designating a minimal posting
price has two effects on the knowledge market.
The next proposition illustrates the effect of a

minimal posting price on the spin-off consumers
of the knowledge market.
Proposition 3: A spin-off consumer j will not post
his(her) question m on the knowledge market if
the minimal posting price
p
VSHFL¿HGE\WKH¿UP
is greater than c(s
j
, q
m
).
2565
Pricing Strategy of Online Knowledge Market
Proof:,IWKH¿UPVSHFL¿HVDPLQLPDOSRVWLQJSULFH
as
p
, then a spin-off consumer’s expected payoff
by posting a question m is
S
c
= (u – c(s
j
, q
m
)) + [c(s
j
, q
m
) – p](1 –

ˆ
i
k
),
whose second term is positive and decreasing in
p when p < c(s
j
, q
m
) and negative when p > c(s
j
,
q
m
). Therefore, the consumer will post a question if
the minimal posting price
p
c(s
j
, q
m
). Otherwise,
he(she) is better off by not posting the question
RQWKHNQRZOHGJHPDUNHW Ŷ
7KHDERYHSURSRVLWLRQLPSOLHVWKDWWKH¿UP
can specify the minimal posting price
p
on the
knowledge market to reduce the proportion of
spin-off consumers. Given the minimal posting

price
p
VSHFL¿HGE\WKH¿UPLWFDQEHLQIHUUHG
that spin-off consumers with the skill level s
j

s
j
w i l l n o t b e s e r v e d o n t h e k no w le d ge m a r k e t , w h e r e
c(
s
j
, q
m
) =
p
, and
s
j
(
p
) is the threshold skill level
for the minimal posting price. The minimal post-
ing price
p
determines the proportion of spin-off
consumers to be served on the knowledge market.
:KHQWKH¿UPLQFUHDVHVWKHPLQLPDOSRVWLQJ
price
p

, the threshold skill level
s
j
(
p
) decreases,
so more spin-off consumers will be eliminated
from the knowledge market.
In addition to its effect on the spin-off con-
sumers, the minimal posting price also affects the
mainstream consumers, but in a different way. The
next proposition summarizes this effect.
Proposition 4: All the mainstream consumers will
be served by the knowledge market no matter what
DPLQLPDOSRVWLQJSULFHLVVSHFL¿HG,QDGGLWLRQ
for a minimal posting price
p
, those mainstream
consumers with the skill level s
j
<
I
j
s
(
p
)will be
mandated to price their questions at
p
, where

the skill level
I
j
s
(
p
) of mainstream consumers is
determined by
ˆ
() 1
1
() ( () )
i
I
jm
i
p
pu
k
pucspq p
k
ww
c
'


'  
ˆ
Proof:)RUTXHVWLRQVZLWKWKHGLI¿FXOW\W\SHDV
q

m
, mainstream consumers with the skill level s
j
<
I
j
s
(
p
) will price their questions at
p
, where the
threshold skill level
I
j
s
(
p
) of consumers is from
() 1
1
() ( () )
i
I
jm
i
p
pu
k
pucspq p

k
ww
c
'


'  
ˆ
+RZHYHUDVXI¿FLHQWFRQGLWLRQIRUDOOWKHFRQVXP-
ers with the skill level s
j
(0,
I
j
s
(
p
)] to remain served
by the market is
P
j
s
(
p

I
j
s
(
p

), where the threshold
skill level
P
j
s
(
p
) is determined from
p
= U(
p
)'u+c(
P
j
s
(
p
), q
m
).
This is to ensure that all the mainstream consum-
ers with the skill level s
j
(0, s
j
(
p
)] have positive
surpluses by posting their questions with the
minimal price

p
on the market. By comparing the
WZRWKUHVKROGVNLOOOHYHOVLWLVQRWGLI¿FXOWWRVHH
that consumers who are mandated to price their
questions at the minimal posting price always
have positive surpluses. First, it can be seen that
at the minimal posting price, a customer whose
skill level is
I
j
s
(
p
) always has a positive surplus
because the maximal price for the skill level
I
j
s
(
p
)
to have a positive surplus is greater than
p
. Sec-
ond, for a consumer with the skill level s
j
<
I
j
s

(
p
),
the maximal price for him(her) to have a positive
surplus is greater than that for the skill level
I
j
s
(
p
), which is certainly greater than
p
 Ŷ
The above two propositions suggest that less
s k i l l f u l c on s u m e r s , e i t he r s pi n - of f o r ma i n s t r e a m
consumers, are generally less sensitive to the
PLQLPDOSRVWLQJSULFHVSHFL¿HGE\WKH¿UPIRU
the knowledge market. For spin-off consumers,
the maximal price they are willing to pay to
obtain a positive surplus from the market is c(s
j
,
q
m
), which decreases in the consumer’s skill level.
For mainstream consumers, their maximal price
for a positive surplus is determined from
p

= U(

p

)'u + c(s
j
, q
m
), where
p

also decreases in the skill
level s
j
. Therefore, a less skilled consumer for the
2566
Pricing Strategy of Online Knowledge Market
knowledge market always has a larger support
of price than a more skilled one. Intuitively, this
result directly relates to our assumption that a less
VNLOOHGFRQVXPHULQFXUVDKLJKHUFRVWIRU¿QGLQJ
an answer to the question by himself(herself)
than a more skilled one. Therefore, a less skilled
consumer is willing to pay more for answers to
his(her) question.
In summary, by specifying a minimal posting
price
p
IRUWKHNQRZOHGJHPDUNHWWKH¿UPFDQ
eliminate some spin-off consumers and mandate
some mainstream consumers to increase their
posting prices to

p
. The reduced proportion of
spin-off consumers on the knowledge market is
thus
s
j
(
p
) J, where J is the original estimated
proportion of spin-off consumers.
Having described the effects of the minimal
SRVWLQJSULFHZHQH[WWXUQWRDQDO\]HWKHLQÀX-
ence of a maximal posting price on the knowledge
market. As we have illustrated, the existence of
spin-off consumers is due to the fact that some
consumers do not derive additional utilities from
the market ('u = 0), so that the term U(p)'u is
reduced into zero and a consumer’s additional
surplus from the market ([c(s
j
, q
m
) – p] – (1 –
ˆ
i
k
))
becomes a decreasing function of price p. In ad-
dition to the effect of the additional utilities 'u,
the probability function U(p) also has the similar

effect when U(pĺ:KHQDFRQVXPHUUHDOL]HV
that the probability function has such property
that when p
*

ˆ
p
, U(p) = 1, and U'(p) = 0, he(she)
will price his(her) question at
ˆ
p
instead of p
*
when p
*
>
ˆ
p
. Suppose a consumer is not aware of
this property of the probability function, he(she)
will still set a very high price p
*
for his(her)
question. The consumer’s total surplus in this
situation will be
U
c
= (u – c(s
j
, q

m
)) + [U(p
*
)'u +
c(s
j
, q
m
) – p](1 –
ˆ
i
k
(p
*
))
§u – c(s
j
, q
m
)) + ['u + c(s
j
, q
m
) – p](1 –
ˆ
i
k
(p
*
)).

Since we know that U(p§ when p [
ˆ
p
, p
*
),
then the consumer will be better off by setting
his(her) price at
ˆ
p
, which barely reduces his(her)
utility but increases the probability for his(her)
question to be answered.
Therefore, by announcing a maximal posting
SULFHWKH¿UPLPSOLFLWO\LQIRUPVFRQVXPHUVRI
the boundary price
ˆ
p
so that they will be better
RII,QDGGLWLRQWKH¿UPZLOODOVREHEHWWHURII
which is shown in the following proposition.
Proposition 5:7KH¿UPLVEHWWHURIIE\VSHFLI\LQJ
a maximal posting price
ˆ
p
such that when all p
*
>
ˆ
p

,
ˆ
i
k
(p
*
ĺ.
Proof:7KH¿UP¶VQHWEHQH¿WIRUDSRVWHGTXHV-
tion m is
S
m
(p
*
) = (1 – D) p
*
(1 –
ˆ
i
k
(p
*
)).
,QVWHDGLIWKH¿UPVHWVDPD[LPDOSRVWLQJSULFH
as
ˆ
p
that is greater than p
*
WKHQWKH ¿UP¶VQHW
EHQH¿WIRUWKLVTXHVWLRQPZLOOEH

S
m
(
ˆ
p
) = (1 – D) p (1 –
ˆ
i
k
(p))
It can be observed that S
m
(p
*
ĺZKHQ
ˆ
i
k
(p
*
)
ĺ  7KHUHIRUH WKH ¿UP ZLOO EH EHWWHU RII E\
specifying a maximal posting price
ˆ
p
such that
S
m
(
ˆ

p
) > S
m
(p
*
) Ŷ
,QVXPPDU\WKHVSHFL¿HGPD[LPDOSRVW-
ing price not only may increase a mainstream
FRQVXPHU¶V VXUSOXV EXW DOVR PDNHV WKH ¿UP
better off.
Firm’s Optimal Decisions
)ROORZLQJRXUSULRUGLVFXVVLRQVWKH¿UPVKRXOG
now determine the appropriate allocation to
UHVHDUFKHUVEDVHGRQWKHVSHFL¿HGPLQLPDODQG
maximal posting prices on the knowledge market,
LQRUGHUWRPD[LPL]HLWVWRWDOH[SHFWHGSUR¿W
7KHUHIRUHWKH¿UP¶VGHFLVLRQSUREOHPFDQEH
formulated as
2567
Pricing Strategy of Online Knowledge Market
1234
[]
m
q
max E 
(7)
where
() 1
1
0()

(1 ) ( ) ( )
j
i
p
s
ii jj
p
k
pgkdkfsds
ªº
«»
«»
¬¼
 
³³
ˆ
() 1
2
0()
(1 ) (1 ) ( ) ( )
I
j
i
sp
ii jj
p
k
pgkdkfsds
ªº
«»

«»
¬¼
  
³³
ˆ
() 1
3
() ( )
(1 ) (1 ) ( ) ( )
j
I
j
i
p
s
ii jj
sp p
k
pgkdkfsds

ªº

«»
«»
¬¼
  
³³
ˆ
ˆ
ˆ

ˆ
11
4
() ()
(1 ) (1 ) ( ) ( )
j
i
ii jj
pp
s
k
pgkdkfsds
ªº
«»
«»
¬¼
  
³³
ˆ
ˆ
ˆ
ˆ
$VVKRZQLQ)LJXUHWKH¿UP¶VWRWDOSUR¿W
FR Q VL V W V RI IRX UF RP S RQH QW V7 KH¿ U VWF RPS RQH QW
S

LVWKHSUR¿WIURPWKHUHPDLQLQJVSLQRIIFRQ-
sumers by specifying the minimal posting price
p
, in which J is the initial proportion of spin-off

consumers on the knowledge market. The second
LVWKHSUR¿WIURPPDLQVWUHDPFRQVXPHUVZLWKWKH
minimal posting price; the third is from main-
stream consumers who set their optimal prices
in between the minimal and maximal posting
prices; and the fourth is again from mainstream
consumers who are forced to have their questions
priced at the maximal level
ˆ
p
.
According to our previous analysis, when
WKH¿UPLQFUHDVHVWKHPLQLPDOSRVWLQJSULFH
p
and decreases the maximal posting price
ˆ
p
,
s
j
(
p
) decreases,
I
j
s
(
p
) increases, and
s

ˆ
j
(
ˆ
p
) decreases.
Therefore, less consumers will be able to price
their questions at their optimal ones p
*
and more
mainstream consumers will price their questions
at either the minimal or maximal price, while
mo re spi n- of f con su me rs wi ll be el im inat ed f rom
WKH PDUNHW 7KHUHIRUH WKH ¿UP PD\ UHJXODWH
the knowledge market by designating different
minimal and maximal posting prices.
'XHWRWKHFRPSOH[QDWXUHRIWKH¿UP¶VPD[L-
mization problem, the closed-form solution of D
is not available. However, Table 2 demonstrates
KRZWKHSUR¿WVWUXFWXUHRIHDFKFRPSRQHQWZLOO
change when the allocation D to researchers in-
FUHDVHVZKLFKJLYHVWKHLQWXLWLRQIRUWKH¿UPWR
practically assign the allocation D. Essentially,
WKH¿UPKDVWREDODQFHWKHWUDGHRIIEHWZHHQWKH
gross revenue of each question and the payment
to researchers; by increasing the allocation to
UHVHDUFKHUVWKH¿UPPD\LQFUHDVHWKHWRWDOJURVV
revenue from each question, but may have to al-
locate more to researchers.
7KH¿UP¶VSUR¿WDOVRFKDQJHVZLWKWKHLQLWLDO

proportion of spin-off customers on the knowledge
market. As the example to show the intuition,
we investigate the following special case. If we
consider that all the questions posted on the
knowledge market are homogeneous with respect
WRWKHLUGLI¿FXOWLHVEXWKHWHURJHQHRXVLQWHUPVRI
their originators, and when JĺRUDOPRVWDOO
the consumers belong to the spin-off type, the
¿UP¶VSUR¿WZLOOEHFRPH
)LJXUH7KH¿UP¶VSUR¿W)RXUFRPSRQHQWV
Mainstream
consumers
Spin-off
consumers
eliminated
1
()p
()
j
sp
2
()p
3
(*)p
4
()p
ˆ
()
I
j

sp
()
j
sp
ˆˆ
2568
Pricing Strategy of Online Knowledge Market
() 1
0()
(1 ) ( ) ( )
j
i
p
s
ii jj
p
k
pgkdkfsds
ªº
«»
«»
¬¼

³³
(1 ) (1 ( )) ( )
j
i
ppp
s
k

   
ZKRVH ¿UVWRUGHU FRQGLWLRQ ZLWK UHVSHFW WR D
yields
()
1
11()
i
i
p
k
p
k
ww
 

which indicates that there exists an optimal
proportion for a given minimal posting price
p
because the LHS of the above equation increases
and the RHS decreases in D. In addition, when
WKHVSHFL¿HGPLQLPDOSRVWLQJSULFH
p
increases,
the threshold knowledge level
ˆ
i
k
(
p
) increases and


ˆ
i
k
(
p
D decreases, resulting in a larger optimal
allocation D. This implies that when the majority
of consumers are not serious about the knowledge
PDUNHWRUEHORQJWRWKHVSLQRIIW\SHWKH¿UP
s h o u l d a l lo ca t e m o r e t o r e se a r c h e r s w h e n i t t r i e s t o
eliminate more spin-off consumers by increasing
the minimal posting price. Intuitively, when there
are less spin-off consumers on the knowledge
market, researchers deserve more from answer-
ing each question.
CONCLUSION
The development of Web and information tech-
nologies provides real-time access for people to
seek and acquire information and knowledge from
online sources. Viewing knowledge transaction as
WKHQHZSUR¿WPDNLQJRSSRUWXQLW\FRPSDQLHVDUH
trying to set up online marketplaces for potential
knowledge buyers and sellers to meet and thereby
make transactions.
Based on the best practice from Google
Answers, we present an analytical model of an
online knowledge market, where knowledge re-
searchers and consumers trade knowledge. The
¿UPPDLQWDLQVWKHRQOLQHNQRZOHGJHPDUNHWDQG

charges fees for all the questions that have been
answered. We analyze the pricing strategies from
ERWKFRQVXPHUV¶DQGD¿UP¶VSHUVSHFWLYHV
First, a consumer’s optimal strategy to price
his(her) question is studied. Based on whether
the knowledge market is used to derive additional
utilities, two types of consumers on the market
can be differentiated. Spin-off consumers utilize
the knowledge market just to quickly retrieve
information without any additional utilities.
Compo-
nent
Organi-
zational
proportion
Selling
price
Mar-
ket
share
Probability of
questions being
answered
ʌ
1
decrease same Same increase
ʌ
2
decrease same de-
crease

increase
ʌ
3
decrease increase in-
crease
increase
ʌ
4
decrease same in-
crease
increase
7DEOH&KDQJHVRISUR¿WVWUXFWXUHZLWKUHVSHFWWRDOORFDWLRQD
2569
Pricing Strategy of Online Knowledge Market
%HFDXVHSULFHVGRQRWUHÀHFWWUXHYDOXDWLRQVRI
their questions, spin-off consumers always price
their questions as low as possible. Mainstream
consumers use the knowledge market to acquire
knowledge to obtain additional utilities. Mostly,
the more utilities they expect to get, the higher
they will be prepared to pay for an answer of their
questions. In addition, a more knowledgeable
consumer tends to set a higher price for his(her)
question.
Second, the purpose of specifying the mini-
mal and maximal posting prices on the market
is analyzed. Basically, the minimal posting price
is used to control the proportion of spin-off
consumers on the market so that the negative ef-
fects of spin-off consumers on the entire market

can be alleviated. The maximal posting price is
used to improve the welfare of both mainstream
FRQVXPHUVDQGWKH¿UP%\VSHFLI\LQJGLIIHUHQW
PLQLPDODQGPD[LPDOSRVWLQJSULFHVWKH¿UPFDQ
effectively moderate the structure of the online
knowledge market.
Finally, the firm’s optimal allocation to
researchers is investigated. Contingent on the
VSHFL¿HGPLQLPDODQGPD[LPDOSRVWLQJSULFHV
WKH ¿UP¶V SUR¿W FDQ EH FDWHJRUL]HG LQWR IRXU
components. When the allocation to researchers
F K DQ J HV  WK H¿ U P¶V S UR ¿ W V W U X F WX UH FK DQ JH VD VZ H O O 
Essentially, the increased allocation to researchers
improves the gross revenue from each question
RQWKHPDUNHW7KHUHIRUHWKH¿UPKDVWREDODQFH
the tradeoff between its payment to researchers
DQGLWVLQFUHDVHGEHQH¿WLQRUGHUWRFKRRVHWKH
best allocation to researchers.
This study serves as our initial attempt to
fully understand the pricing mechanism on the
NQRZOHGJHPDUNHW'XHWRWKHGLI¿FXOWLHVRIRE-
taining researchers’ data from Google Answers,
the empirical validation of our analytical results
is still in preparation. We plan to conduct a de-
tailed analysis to not only verify the results in
this research, but also make extensions to reveal
more hidden facts on knowledge marketplaces. In
addition, future study may also include network
effect in the model and explore the variations of
pricing strategies on the knowledge market.

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This work was previously published in the International Journal of E-Business Research, edited by I. Lee, Volume 4, Issue 1,
pp. 55-68, copyright 2008 by IGI Publishing (an imprint of IGI Global).

2571
Copyright © 2009, IGI Global, distributing in print or electronic forms without written permission of IGI Global is prohibited.
Chapter 8.13
Evolving E-Health System
Symbiosis:
Theoretical Constructs in International
Realpolitik Space
Denis H. J. Caro
Université d’Ottawa, Canada
ABSTRACT
The 21
st
century continues to witness the trans-
formation of organizational systems globally
through the deployment of information and com-
munication technologies (ICT). The emerging
IXWXUHLVZLWQHVVLQJWKHFRQYHUJHQFHRIDUWL¿FLDO
intelligence, biotechnology, nomadic informa-
tion systems, and nano-technology. This prom-
ises to further compel inter-organizational and
inter-sectorial interactive transformations. The
health care sector is no exception to the inter-
organizational dynamic imperatives driven with
ICT innovative advances. This article proposes a
conceptual model of symbiotic e-health networks
in a meta-cultural domain that goes beyond the
realm of extant literature on dyadic relation-
ships. The model dimensions are posited on a
key informant approach and content analysis of
the strategic perceptions of international ICT and

health care executives interacting through dyadic
SDUWQHUVKLSV 7KH ¿QGLQJV DQG LPSOLFDWLRQV RI
the study for the model and further information
management research are underscored. The un-
derlying meta-cultural frame is characterized by
public governance values and the article explores
its perceived role in sustaining symbiotic e-health
networks in Canada and Sweden.
INTRODUCTION
The 21
st
century continues to witness the transfor-
mation of organizational systems globally through
information and communication technologies
(ICT), which drive and evolve systemic goals.
The implementation of ICT, such as business in-
telligence systems, knowledge management, data
mining and warehousing, supply chain manage-
ment, systems development and implementation,
systems integration, and security systems continue
to compel different sectors to engage in chal-
2572
Evolving E-Health System Symbiosis
lenging inter-organizational relationships (Senge,
Carstedt, & Porter, 2001). With the cogent and ub
iquitous
developments in nomadic information systems and
wireless and wearable technologies, the emerging
IXWXUHLVZLWQHVVLQJWKHFRQYHUJHQFHRIDUWL¿FLDO
intelligence, biotechnology, and nano-technology

(Orlikowski & Iacono, 2001; Pearson, 2001). This
promises to further propel inter-organizational
and inter-sectorial interactions. Strategic dyadic
partnerships, with its characteristics of longev-
ity, management control and direction, mutual
EHQH¿FHQFH DQG VWDELOLW\ H[HPSOLI\ RQH W\SH
inter-organizational relationship. The literature
underscores the critical role of strategic inter-
VHFWRULDO SDUWQHUVKLSV LQ IRVWHULQJ HI¿FLHQFLHV
sectorial growth, and social actualization through
innovation and mutual organizational learning
(Burgelman & Doz, 2001; Etemad, Wright, &
Dana, 2001; Kodama, 2001; Nooteboom, 2000;
Oliver, 2001; Robinson, Savage, & Campbell,
2003). These linkages have the potential to liberate
thinking beyond closed organizational paradigms
and embrace complex changes and uncertainty
extra-organizationally and proactively (Dickson,
Farris, & Verbeke, 2001).
The health care sector is no exception to the
inter-organizational change imperatives driven
through ICT innovative advances. Regionally
integrated e-health networks promise less re-
source duplication, lower operational costs,
reduced clinical waiting times, and lengths of
stay and greater quality care in the face of care
provider and clinician shortages. E-health is the
t ra nsfor mat ion al wave of t he f ut u re i n healt h ca re
systems (Adewale, 2004; Gutierrez, 2001; Sahney,
2003). The upcoming generation of consumers

and providers instinctively understand the trans-
formational power of ICT to improve delivery
HI¿FLHQFLHVDQGTXDOLW\RIKHDOWKFDUHUHJLRQDOO\
through inter-organizational interactions. On the
basis of extant literature, this article proposes a
conceptual model of symbiotic e-health networks.
The model dimensions are posited on a key infor-
mant approach and content analysis of the strategic
perceptions of international ICT and health care
executives interacting through dyadic partner-
VKLSV7KH¿QGLQJVDQGLPSOLFDWLRQVRIWKHVWXG\
underscore directions for future international
research in information management.
INTER-SECTORIAL
DYADIC RELATIONSHIPS:
GENERIC AND
THEORETICAL PERSPECTIVES
This article posits that strategic partnerships and
alliances are, in essence, symbiotic information
networks. These are, in essence, mutually advan-
tageous inter-organizational systems between
informational cultures differing in values, mis-
sions, perceptions, and evolutions. Moreover,
these informational cultures incubate and thrive
in informational cultural polities, which are ar-
ticulated through the governance organizations.
Networks are systems of interconnected individu-
als and organizations through which informational
DQGUHVRXUFHVÀRZ)RUG:HOOV%DLOH\
These networks interact and coalesce through an

exchange of informational, relational, and trans-
actional capital, and sustained through transac-
tional and transformational processes. Moreover,
these processes are articulated through skills sets
exercised through system participants, called
executives. Tight coupling of different sectors
occurs when relational capital and transactional
capital is leveraged through transactional and
transformational skill sets. Where the capital and
process resources are inadequate, a supra-level
(governance agents) foster and leverage evolving
symbiotic information network. Symbiotic infor-
mation networks are the result of the interplay of
management and technical processes.
The extant literature on strategic partnerships
and alliances is germane to the evolution of inter-
sectorial symbiotic information networks that
incubate in meta-cultural information domains. In
so doing, the article subsumes a realist approach,
2573
Evolving E-Health System Symbiosis
rather a strictly positivistic, or phenomenological,
one to the exploration of inter-sectorial networks
(Stiles, 2003). It responds to the call for a polity
system perspective, where social-political ele-
PHQWVLQÀXHQFHLQWHUVHFWRULDOQHWZRUNEHKDYLRU
and integrate elements of trust within economic,
political, socio-cultural and strategic dimensions.
0RUHRYHUWKHXQGHUO\LQJPRGHOUHÀHFWVDSOXUDO-
ist epistemology, where the emphasis is on an

XQGHUVWDQGLQJ ³RIWKHEHFRPLQJ´ GH 5RQG 
Bouchikhi, 2004). Moreover, it views the orga-
nizational and national cultures as heterogeneous
elements that interact dialectically and dynami-
cally in the evolution of information networks
(Townsend, 2003).
The literature points to management control
factors that implicitly form the basis for effec-
tive inter-sectorial strategic dyadic partnerships
(Dyer, Prashant, & Singh, 2001; Judge & Ry-
man, 2001; Weech-Maldonado & Merrill, 2000).
Such elements include leadership with executive
vision, solid strategic and operational planning
constructs, rigorous feasibility studies and cost-
EH QH¿WD QDO\ VH V V W D EOH¿ QDQFL QJW K URX J KDU D QJH
RILQQRYDWLYHDQGÀH[LEOH¿QDQFLDOLQVWUXPHQWV
DQG VSHFL¿F SHUIRUPDQFH PHWULFV DQG WDUJHWV
Other extant elements to effective inter-sectorial
dyadic links, or strategic partnerships, include
the mutual understanding of business models,
motivations, priorities, resource strengths, and
OLPLWDWLRQVWKHFOHDUDQGH[SOLFLWGH¿QLWLRQRI
PXWXDOEHQH¿WVH[SHFWDWLRQVDQGSULRULWLHV
DQGWKHPXWXDOVKDULQJRI¿QDQFLDODQGSROLWLFDO
risks (Das & Teng, 2001). Structural bonding
(economic and functional factors that involve
H[SOLFLWEHQH¿WVDQGVRFLDOERQGLQJHPRWLRQDO
and affective resources) are the prerequisites to
relationship cohesion (Rodriquez, 2002). Mutual
t r u s t , o r r e l a t i o n a l c a p i t a l , f o s t e r s a c l i m a t e o f g o o d

faith and open collaboration in forging congruent
goals and objectives.
Perception, mutuality, trust, and understanding
are the drivers of organizational system behaviour.
This points to the critical need to understand the
inter-sectorial cultural and organizational cli-
mates. Zhu’s Wu-Shi-Ren (WSR) Li-stage model
underscores the perspectives, sensing and the
psycho-cognitive elements (Shi-Li) which interact
synergistically with socio-political elements or
power structures (Ren-Li) to release technical ICT
UHVRXUFHV:X/LIRUFHV=KX³6HQVLQJ
DQGFDULQJ´WUDQVIRUPWKH³NQRZLQJ´=KX
This study explores inter-sectorial informational
networks transcending national cultural contexts.
It extends Zhu’s WSR-Li framework into the
Realpolitik of e-health systems transnationally.
In particular, the proposed model in this study
FHQWHUV RQ ¿YH V\PELRWLFLQIRUPDWLRQ QHWZRUN
dimensions, which are not explicitly reported in
the extant literature.
1. Relational capital (Shi-Li) dimension: The
extent to which inter-sectorial executives
harmonize perceptions, values and motiva-
WLRQVLQDQDWPRVSKHUHRIWUXVWDQGEHQH¿W
to effect symbiotic information networks;
2. Transactional capital (Wu-Li) dimension:
The extent to which inter-sectorial execu-
tives effectively avail and access strategic
resources to effect symbiotic information

networks;
3. Transactional skills (Ren-Li) dimension:
The extent to which inter-sectorial execu-
tives mobilize internal power resources to
effect symbiotic information networks;
4. Transformational skills (Ren-Li) dimen-
sion: The extent to which inter-sectorial
executives exercise vision and strategic
leadership to effect external symbiotic in-
formation networks; and
5. Supra-network transgenic (Supra-Ren-
Li) dimension: The extent to which external
third parties engage, enable, and sustain
symbiotic information networks through
transactional capital and fostering transfor-
mational skills externally.