Date of Award

Spring 5-3-2015

Degree Type


Degree Name

Executive Doctorate in Business (EDB)


Computer Information Systems

First Advisor

Daniel Robey

Second Advisor

Patricia Gregory Ketsche

Third Advisor

Nathan Bennett


Spending on robot surgery is expected to increase by $17 billion in the next 6 years. This new surgical treatment has challenged hospitals with higher costs and varying performance. Healthcare executives struggle balancing the adoption of medical innovations with managing healthcare costs. This dilemma can be further complicated by industry structures relative to capital-intensive medical innovations. This research explores the interaction between industry structure and customer value. Specifically, how can hospitals apply an understanding of supplier industry structure and customer value to improve the value of a robotic surgery program (RSP)? This industry study represents an exhaustive longitudinal review of over 15 years of public data relative to robotic surgery, across three distinct time periods. Within the research, industry structure is evaluated using Porter’s 5-forces model. A framework based upon contributions from Grönroos as well as Menon, Homburg, and Beutin is introduced to assess customer value based upon clinical, financial and strategic (CFS) value. The implications of periodic industry structure on customer value were examined to identify opportunities for hospital executives to increase RSP customer value.

There were several empirical and theoretical findings from this research. First, in the face of increasing industry structure the identification of favorable forces may create opportunities to increase RSP value. Secondarily, exploring customer value through the lens of core, add-on, relational and transactional benefits in the sub-context of CFS value aids in the identification of market power influences on customer value. The implications of the absence of high levels of relational and transactional benefits without high levels of core and add-on benefits may influence avenues of pursuit in improving RSP value overall. The research also suggests that clinical and strategic value was present despite varying degrees of industry structure. Finally, this study represents an empirical joint analysis of industry structure and customer value in robotic surgery. Some proponents may find the introduction of an integrative model for measuring customer value in robotic surgery, applicable to other capital-intensive medical innovations or disruptive technologies at large.