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The gradual transition of health care toward businesses during the past 50 years has converted passive patients into active customers. In our digital society, patients increasingly use online health communities to satisfy complex needs that healthcare professionals leave unmet, including the creation of cure-oriented (i.e., functional) and care-oriented (i.e., emotion) value. This research investigates patients' reference frames (self versus other) as an information processing mechanism and their impact on value creation in online communities. The analysis of 1,687 online postings of a leading healthcare platform shows that self-referencing is typical for information obtained through an individualistic, patient-doctor encounter; other-referencing emerges when patients focus on the needs of their peers. Information gathered through the patient-doctor encounter and processed with a self-referencing frame accordingly enhances cure-related value, but limits care-oriented value co-creation. Other-referencing does exactly the opposite: it creates a barrier to cure-related value, but stimulates care-related value. A patient's experience with the community largely moderates the impact of both self- and other-referencing on cure- and care-related value. These findings show that online health communities can identify and address unmet patient needs, but healthcare professionals still play a critical role in terms of ensuring information quality in online health communities.

Purpose – The purpose of this paper is to develop a framework investigating patterns of online health communities. In particular, the study draws on coordination theory to identify four community configurations. Their distinct features determine communities’ capacity to internalize and externalize knowledge, which ultimately determines their value creation in a service context. Design/methodology/approach – The authors apply qualitative and quantitative techniques to detect similarities and differences in a sample of 50 online health communities. A categorical principal component analysis combined with cluster analysis reveals four distinct community configurations. Findings – The analysis reveals differences in the degrees of cognitive and affective value creation, the types of community activities, the involved patients, professionals, and other stakeholders; and the levels of data disclosure by community members. Four community configurations emerge: basic information provider, advanced patient knowledge aggregator, systematic networked innovator, and uncomplicated idea sharer. Research limitations/implications – The findings show that communities can be categorized along two knowledge creation dimensions: knowledge externalization and knowledge internalization. While, previous research remained inconclusive regarding the synergistic or conflicting nature of cognitive and affective value creation, the findings demonstrate that cognitive value creation is an enabler for affective value creation. The emerging configurations offer a classification scheme for online communities and a basis for interpreting findings of future services research in the context of online health communities. Originality/value – This research combines coordination theory with healthcare, service, and knowledge creation literature to provide a fine-grained picture of the components of online health communities. Thereby, inherent trade-offs and conflicts that characterize the components of coordination theory are investigated.