3 steps ahead strategy

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3 STEPS AHEAD from within A DESIGN-DRIVEN STRATEGY FOR DENTAL SOLUTIONS

by Iida Nyyssรถnen, Ana Paula Lafaire, Cong Bui Dinh, Anton Drachuk

Submitted as part of the examination for KDS772 Design, Strategy and Innovation

Master of Science (M.Sc.) Business & Design at the University of Gothenburg 2017

Date of final submission: 13.02.2017



Table of Contents II. List of Figures ���������������������������������������������������������������������������������������4 1. Abstract ������������������������������������������������������������������������������������������ 5 2. Background of Dentsply Sirona and Dental implantology market ��������������������������������������������������������� 5 2.1 The field ������������������������������������������������������������������������������������������������� 5 2.2 Dentsply Sirona �������������������������������������������������������������������������������� 6 2.3 Digital Implant Solutions - department ����������������������������������� 6 3. Theoretical Background ������������������������������������������������������������ 8 3.1 Strategy in this context ������������������������������������������������������������������� 8 3.2 Design-Driven Strategy ������������������������������������������������������������������ 9 3.3 Innovation in this context �������������������������������������������������������������� 9 3.4 Service design ��������������������������������������������������������������������������������� 10 3.5. Organisational structure, learning organisation ������������������11 4. Logic ���������������������������������������������������������������������������������������������12 5. Strategic proposal ���������������������������������������������������������������������15 5.1 Resources ��������������������������������������������������������������������������������������������15 5.2 Capabilities �����������������������������������������������������������������������������������������15 5.4 Resource Gaps �������������������������������������������������������������������������������� 16 5.5 Strategy ������������������������������������������������������������������������������������������������������������������������� 16 5.6 Strategic recommendations ��������������������������������������������������������18 5.7 Measurement ����������������������������������������������������������������������������������� 20 5.8 Service proposal ���������������������������������������������������������������������������� 20 6. Motivation of Results ���������������������������������������������������������������24 7. Conclusion �����������������������������������������������������������������������������������29 8. List of References ���������������������������������������������������������������������30


II. List of Figures Fig. 1

Dentsply Sirona logo

Fig. 2 Atlantis abutments Fig. 3 Mysimplant app Fig. 4 Dentsply Sirona’s DIS department website Fig. 5 Resource-based strategy Fig. 6 Design Strategy Fig. 7 Short term goals Fig. 8 Long term goals Fig. 9 Fourth industrial revolution Fig. 10 Silos in organisation Fig. 11 Differences between products and services Fig. 12 Design at a strategic level Fig. 13 Four generations working together Fig. 14 Employee experience quatione Fig. 15 DIS strategy Fig. 16a Steps of service from user perspective Fig. 16b Steps of service from user perspective Fig. 17 Service design methodology Fig. 18 The group’s workspace and methods Fig. 19 Dentsply Sirona building Fig. 20 Group members at work Fig. 21 General service phases ideation Fig. 22 Low-fidelity service concept Fig. 23 Bluewolf logo Fig. 24 “Bluewolf effect” Fig. 25 SCVNGR app

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1. Abstract Dentsply Sirona is one of the leaders in the field of dental care. The Digital Implant Solution department (hereafter referred to as DIS) of Dentsply Sirona realises its offering through Atlantis and Simplant. Atlantis offers various products for major implant systems, while Simplant provides assistance for dental professionals who work with implants (Dentsply, 2017). In the field of dental implants, markets are cast, competition is tough, and the traditional competitive advantage like machinery or technology are not sustainable anymore. Companies in this sector now try to find new ways to differentiate, stay ahead of competition and innovate. Therefore, DIS showed interest in developing a strategy from a design perspective. This paper is a report of the project within the course of Design, Strategy and Innovation in Spring 2017, as part of our Business and Design master programme. The objective of the project was to develop a design-driven strategy for DIS in alignment with specific requirements as well as to gather new insights and inspiration for them. In addition, a new service for DIS was drafted as an example of service design application. The base of our suggestions was that DIS already has many valuable resources they are not yet fully utilising. We see that a solid foundation for competitive advantage comes from the inside. By encouraging creativity, developing a service mindset, and investing in its employees, the DIS department can learn to use its strengths better and become more innovative in order to gain a sustainable competitive advantage. With these resources, DIS can continuously improve the experiences of its customers, employees, and other stakeholders involved. Fig. 1 Dentsply Sirona logo First, we describe briefly the state of the field of dental implants and the services and products that DIS currently offers. Afterwards, we provide a theoretical background, describe our logic and strategic proposition. Finally, we present a new internal service for DIS and justify our proposals and conclusions with our findings.

2. Background of Dentsply Sirona and Dental implantology market Before describing Dentsply Sirona and Digital Implant Solutions we’d like to present a current overview of the dental health care industry in order to observe connections between relevant factors.

2.1 The field Oral health is the window to your overall health, and is directly connected to it (Hung, 2016). Globally, 90% of the population is suffering from oral diseases such as gum disease or tooth decay at least once in their lifetime (Dental Health Services Victoria, 2016). In cases of losing teeth, most people who have access to an established dental health care system consider filling the free space with oral implants. Tooth loss or missing teeth aren’t issues defined by age, but still predominantly appears among the elderly population. The country with the highest number of placed implants in 2015 was Korea with 408 patients per 10,000 individuals

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(Global Industry Analysts, 2016). The US, with 72 patients per 10,000 people, is on the fifth place after Italy, Germany and Brazil. In fact, it was estimated that globally, on an annual basis, more than 12 million implants are placed (Albrektsson et al., 2013). In other words, about 50 percent of adults will be in need of at least one dental implant by 2020. These numbers are closely related to the rising awareness of health-related quality of life and the ongoing demographic changes (Badkar, 2014). On the one hand, general practitioners are noticing this attractive economic option and are investing in the implant industry. General practitioners (hereafter referred to as GPs) often gain basic knowledge of how to restore and place implants. Also, big enterprises have already recognized the profitable market trend and focused on technological innovation. Dentsply Sirona invests roughly 80 million dollars a year (Sirona, 2015), and their main competitors, Straumann and CAMLOG, make no less effort in the direction of technological advantage.

2.2 Dentsply Sirona Dentsply Sirona, Straumann and CAMLOG are occupying 75% of the implant market (Isbaner, 2002). Dentsply Sirona has more than 40 locations worldwide. They employ about 15,000 employees including staff in manufacturing and supply chain, sales and service, research and development, marketing, G&A and others (Massoels, 2017). Their offerings across all key categories for both GPs and specialists include a wide range of choices. These include preventives, restoratives, prosthetics, instruments, and endodontics — pooled in the group of consumables and healthcare; as well as CAD/CAM, imaging, treatment centers, implants and orthodontics — pooled in the group of technology and specialties (DENTSPLY Implants, 2017). Implantology involves a set of complicated processes that requires a lot of special knowledge that not many GPs or even specialists have. Dentsply Sirona has tried to tackle this problem by providing educational service at the “DS Academy for professionals”, to teach them to use, among others, the SimplantSoftware to create 3D models of patient’s jaws. Another service (branded “solution”) that Dentsply Sirona provides is Simplant, which is designed to help inexperienced professionals to plan and place implants. The service covers every single step of an implant placement process.

2.3 Digital Implant Solutions - department Digital Implant Solution is described as a product and service. It is a comprehensive solution for all phases of an implant therapy. The main purpose of the service is to provide professionals with tools and the technology for implementing implant therapies, but also offering professionals to outsource parts of the therapy and built up a constant communication and connectivity to DIS. The service is divided into two parts: Simplant and Atlantis. Simplant offers a digital planning assistant for placing an adjusted screw into the correct spot in the patient’s jaw. Data gained by professionals through a scan or

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Fig. 2 Atlantis abutments


an x-ray is delivered to DIS. If needed, DIS provides tools for scanning. Simplant will then create a 3D model of the jaw with a proposal of how to place screws into the jawbone. In addition, the so-called Simplant Guide, a prosthetic guide, can be requested to make the placement process easier. Atlantis is a “solution”, service delivering custom-made products, for creating the right abutment on top of the screw by using the data of a digital 3D model. The importance of a well-adjusted abutment is similar to the screw itself, because it prevents possible arising bacteria between gum and abutment. Atlantis can also provide the actual crown of the implant in different materials. Atlantis involves cooperation with external dental technicians. With these services, it is possible for dentists to outsource their whole workflow to Digital Implant Solutions and take advantage of a variety of tools. Dentsply Sirona’s designers, technicians, and other professionals offer assistance with their experience in production of implants and surrounding processes. Depending on the level of skills and needs, professionals either use Atlantis to various extents or turn to Simplant (mostly GPs).

Fig. 3 Mysimplant app

Differentiation through services is a future direction Dentsply Sirona takes into consideration; however, competitors offer similar products/ solutions at a similar level of sophistication.

Fig. 4 Dentsply Sirona’s DIS department website

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3. Theoretical Background To back up our proposal presented later in the report and make it easier to read, we provide definitions to some of the key terms used in the report.

3.1 Strategy in this context One way of seeing strategy is as a match between internal resources, risks and opportunities of the external world (Grant, 1991). Often, more attention is paid to the external, at expense of the internal. However, when division of market or targeting customers becomes extremely hard, as does strategy based on those factors. Internal resources, on the other hand, are more stable, provide the basic direction for firm’s strategy and are the primary source of profit (ibid.). Therefore, we suggest that the starting point of the strategy should be the resources. Resource-based view sees that resources build the competitive advantage. Resources are all things that can be thought of as strengths or weaknesses, or tangible and intangible assets that the company holds (Wernerfelt, 1984). These could be not only machinery, capital and real estate, but also resources like knowledge, employees, processes, and contacts. (ibid.) Traditionally, it is assumed that these assets are distributed unequally among the firms and this disproportion is long lasting. (Barney, 1991.) The most sustainable resources are durable, difficult to identify and understand, imperfectly transferable, and are not easily replicated (Grant, 1991). The one with better resources has more long lasting competitive advantage. Resources themselves don’t create competitive advantage; they also need to be used and managed in the right way. Strategy should be designed to make the most of the resources (ibid). Capability is the capacity for a group of resources to perform tasks or activities. The key connection in between resources and capabilities is the ability to achieve coordination and cooperation in between teams. Capabilities, then again, are the source of competitive advantage (ibid). As mentioned earlier, sustainable competitive advantage demands specific kinds of resources. If the resources of the company don’t offer a long lasting advantage, then the timeframe of strategy should also be set for shorter time, or the energy should be put into developing new, more sustainable resources (Grant, 1991) These long lasting resources usually demand complex patterns and coordination among people, such as, for instance, styles, values, traditions and leadership of the company (ibid). According to Grant (1991), companies should start their strategy making from identifying their resources and trying to find ways to utilize them better. Secondly, they should recognize their competences and resource inputs they need. Thirdly, appraisal of the resources and competences ought to be done in terms of obtaining sustainable competitive advantage. Having identified the strengths, a strategy can be chosen to fit those. Finally, the resource gaps should be identified and developed further.

Resources

Capabilities

Competitive advantage

Capabilities 8

Strategy Fig. 5 Resource-based strategy


ra

s ig

St y

De

g te

Following the resource-based view, we understand design-driven strategy as a process to be incorporated within a company. Design is a valuable resource, since it is a continuous activity that enables the company to innovate, differentiate, integrate and transform, which leads to a good business practice (Borja de Mozota, 2010). The strategy of applying design may seem intangible, because it could be described as a connector between creativity and the implementation of these ideas to impact process, thus creating value (Whyte et al. 2015). Nevertheless it can and must be measured (Polaine, Løvlie, and Reason, 2013). The ultimate goal is to enable the company to develop a competitive advantage based on the culture and people. Employee-centred organisational models allow for development of functionality and empowerment. Design-driven strategy in this context could be better specified with a set of short term and long term goals.

n

3.2 Design-Driven Strategy

Technology Fig. 6 Design Strategy

Short term goals: • • • •

Develop the ability to set objectives linked to the business strategy. Define criteria to measure and report the outcomes of this activities. Reward the performance. Provide training to support the short term goals.

set objectives

set KPI

reward

train

Fig. 7 Short term goals

Long term goals: • Creative leadership that delivers and embodies the company’s strategy. • Workforce prepared for the long term with basic skills and aspirations aligned in the strategy mindset. • Ensure the long term success with a strong organisational structure and values.

aspirations and skills

creative leadership

3.3 Innovation in this context

strong structure

Fig. 8 Long term goals

Today the competition among companies is no longer just about product or service performance, but also the effectiveness of their innovation strategies. It can be said, that the main area of companies’ competitiveness in now the management of innovation, and innovation itself is a characteristic of competition (Le Masson, Weil & Hatchuel, 2010). The purpose of being innovative is not to follow markets, but to create them (Verganti, 2009). Innovation is not anymore about coming up with one major idea, that changes the world. It is now intensive: systematic, repeated, and oriented

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(Le Masson, et al., 2010). An intensive innovation process is based on innovative design activities, and companies should take these into account in their strategies (Le Masson, et al., 2010). The intensive innovation is not just about new goods or changes in production methods, it should be present in everyday work. This creates a permanent need for new systems of knowledge and exchange, that can be used to redesign the markets, competences, and user values (Le Masson, et al., 2010). Uncertainty and risk are part of innovations, and companies need to find ways to handle those feelings. Moreover, companies need to intensify their resources and capacities to improve their innovative activities (Le Masson, et al., 2010).

3.4 Service design To exactly formulate what service design is in a concise form can be challenging, as it is a very complex and broad discipline with ranging definitions (Nisula, J.-V., 2012). When we mention service design in this context, possibly the most appropriate definition would be: “Service design aims at designing services that are useful, usable and desirable from the user perspective, and efficient, effective and different from the provider perspective. It is a strategic approach that helps providers to develop clear strategic positioning for their service offerings. Services are systems that involve many different influential factors, so service design takes holistic approach in order to get an understanding of the system and the different actors within the system.” (Mager B., Sung T-J., 2011). Last century’s massive industrialization led to the birth of industrial design in the 1920s. That’s where the fairly new discipline of service design, as most design fields, takes its roots. Various designers on the forefront of industrial design were driven by ideas of using new industrial technologies to improve people’s standard of living. Now, however, this standard in the developed world has largely increased to the point of over-consumption and change in human needs, especially with digital technologies. Service design is a child of the digital generation raised in network thinking (Polaine, Løvlie, and Reason, 2013). In other words, it is the design of the whole picture of interconnected parts that create a service. It ultimately influences the experience, company’s position and industry at large.

1. Steam engine

2. Mass production

3. Internet technology

4. Internet of Things

When services are indeed designed based on genuine insights with people in mind, we can be sure to deliver authentic value (ibid.). Simplified complexity, consistency of all elements and intelligent use of existing resources can provide greater services for the customers and experiences for all people involved. When resilience is built into the design, services will adapt better to change and perform longer for the user and the benefit of business.

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Fig. 9 Fourth industrial revolution


However, designing services is very different from designing products, thus the most effective service design takes place in companies that are organised appropriately to service delivery. (ibid.)

3.5. Organisational structure, learning organisation Many companies find it difficult to design services, mainly because of applying industrial logic to services. Products are objects, thus companies that make, develop, market and sell often have a department for each function and a vertical chain of command, operating in silos. “The division of the silos makes sense to the business units, but makes no sense to the customer, who sees the entire offering as one experience” (Polaine, Løvlie, and Reason, 2013). Often individual parts of a service are well-made and functioning, however touchpoints of interaction in between aren’t or some parts don’t work as well as the others between each other, thus not completing into a whole picture. That derives from product-oriented organisation in silos, as each part is made not as a part of a whole but as a separate, which is fine with products, but doesn’t help services to be experienced in totality and deliver whole value. (ibid.)

Fig. 10 Silos in organisation

Many service companies think they are selling products, for example in the financial sector. While insurance policies or bank accounts might seem to be products, they’re indeed in large part services, especially at a point when something goes wrong. (ibid.) Market for talent is extremely competitive, whether as customers, KOL or employees, especially in a global environment (Searls, 2012). Learning organisation concept is also called “organisational evolution”, it is about facilitating the learning of its members and ability to transform, or rather, evolve. By empowering employees, adapting and smart management of resources and networks a company can be able to retain their best people and foster conditions for new ideas and solutions (Woodhead, 2012) Learning organisation is successfully adopted by many companies, especially large, including Microsoft and Facebook. It involves evolution at organisational, individual and ecosystem levels (Wilson, 2012). This concept seems to bind the different aspects of our strategic proposal, however we’ll mainly focus on the individual level.

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4. Logic As described in chapter 1, Dentsply Sirona is one of the world’s largest manufacturer of professional dental products and technologies providing, as they say: “products and solutions”. (Dentsply Sirona, 2017) . In this chapter, we describe, why the changes presented later in this paper are valid and needed.

Approach Design-driven strategy for such a large and long-established company (recently merged from two companies both having over 100 years of experience) is quite a challenge, especially when constrained to a rather brief timeframe and limited data for research. The fact that the task is about focusing on DIS department made it more specific, nevertheless we had to establish a certain framework in order to ensure delivering a viable strategy with some tangible outcomes. We decided to act similarly as a strategic design consultancy would in such case. Specifically, to conduct research and analysis based on the client’s brief and propose a creative debrief, outlining directions and processes as part of a suitable strategy for the post-industrial economy in context of DIS and possibly Dentsply Sirona at large, to the best of our knowledge.

Innovation in the digital age For most knowledge-intensive companies at present, the business environment where they compete is complex, characterized by rapid change and uncertainty (Rylander & Peppard, 2003). To bring user-led innovation to market, fast and continuously is a task demanding various capabilities. Some of them are adaptability and scalability. Though large organizations typically know how to scale, they struggle to be agile. Digital innovation with design at heart can provide the key to effectively tackle both (Accenture Fjord Trends, 2017). Businesses realise the potential of design in innovation and start implementing it on an organisational level. Now there is the need for new strategies to take this further. Fjord (one of the leading innovation consultancies, recently acquired by Accenture) claims that in 2017, organizations will acknowledge the need to rewire completely to become more people-centric. They will do this by upscaling the principles and practices of digital design to create the fertile ground needed for organization-wide flexibility.

DIS isn’t a product and a service, but services and products. After being introduced to the main offering of DIS — Atlantis (branded as product) and Simplant (branded a solution), we’ve quickly realized that there is more to them than one can think looking at the company’s website or even their own presentation. Mainly, that Atlantis, focusing on creating custom made implant-related parts is not a mere collective of products, but indeed a service that delivers products to dental professionals in a string of advanced processes. We’ve even drafted a service blueprint (step-by step process of delivery involving various actors and touchpoint involved) for analysis, which clearly presents Atlantis becoming a service beyond product sales at very early stages, even a range of services.

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Fig. 11 Differences between products and services

Product

Service

Tangible

Intangible

Storable

Perishable

Quality control with data

Define quality by experience

Measure output

Measure outcome

Repeatable

Very difficult to repeat Bonus

Can be patented

Very difficult to patent

Furthermore, if one uses Atlantis, the data gathered by DIS makes it easier to provide their Simplant service, yet the two aren’t presented as interlinked beyond being in the same department (DENTSPLY, 2017), the fact that those we’re developed in-house and that economy is shifting from industrial logic to experience-delivery through service-dominant logic (Kowalkowski, 2010) made apparent the benefits of approaching the analysis with service design in mind.

Using service design at the strategic business level Digital technology has transformed the way products and services are created, distributed and consumed. In response, many organizations set out to acquire or build the design skills needed to develop these services, often turning to design thinking. Despite such efforts, organizations still can face a sort of crisis in innovation. Design and innovation are not the same, but they are closely connected. Design thinking is a catalyst, but can be hard to implement (Accenture Fjord Trends, 2017). Service design does, ideally work at the strategic business level, as it allows to connect business propositions with the details of how they will be delivered. It’s also about designing with people and not just for them. While we do keep design thinking in mind in this context, service design seems more suitable as it is specifically about services and design doing (Polaine, Løvlie, and Reason, 2013).

Internal resources for sustainable competitive advantage Employees and other intangible resources (i.e. intellectual capital) generally represent the most critical resources in the value creation process. Crafting strategy in such contexts is not helped by conventional models and tools of strategy. The assumptions which underpin many of them do not hold in the present competitive environment, making them at best irrelevant, but at worst leading to the development of strategies that can put the success of a company in jeopardy (Rylander & Peppard, 2003).

Participatory

DESIGN STRATEGY Engage stakeholders Make things tangible Think integration Test multiple options Connect design and use

Iterative

Integrative

Fig. 12 Design at a strategic level

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Empower people: from employees to customers (and potentially end-customers) During the next 10 years the work force will be a mix of people from different generations. The baby boomers and Gen X have a mindset of traditional career progression. On the other side, millennials and Gen Z, prefer to work where social impact plays a role (Accenture Fjord Trends, 2016). The mismatch is very visible in digital tools, companies need to move fast to re-imagine the digital services and touchpoints that their employees use (2016).

Fig. 13 Four generations working together Employees now expect tailored experiences, fast evolution and personal connection in their careers. As a result, workplace processes, structure and culture can all be reimagined at an organizational level (2016). If employees are trusted to be leaders who can make important decisions autonomously the company would benefit itself. Enabling external growth through empowering the employees and preparing them for the service logic and integrated approaches is one of the core principles of our strategy (2016).

Fig. 14 Employee experience quatione

Organizational structure The mindset shift and learning the ability of creative and productive utilisation of own resources has to be supported by the organisation. Connecting silos or adopting more horizontal structures could be a start but it’s usually still not enough. For long-term sustainable change executive decisions have to be made on a higher organisational level. The benefits of rewiring have to become apparent in value through practical application and outcomes through time and response (Trends 2017). Every person, product and service representing the company represents and makes up the organisation, therefore progressive change from within can eventually motivate organisational changes. Applying approaches

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and methodologies from design perspective can help connect the inner organisational functions and outer market challenges (Ainamo et al., 2016). For self-sufficient development and internal ground for creating novelty, it is beneficial for organisations not only to be structured in an appropriate way, nor only to apply methodologies and practices, but to be able to learn. To stay at the competitive edge, companies have to continuously sense and respond to changing conditions, while being prepared for multiple scenarios (Searls, 2012). Therefore, we keep in mind orientation towards learning organisation and organisational changes overall in our proposal.

5. Strategic proposal The base of our proposal for strategy is Grant’s (1991) practical framework of a resource based approach to strategy analysis. First, we introduce the main resources of the Dental Implant Solution department of Dentsply Sirona, then we identify the key competences and resource inputs needed. Thirdly we appraise the potential of these resources and capabilities, and finally offer our final proposal for a strategy.

5.1 Resources Like discussed earlier in this paper, the most valuable resources are durable, difficult to identify and understand, imperfectly transferable, and are not easily replicated. These kinds of resources can offer a sustainable competitive advantage. Furthermore, traditional resources such as machinery, real estate or even technology can no more provide this kind of advantage. Instead, companies should invest more on intangible resources (1991). DIS has a long history of working with dental implants. The people are professionals, and have a huge knowledge of the field and products. Their range of professionals is wide, since the process of making implants demands different skills and steps. Employees need to cooperate to make sure, that every implant is high quality. The processes and methods for making implants are fluent and efficient. Key resources: people, data, processes and methods, culture and mindset, knowledge, network, structure

5.2 Capabilities We’ve defined 3 core capabilities for DIS to achieve long-term advantage over competitors. • Delivering experiences, not only products or services. • Continuously improving customer and employee experiences. • Ability to scale up, and still be agile. In practice these mean that a company should be integrated, so that customer experiences are as seamless as possible. To be able to deliver experiences, the company needs to have service mindset and human-centered approach and make the most out of their knowledge by cooperation and co-creation. Moreover, to succeed in continuous improvement of these experiences, the company needs to be innovative, explorative, and proactive. Ability to change, modify itself and its processes are crucial for effective action. Key resources needed to achieve these capabilities lie in harmonious organizational culture and mindset, knowledge, people, and internal processes.

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5.3 Competitive advantage The company must seek to obtain a competitive advantage in their intangible resources. Investing in the internal processes and organisational culture can harvest long lasting resources; this allows the firm to be resilient even if the employees change (1991). To do this efficiently, a strategy is needed to empower everyone in the firm. It is not enough to prioritize for the top managers. Strategy is about a unique combination of resources to secure a competitive advantage. What they are and how they are developed is just as important. Technological and digital resources enable humans to focus on the tasks of creative decision making and realising potentials beyond automatization. Human: Design has a human centered approach; employees and customers are the key focus. An example of this approach could be the change from a department that delivers “software solutions” to the one that “provides customers with tailored experiences of solutions supported by software.” It’s about designing with people and not just for them. Digital: Key resources enable interactions and create authentic experiences between humans as part of a broader picture involving versatile physical materials, locations and timeframes.

5.4 Resource Gaps To be able to successfully achieve the aforementioned capabilities and build competitive advantage, selected resources need to be brought into use more efficiently. 1. People: the knowledge and ideas of people need to be used. People should first learn to recognize their own potential and then share and use it with the team. 2. Culture and mindset: Courage, team-spirit, and exploration should be cultural values. 3. Networks: connecting with other employees across the department(s) is crucial. Good networks help to perform and construct new ideas.

5.5 Strategy 5.5.1 Objectives: The goal is to provide experiences to humans, starting with the customers and employees, and empower their continuous self-improvement. In order to do so, the organizational mindset of DIS is turned towards services. This is done by using and improving the main resources – people, culture, knowledge, and processes. A long-term adaptation to innovative designdriven strategy fosters abilities for agile responses to changing environments. A self-sufficient organization can provide better experiences for all the stakeholders and innovate continuously and rapidly for progressive upscaling.

5.5.2 Principles: Our principles can be simply seen as the outline of the service proposed. It guides the users and us through the journey and the usage of services.

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Fig. 15 DIS strategy

STRATEGY

Tangible

RISKS AND OPPORTUNITIES

SCALE UP AND BE AGILE

Internal resources

Culture & Mindset

Process & Methods People

Data

Network

Structure

y Rapidl

Ability to fa ce

Intangible

Knowledge

CAP A B I LITI E S

DELIVER EXPERIENCES not just products and services

CONTINUOS IMPROVEMENT of human relationships

They are defined as lasting and interconnected. Seamless - An experience on different levels of perception, that is not describable together in words and numbers. Employees will enjoy and not feel consumed by the process. Explore - Exploration is a concept based on learning. This concept is to be reinforced by evident motivation and success. Try Out - Without the step of being curious and trying out people will not having the extra incentive for trust. Dare - It is then the demand of new regarding thinking, innovation together with anxiety. Co-operate - One unit will not be able to solve problems at large scales. It is important to use diverse advantages and be able to combine them. Co-create - synergy for effective user-centered value generation. Empathize - Empathy empowers simultaneous growth of experience, trust and value. Accepting, understanding and relating to the n==eeds of others are highly dependent to empathy. Learn & Share - Knowledge should be distributed in various ways, any time and place. Since information is not easy to gain even in the digital age, different voices can help and provide valuable insights from not only theoretical, but tacit knowledge as well.

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5.6 Strategic recommendations 5.6.1 Introduction This study proposes a number of recommendations linked to the proposal. At the core of those are the key resources and their developing: people-centricity, service-orientation, organisational agility and internal abilities for creating hard-to-replicate competitive advantage. DIS needs to be powered by service mindset and its people for integrating and improving the existing services and creating new ones. Before presenting the recommendation of phases, it is worth noting that the strategic proposal is somewhat broad and adjustable due to specific reasoning. The team working on it had a number of constraints regarding time, resources, research and data, therefore, to propose solutions too specific would be poor judgement based on insufficient insights. Nonetheless, there has been enough research and analysis combined to give some advice with sufficient certainty and relevance. For the recommendations to achieve best results, we suggest considering long-term cooperation with a company specialising in service design, business design and strategy. Measurement of outcomes and impact is critical for DS to be able to confidently invest in service design and innovation. Ultimately, the advantage of cooperating with highly acclaimed professionals in this field should not only improve your capabilities and competitive advantage, but lower the need for external help from numerous consultancies and experts.

5.6.2 Phases The recommendations include 3 general phases (A,B,C), each one being connected to each other and best working as a whole — Analyse for best offer, Co-create for smooth transition, Evolve for viable advantage. The general recommendation to implement those with help of a professional service design company applies. These recommendations are also designed to fill the resource gaps presented earlier in this paper.

Phase A Analyze for the best offer We’ve mentioned before that our analysis proved that Atlantis is not just a product, but products surrounded by a service. Realizing that DIS in fact provides an opportunity for more natural catalyst for shifting the logic from products to services.

Atlantis and Simplant as services To better understand what could be improved in the existing services and how to integrate them in order to have higher volumes of sales and customer loyalty through delivering an unmatched experience, it is beneficial to analyse every step of the process from the user’s perspective. As there are many stakeholders involved, the services should be working well for everyone involved, which requires application of service design methods including analysis using a service blueprint and research e.g. customer journeys. Even internally those processes could be made, the desirable outcome would be improvement in service delivery and apparently related proposition of Simplant and Atlantis.

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Atlantis as products As the products of DS are of the highest standards, the way to encourage higher sales and more customers would be to take into account services surrounding them. Existing (like customer support, salespeople, returns etc.) and non-existing (through exploring new opportunities to create ecosystems). This recommendation could be applied to other departments of DS as well, however in any case requires to utilise research and analysis methodologies with a service design (or design thinking) approach.

Phase B Co-create for smooth transition As employees have more and more choice of employers, “liquid expectations” (expectations from different industries, products etc.) and gradually come mostly from the youngest generations, the employers should make sure to provide attractive conditions. More importantly, in order to use employees as key assets and empower their abilities to contribute to the company’s success and value proposition, the working environment should be as encouraging and appealing as possible. If a company wants to make imminent changes to respond the changing industrial and economic environments, everyone should be able to adapt and it’s best if everyone is on board and is able to commit. The best way of demonstrating, testing and embedding the benefits of service-oriented mindset is to incorporate it through something tangible and relevant to the employees themselves. This is why we recommend to work on a service specifically for improving the experience of people at DIS. In the service we propose later in the paper we derived from the idea of making a workplace more fun and integrated on top of demonstrating and practically teaching the skills for service innovation, nevertheless it could be done in other ways as well. The main purpose is to truly start from within, connect the creative professional potentials and explore the hidden ones. More than that, it is about creating ground for standing out on the market as a service provider and industry leader thorough standing out as an employer.

Phase C Evolve for viable advantage Bring user-led innovation to market rapidly is easier said than done. Even if you create the best functioning service or a truly revolutionary one, the first thing that follows will be your competitors trying to replicate your success. In other industries, many organizations break down silos and build spaces to inspire creative thinking, in different ways approaching “design from within”. However, even if they manage to apply design thinking methodologies, they can face problems thinking it’s enough to waive the “magic wand” of design thinking. To innovate significantly, fast and continuously, one has to live and breathe innovation across the entire business — thus enable not just thinking, but “design doing”. Service design approach is a great possibility for this, as it’s main difference from design thinking lies in doing design and implementation. To effectively use it the organization should learn to self-optimize by cultivating appropriate culture and adjusting structure.

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That is not to say that the previous recommendation phases can’t work without this one. It’s all about the scale. Siloed teams developing and implementing ideas for a specific part of the company have success, but attempts to replicate that success on a bigger scale often fail. To viably innovate at scale requires full organizational commitment, this means a willingness to change procedures, policies and strategies at large. A new mindset, a clear framework for change and the goal of scalability from the outset are essential, along with commitment to re-establish what success looks like for your business and how to measure it. There a lot of things that go along with it and it is a big step, but it starts with reconsidering your current position, processes and organisation.

5.7 Measurement In a collaborative novel process, it is fundamental to be able to measure the results. Being transparent with the data allows everyone involved to reflect more easily and more quickly on the results and improve valuable relationships. The traditional feedback is portrayed as quantity of productivity, but it may go beyond that. Focusing on quality of life is more valuable than just numbers. Measuring data can highlight the systems’ problems and trigger conversations that engage innovation. The outcome could have economic, social and environmental impacts. From the earliest stages, service design provides tools to visualise the user journey and the blueprint of a service; from there it’s easy to analyse and spot where the costs are reduced relative to the revenues generated. Despite some outcomes having to be measured after longer periods of time, certain impact of designing a service could be measured quickly and cheaply. (Polaine, Løvlie, and Reason, 2013).

5.8 Service proposal 5.8.1. Internal service for smooth transistion Dentsply Sirona is a company with great experience and highly professional employees. We had the pleasure to experience it first hand by talking to several people from the DIS department. It’s apparent that people who work there have various backgrounds and expertise while being involved in very different stages of delivering products and services. There is a wide range of professionals involved: administrators, marketers, salespeople, technicians and many more. Everyone has their insights and play important roles in assuring DIS operations run smoothly. After our visit to the workplace, we had a chance to partially witness how the environment looks like. There are many rooms and spaces and everyone comes together in the main hall for a lunch break (or a fika) and have a chance to come be in the same open space. It feels like DS is a friendly and rewarding place towards its employees, but we’d like to enhance that and take it to another level. Most employees can fill absorbed in daily tasks and feel the work becoming a routine. If the company wants to introduce something new, people might feel like it is extra work and be therefore even more reluctant to change. In order to empathise with being introduced to ashift of mindset, service thinking, design tools and etc. we started with a question “how do we make work more fun and empower people through service”? An additional question was “how do we evaluate resources thorough service co-creation?”.

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After research and ideation we came up with an idea involving the recent trend of gamification. Gamification is already used by businesses to motivate employees, create healthy competition among teams, generate buzz or social proof, encourage customer loyalty and more (Stanley, 2014).

5.8.2. New service draft Our service draft is made up of different activities running through an established timeframe (for example 9 months), that we call “season” (referring to sporting or sales’ seasons). It involves physical objects and digital software — an app and a website for tracking progress, interacting with users (employees) and collecting data. The main purposes of the service (in addition to those mentioned) are to create an interactive, inclusive experience, develop knowledge about the employees’ and the company and to motivate employees for involvement in the company’s strategy and development of innovation. We’ve illustrated the service with the user story (service mainly from the user’s perspective) developed using the “serious play service concept” and “service blueprint” tools combined. It involves 4 stages: 1. Aware (triggering to notice and engage), 2. Join (decide and start to use), 3. Use (usage and development) and 4. Leave (after use and stimulating re-use). The stages are described below.

1. Aware First, the employees would start noticing some recurring image around the office (let’s say magnets or stickers with a symbol of sorts), ignoring or wondering about it, but either way having it subliminally embedded into their sub-conscience. This symbol(-s) could be just something standing out (like an elephant) or a visual puzzle (a rebus), simple and recognisable.

2. Join After a week or so, everybody would get a text message with a question asking about this symbol and the answer to solve it. As the person replies with an answer, the reply contains a sort of password. For user inclusion the password could be also sent with a delay to those who didn’t respond.

AWARE

Recieve password

“Virus” on computer

Confusion, disappointed

Annoyed, freaked out

Continued on the next page

Task to solve by direct contact Puzzling, challenging

Get explanation + reward

Engage Risk, guilty pleasure

Clarity, confusion, pleasure

Figure out Epiphany, confusion

Couple of days would pass as the majority receive the password, and one morning (when it’s estimated that most employees would be at work) everyone would get an unexpected screen upon starting their computers. It would ask for the password. It is safe to assume that not everyone will

Enter pass. + join

Try to figure out Curiousity

What does the user feel in this step?

Relief, closure

Pay attention Triggered

EXPERIENCE

Call IT

Notice visual symbols

What does the user do in this step?

Decide to use, pre-use

Ignore

USERS

ACTIVITY

JOIN

Notice, understand, be triggered.

Hope, fear

STEPS

Fig. 16a Steps of service from user perspective

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simply put in the password from the text message, but rather call the IT department for help, probably being baffled by the “virus”. The IT should be in on the whole thing and be ready to respond appropriately with assisting the employees towards entering that password. As the password would be entered, the computer would give a message confirming success and notifying about joining the “league” (let’s call it that for now). Moreover, there will be a message about a reward and short explanation of the strange happenings involved in the previous stages. However, it would be just the beginning and the user will be asked to download an app and provided with a link to the desktop version of a digital platform with a unique username and the password used before. The user won’t have to do it instantly with all that information delivered through e-mail (in case there’s an urgent thing they have to do).

USE

LEAVE

Get access, download app

First task

Field task

Group task

Trust task

Understand game logic

End of season

Rewards & gratitude

Waiting for next season

Pre-season party

Ego boost, satisfaction

Secret kid, creativity

Discomfort, validation, belonging

Exploration, excitement, uncertainty

Reflection, comfort, pro-feeling

Epiphany, relief, loss

Satisfaction, pride, bond

Excitement, wonder, missing

Popularity, engagement

After use, re-use

Curiousity

Continued from the previous page

First use, further use

3. Use The digital platform would include a sort of dashboard with the current challenge (task) and possibly more information over time. The tasks would be delivered through the platform once a week and from time to time complemented by real-life happenings. The tasks are designed to gradually develop certain qualities, among others: team work, attentive interaction with the surroundings, exploration of the workplace, trust in the process, getting to know people, personal motivation (“ego boost”), creative thinking, sharing, open attitude, new knowledge and community feeling. Each task is a step to progressively enhance those through activities. Task A would be something simple, involving some problem-solving skills. It will aim highly at emotionally rewarding the user and building confidence. Task B would involve going out to the office a “field task” with focus on creativity, for example, creating a symbol drawing illustrating the most exciting and challenging things or emotions during the day. It could involve sharing the picture by going out to the kitchen and taking a photo of the fridge, which would digitally place your drawing on the fridge with the others’. That could provide an interactive transition to group tasks and feeling of belonging. Task C would be a bit more challenging, involving group work, uniting different people to multidisciplinary teams and intro-

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Fig. 16b Steps of service from user perspective


ducing some, for instance, ideation task to tackle an issue related to their work. Task D would involve a challenge with more specific directions for teams, to build trust in each other and the process. Task E Would be about reflection and synthesising previous experiences, connecting those involved with something practically assisting their daily activities in work. This would be followed by some type of reward or incentive. Depending on the amount of time, complexity of tasks and involvement, the types of tasks could be repeated in cycles, with challenges becoming more developed. With progress, the platform itself could be developed, with some available statistics of the individual and group game progression, as well as customised data about performance levels or relevant information to their in-and-out of game activities, making the platform/ app learn about the user and provide valuable interactions.

4. Leave After the end of game cycle(-s), the game would be completed and marked with individual and group rewards, branded as the “end of season” in case of predominantly positive outcomes. There will be a new experience for the employees and other stakeholders, a test of change and service and some amount of data. If the overall reaction is positive, the idea of “seasons” comes into play (as in sports’ seasons or maybe even correlated to sales seasons). In between those there are a number of things that could be done. From the employee perspective, this would be the time to reflect and let the new experience sink in, to observe the influences and changes. During a break, one can start missing such a service and grow expectations for what’s next. To appropriately respond to that, there could be a party organised, a sort of throwback involving highlights of the season and perhaps even hints to the next one. On the other hand, for the employers and those involved in the service’s administration, the time could be used to evaluate and analyse data and outcomes, as well as identify ways to improve, reinvent or reapply the service. Finally, it is about practically testing the approaches, methodologies and influence on the people within the company. As such a service would need to involve people from software development and other parties, this could be an opportunity for alternative involvement of the existing workforce and reassessment of assets and capabilities. Ideally, such a service would need to be prototyped, tested and designed appropriately to the needs and preferences of the company and the employees. This could be more or less ambitious, but even with the simplest tasks and activities this service would very probably improve the employees’ experience, involvement and capabilities for authentic innovation. If it is truly successful, it will make realising the service design potential and using its tools and mindset a natural process. People would be more eager to embody and reinforce the company’s strategy, mission and vision.

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6. Motivation of Results Here we discuss how our team found its way through the task of designing a strategy for Dentsply Sirona in the service- and user-driven logic. Our team consists of members with different backgrounds, such as communication and UX design, industrial design, business and IT. This diversity enabled us to have a broader view of the situation and focus on convergent and divergent thinking. We also mention some examples of gamification in business context. As a guideline, we used a service design toolkit created by Namahm and Design Flanders (Vermaercke, 2014). This methodology comprises eight different parts: 1) framing, 2) user insight, 3) personas, 4) design scope, 5) ideation, 6) service concept, 7) prototype and test and a 8) feasibility. We were not strictly following every single step, as we iterated and experimented with different tools to develop the work phases of our own journey specifically tailored to match the specific context of this project. We “trusted the process”, or rather a combination of processes.

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Fig. 17 Service design methodology

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Research and analysis 1) Framing: We tried to understand the general context and the main actors in the network of DS by visualizing possible touchpoints among patients, dentists, LABs, dental technicians. This led us to screen our existing knowledge and generate research questions. Then, we performed desktop research, providing broader acumen into company, as well as the market and industry trends affecting DIS and DS. We used the STEEPV method from design thinking to established most relevant points for futures thinking and foresight development on various levels — social, technological, economical, ecological, political and value, making up the STEEPV acronym (Meissner, Gokhberg, and Sokolov, 2014). We realised the growing potential of implantology field, increasing education and interest in it, as well as predicted high demand for implants and digital services surrounding them for patients and professionals. Moreover, we got a view of the complexity and varying environments depending on local peculiarities on political and other levels, demanding high adaptability for worldwide presence and delivery. 2) User insights: to gain more insights about our open questions, we interviewed patients and dentists working with implants. We found out that patients don’t know too much about the dental implant industry. They are mainly satisfied with trusting the professionals to make choices for them. Unfortunately we could not gain a lot of directly relevant information from the professionals’ perspective because, as they were not clients of DS.

Fig. 18 The group’s workspace and methods

3) Visit and Q&A in Dentsply Sirona. The visit to the DS office in Gothenburg revealed a lot of interesting insider information. DS largely focused on professionals as end users and hence we shifted our focus away from the patient (end-user) as “target” within our framework. In addition DS is strictly enacting their long-term collaboration with clients on their performance in numbers, an indicator for an industrial mindset.

Fig. 19 Dentsply Sirona building

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4) Blueprint for service analysis. The breakthrough happened when we mapped out the blueprint of the existing “solutions”: Atlantis and Simplant. Based on the information gained during our DS visit, we had visualized the connections between channels and touchpoints in the customer journey and the backstage processes that are required to deliver them. In this part we confirmed our speculations that Atlantis is more of a service, than products and the high correlation of Atlantis and Simplant. 5) Design scope: After research on literature of service design, we recognized the complexity of implementing a new service and the difficulty to change an already established process. It became clear that the best way to change the structure was to start from the core. This means addressing the mindset, the philosophy, the way of thinking of employees within DS. Therefore we decided to focus on the employees as our “target”.

Creative debrief and service drafting 6) Ideation: To generate options we used the so called COCD box. The table is divided in four different categories separating the ideas. More than twenty proposals were generated in a set up timeframe, ranging from ordinary and non-feasible to original and feasible. Our final choices were the concepts of “gamification” and “data visualisation” and we put them up to test following the consequent step of service design process. 7) Alternative methods: To stimulate our creativity and empathy for people pulled out of their comfort zone, we decided to explore the school with some of our senses blocked. We had to assist each other without being able to see, talk or hear. This help us to realize that a shift of mind is not easy and has an emotional impact on any user. Next task was provided by Samantha Hookway. Empathy enabled us to visualize how a new strategy would look like if it had a “human body”, with placing various keywords across different parts and exploring various associations. This helped us synthesize the core concepts of our strategy.

Fig. 20 Group members at work

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8) Service concept: Our proposal departed from the keywords of “gamification” and “data visualisation”. We created a low-fidelity service draft that (further developed) would allow the company to begin the journey of shifting the mindset from within. The concept and method are described in more detail in the preceding “Service proposal” part of this paper (p.??). The outcome helped us illustrate an sample application of service design methods in DIS context and how it could involve and encourage employees with the company’s interest in mind. In broader context, it is a viable idea and possibly elegant approach for recurring challenges of implementing design methodologies and strategies, especially in reference to design thinking (Carlgren, Elmquist, and Rauth, 2016).

Fig. 21 General service phases ideation

Fig. 22 Low-fidelity service concept

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Gamification Case Studies In the following case studies we illustrate how companies can benefit from motivating their employees by using gamification. Social technologies have the potential to bring value to companies; according to McKinsey’s report of 2012 that could be between $900 billion to $1.3 trillion annually (Bluewolf, 2016).

Employee motivation

Business Results

Fig. 23 Bluewolf logo

Employee value

Customer value

Fig. 24 “Bluewolf effect”

Bluewolf Case This company was acquired by IBM in 2016 for $200 million (Hay and Bandt, 2016). Four years before they encouraged their employees to collaborate in building the brand. They created a program called #GoingSocial that rewards people who share posts about their job on social media (2016). For Bluewolf, the result is social presence that engages potential customers and boosts employee satisfaction. It all started with a small group within the business that struggled to amplify their voices (Bluewolf , 2016). They found that collaboration and communication increased by triggering internal conversations about the content posted on social media. Instead of rewarding only the top performing sales people, the company engaged in empowering those who embody Bluewolf’s culture and values (2016).

SCVNGR Case SCVNGR is a social-location gaming platform. It means that it engages users in the places they visit frequently. The app builds a game “layer” on top of the reality (augmented reality, as in Pokemon Go for instance). Companies, educational institutions and organizations have build challenges for their users. The players earn points for completing challenges, unlocking real-world rewards, such as discounts or free items (Mashable, 2012).

Fig. 25 SCVNGR app

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7. Conclusion As this report represents, companies today need new tools to gain competitive advantage. We therefore suggest that DIS should empower its best resources – people, organizational culture, processes, and knowledge; in order to be able to deliver and improve experiences, and scale up without losing agility. To succeed, we suggest that DIS should (1) re-analyze its offers, (2), co-create with employees to design smooth transition towards service-centered mindset and (3) consider if its organizational structure fits with its offerings. Moreover, we provided an idea for a new internal service, that can be used as a catalyst for a change from inside of the organization, smooth transition and testing. Some limitations need to be taken into consideration. This project was done in comparatively short time and with limited information. Deep analysis of the company, department, structure, and processes among others is needed if this suggestion is to be implemented. We highly recommend that professionals are used as help to start the process. Structural changes in an organisation can be a long, hard and costly, especially with newly merged long-established companies, therefore it is important to be able to justify such changes through actionable strategic orientation. With the proposed internal developments, we believe that the Digital Implant Solutions can not only become truly innovative and operate independently in ever-changing environment, but also attract talented new employees, while stimulating the current ones. As a result, DIS can provide and develop its customer experiences, and become the number one experience provider in the field, reach new customers, and increase revenue.

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Namahn, P.V. (2014) Service design Toolkit – improve the quality of your service with this hands-on toolkit. Available at: http://www.servicedesigntoolkit.org/ (Accessed: 11 February 2017). Nisula, J.-V. (2012) Searching for definitions for service design – what do we mean with service design? Available at: http://www.servdes.org/wp/wp-content/uploads/2012/02/Searchingfor-Definitions-for-Service-Design-%E2%80%93-What-do-we-mean-with-Service-Design.pdf (Accessed: 11 February 2017). Mashable (2012) Scvngr. Available at: http://mashable.com/category/scvngr/ (Accessed: 12 February 2017).

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