Abstract: The traditional community medical paradigm focuses on providing offline, face-to-face medical services, whereas the O2O community medical platforms have the potential to fully leverage and attract more social medical resources, and provide personal and diverse services for patients. However, due to the fact that service cannot be stored or produced in advance, suppliers usually participate in the operations of multiple SSCs at the same time to improve the utilization of service capacity and reduce the irreversible idle loss. Therefore, the O2O community medical platforms may not be able to find a completely matched resource under the constraints of a certain time and region, resulting in the disruptions of medical service supply chain, which has negative impacts on value creation and delivery. In response to the underlying service interruptions, the O2O medical platform should carry out reasonable dynamic reform of medical resources in different stages of diagnosis and treatment in accordance with patients' personal demands. Practically, it is not uncommon for focal firms to guide suppliers reforming their service content and delivery manners to satisfy customers personalized requirements. For example, in the field of elderly health care, after completing the basic treatment for patients, medical staffs can provide extra psychological counseling according to the psychological and disease characteristics of the elderly; in the field house decoration, after the house-moving services, workers usually offer house-clean services if customers need them. Obviously, the above-mentioned psychological counseling and house-clean services are both personalized requirements beyond the scope of suppliers' basic services. Suppliers with relevant resource endowment have the potential to extend their service scope to adapt to customers' diversified demands. Theoretically, in the field of service supply chain management studies, only limited attention has been paid to the dynamic reform activities of suppliers.
Based on the in-depth analysis of the operation characteristics of medical resources under O2O community medical platform, this study scrutinizes the dynamic reform mechanism of medical resources, which emphasize the capability of medical resources in extending their service boundary through reorganizing the resources in disposal. Specifically, a service order usually consists of multiple processes. In each process, customers may make personalized requirements in addition to basic ones, for example, a patient with chronic disease requires a detailed physical examination after rehabilitation treatment; an elderly patient requires home acupuncture and massage services. When receiving orders from customers, focal firms should primarily ensure the fulfillment of basic requirements, which is of importance to their business credit, and then the fulfillment of the personalized ones. In the specific time and place, if no supplier in the platform can completely meet customers' demands, then the dynamic reform mechanism will help suppliers to absorb new resources and restructure the organization of the resources to form new capabilities according to customers' demands. Since different suppliers usually present different efficiency in reform activities, in this study, we use the data envelopment analysis (DEA) to measure the reform efficiency. Based on the principle of constant returns to scale (CRS) technology, this study constructs a super-efficiency CCR model with non-Archimedean number, and calculates the efficiency in joint service scenarios and separate service scenario, respectively. Through comparing the efficiencies in the two scenarios, the degree of scope economies can be measured. The suppliers with higher degree of scope economies usually have competitiveness in saving cost. Besides, the dynamic reform activities will also influence suppliers' value creation for customers. This study evaluates customers' satisfaction in multiple dimensions, including service content, delivery manners, degree and convenience. On this basis, a multi-objective optimization model of the O2O community medical platform resource scheduling is constructed and solved through the improved NSGA-Ⅱ algorithm. The optimization model captures the optimal scheduling scheme through a trade-off among service cost, customers' satisfaction and strategic synergy. Besides, the crossover and mutation operators are improved to inhibit inbreeding.
We adopt a famous O2O medical service platform as an example to test the effectiveness of the optimization model and the corresponding algorithm. Since the DEA model is very sensitive to the correctness and objectivity of the data, to avoid a distortion of the evaluation results, we collect the operation management information of 145 medical suppliers in Beijing from September to December in 2020. The numerical study shows that the optimization model and the corresponding algorithm can solve the scheduling problem under resource dynamic reform, which provides an effective decision-making tool for managers. This study demonstrates the following implications from a managerial perspective: (1)In the changing environment, the dynamic reform mechanism is critical to improving the performance of the service supply chain. (2)Since service supply chain consists of multiple participates, including focal firm, supplier and demand market, the configuration of SSC should consider the interests of the three main entities through setting different priorities for different objectives.
The authors would like to thank the anonymous reviewers and editors, whose valuable comments and corrections substantially have improved this paper. This study is a preliminary exploration of the self-adaptive SSC configuration, so there are still some limitations. In future study, we will focus on multi-period optimization model under dynamic reform mechanism.

Key words: O2O community medical platform, resource dynamic reform, scope economies, scheduling optimization

摘要： 不同于传统单一线下医疗模式,O2O社区医疗平台模式能够广泛链接更多种类和数量的医疗资源为患者提供个性化服务。但该模式的运营特征决定了医疗资源往往会并行参与多项服务,调度主体不一定能够在特定时间和地域约束下找到完全贴合的资源,导致医疗服务供应链的中断。为应对这一问题,平台需要在不同诊疗阶段针对患者需求进行医疗资源的动态改造。在对O2O社区医疗平台运行特征分析的基础上,提出了医疗资源的动态改造机理,并对客户多维满意度和资源改造效率的刻画进行研究。在此基础上,构建了O2O社区医疗平台供应链资源调度的多目标优化模型和改进的NSGA-Ⅱ求解算法。最后,通过算例验证了模型和算法的可行性、有效性和适用性。

关键词: O2O社区医疗平台, 资源动态改造, 范围经济, 调度优化