Innovation as a Singular Enabler

In this paper, we consider the value of knowledge in an innovation context and deliberate a contrary perspective from existing empiricisms to bring about better innovation efficiency within multi-agent arenas. To do this, we consider why, if innovation is key for developmental trajectories in a healthcare environment, and despite the resource utilised to examine its characteristics, the transfer of knowledge within healthcare, practitioner or organisational innovation domains remains a problematic event.<br><br>We reflect on this duality with a doxastic attitude and draw on modal maps as underpinning structures to present a critique. Furthermore, we draw from these qualitative descriptions of conditional maps as a natural extension of contemporary KBF (Knowledge Belief Frame) models. Thus, from an innovation context, we can deliberate the parallelism between an agent who establishes belief in real time propositions, and a formal system from which they derive the proposition and reality. Uniquely, in doing so we build a legitimate frame of reference by highlighting managerial parallelisms, which synthesise key epistemic doyennes and, efficaciously underpin the plausibility of logical associations and decision-making drawn from a first-person architype of belief.


INTRODUCTION
For this discussion, we adopt structures of Healthcare Management as the context of innovation within the core discussion, by recognising the logic of epistemic actions as a priori aspects of decision making in relating to innovation. Our critique is positioned from the perspective of conceptual empiricism (Ginsborg, 2006;Moyal-Sharrock, 2013). We further draw from (De Marco & Romaniello, 2011;Gardenfors, 1986) for belief revisions and link to (Yager, 2001) for primary discussion around multi agent decision making. This allows for a logical descriptor point as the juncture between innovation and knowledge and permits a useful predicate for axiomatization of decision making at the onset.

Innovation as a context
Sheng et al (2013) argue that the purpose of knowledge transfer is to improve the ability of members to enhance organizational performance. Credible authors such as Brockman and performance are only achievable once an organization increases its knowledge internalization to a sufficient level to support an innovation trajectory. Drawing from this research, we can see that they exposed an unfamiliar perspective, whereby, utilising effective information technology competencies can allow healthcare organisations to overcome recognised limitations in both knowledge stickiness. Therefore, provisioning a higher degree of innovation becomes realised (Chien Hsing, Shu-Chen, & Hsin-Hui, 2013;Gausdal & Nilsen, 2011;Oborn, Barrett, & Racko, 2013;Tuan, 2008) and 'knowledge ambiguity' (Fulop, 2012;Stetler & Magnusson, 2015;Tansley, Huang, & Foster, 2013;Windecker et al., 2015). However, information technology is not the only solution needed to support knowledge transfer in this environment. This is because aligning knowledge transfer effectiveness and innovation can be viewed as a complex, dynamic process, which is difficult to embed (M. Fascia & Brodie, 2017).

The inevitability for improvement
By placing validation of innovative elements at this juncture, it is easy to see many informed perspectives, driving the need for innovation (Christina Beach, 2007;Lee, Moy, Kruck, & Rabang, 2014;McLaughlin & Militello, 2015;Savory & Fortune, 2014), particularly within a pressurised environment such as the healthcare sector (M. Fascia & Brodie, 2017).
Contemporary work indicates three acute facets, which rely heavily on innovation to stimulate business trajectory and sustainable growth (Bhayani, 2015;Genaidy, Sequeira, Rinder, & A-Rehim, 2009;Servaes & Lie, 2013). Thus, we can readily identify these rudiments as social and economic aspects affected by rising costs of treatment. Thus, all three necessitate a focus on innovation to improve efficacy and efficiency and or an underpinning strategy enabler (King & Foley Iii, 2010;Love & Roper, 2015;Roberts, Liu, & Hazard, 2005;Truss, 2003).
As such, innovation in a healthcare setting demands a move beyond the traditional or perhaps myopic view of innovation in a generalist business arena, and often seen in mainstream literature (Fellnhofer, 2018;Mohammad & Quoquab, 2017;Mohelska & Sokolova, 2017;Rahko, 2017;Santos, Navarro, & Kaszowska, 2017). This point of view tends to focus on innovation as being "the conversion of a new idea into revenues and profits" (Lafley & Charan, 2008, p. 21). Instead, when defining innovation in healthcare, there may be justification around embracing a broader definition of innovation. Such terms include efficiency, quality, and affordability (World Health Organisation, 2017). Wherein, de-emphasises the monetary gains to be made and refocuses on innovation from a social perspective. The World Health Organization (WHO) explains that, innovation in healthcare needs to bring about new or improved health policies, systems, products, technologies, services and delivery methods. Both Kimble and Rashmad, (2017) and (Barlow, 2016) derive similar conclusion, whereby, in this context, health care systems strive to offer improved diagnosis, treatment, prevention and thus, ultimately better access to healthcare for all.
From an innovative point of view therefore, it is relatively straightforward to explain why structured decision making in an innovative healthcare setting becomes important, and why the development of a deliberate strategy is particularly barrier laden and difficult (Fascia, M., Sanderson, M., Tan, H., & Fascia, S. 2019). Examining these barriers, Herzlinger (2006) highlights three main types of health care innovation and the six forces (problematic issues) which affect them. Thus, we can relate these directly to a knowledge transfer paradigm of the same or similar context.
Herzlinger notes transient problems with delivery (how patients buy and use healthcare), technology use (utilised to create new products and treatments) and business models (seeking to integrate healthcare organisations and activities). Running in parallel to these three areas of multiplicity, there are additional issues, which can arise. Notably, stakeholders, funding, governmental policy, introduction of new technology, expectations of healthcare service users and unsurprisingly, the necessity of accountability.

FIGURE 1 -INNOVATION AS A SINGULAR ENABLER
As we can see from Figure 1, innovation in this context, as a singular enabler, is limited when used as leverage for improvement or innovation, as any development would be limited to a single perspective or expected outcome. Thus, to gain value, it may be more appropriate if an agent could establish a real time state of validity for any value expectation(Caccia-Bava, Guimaraes, & Guimaraes, 2013;Chatzoudes, Chatzoglou, & Vraimaki, 2015;Gagnon et al., 2014;Prasarnphanich, Janz, & Patel, 2016;Rouch et al., 2015) , thus, devolve both predict and precept notions of value accountability as a reality. That is, an internal locus or state of belief of either knowledge value or precipitation which can directly or indirectly relate to an innovation outcome and equal value emphasis. Whereby, all iterations of probability relating to a decision making knowledge transfer dilemma remain as valid, only if, they are logical along a constant frame of reality from an actor's perspective of useful innovation.
Formalisation of a position such as this, for example in a healthcare environment, allows principles of innovation to become evident as conditional interpretations of process outcome, importantly, still in the context of surrounding decision making protocols and knowledge transfer mechanisms (Argote & Fahrenkopf, 2016;Boyd, Ragsdell, Oppenheim, & Martins, 2007;Goyette, Cassivi, Courchesne, & Elia, 2014;Song, Zhu, & Rundquist, 2015;Zhang & Jiang, 2015). Thus, exchanges to practical and recognisable environments may now use innovation as a leverage mechanism or driving force for any successful outcome.

PROBLEMATIC PERSPECTIVE
[P] Subsequently, we can then relate interpretation within an aperture of reality and change, as this allows for the formation of informal axiomatic theories of belief based on interpretational realism (Godel, 1932;Bull & Krister 1984), and therefore, decisions remain perpetual or dynamic within the knowledge exchange/belief framework.
However, for this position to become valuable, it is only by analysing the somewhat complex processes at work within a Healthcare environment, such as daily working practices, that useful identification of normative and appropriate interaction between the perceptual or dynamic decision making process emerges (Bansemir, Neyer, & Möslein, 2012;Moncaster et al., 2010;Murdock, Shariff, & Wilding, 2013;Swaroop et al., 2014). This perspective is a Authors such as (Dinur, 2011;Henriques, 2014;Huang, Ling, Yang, & Zhao, 2010;Littrell, 2013) explain that since knowledge is a subjective perspective of an individual's experience, any assimilated outcome or perspective must also be experiential and subjective. Whereby, alternative views assume an interpretive congruence as an explanatory position, and nothing more. This view in itself becomes understandable if you also consider interpretation of knowledge from the perspective of managerial expectation of the same innovation project within the organisation (J. Barnett, Vasileiou, Djemil, Brooks, & Young, 2011; L. Barnett & Carter, 2015;Storey & Barnett, 2000). A cumulative viewpoint therefore allows an individual's past experiences of the organisation to be related to 'meaningful' knowledge from the organisations point of view (Fascia et al. 2019). As such, experiences can contribute to the retaining of knowledge, and resources, which contribute to the current position of understanding and underpins aspects of competitiveness.
Relating this position to value in a Healthcare Management context (White & Cicmil, 2016, Jehn, De Wit, Barreto, & Rink, 2015 reflect on the different beliefs asymmetries to which practitioners, as human beings, hold in two very distinct ways. These are basic and non-basic. (Lambek & American Mathematical Society., 2009). Thus, in this reality, any revision of proposition would result from the relationship between the two axioms, however, could not be interpreted as a defining measurement of value, only a differential of perspective.

Problematic framework
We could now argue that this is a natural event, since the practitioners view of knowledge is subjective and assumes any possibly relevant mental evaluative states, relative to the effectiveness of decision, innovation or outcome, are in effect, experiential (Kranjec, 2005).
Therefore, examination of an overriding epistemic principle would be required as a baseline for successful critique or measurement. We can therefore establish, or at least infer, why plausible extensions and reciprocal elements of classical belief revision theory may indeed be useful when underpinning strategic outcomes, particularly within complex association of outcomes such as a pressurised environment. Further, it is easy to understand why this simplistic view could be appealing and offer a natural answer for creation, expectation and definition of planned outcomes.
Consequently, simplification of context or category of meaning, possibilities and necessities also becomes conceivable, wherein, plausibility tasks or probabilistic events can become graded measures based on the same reality model. However, this baseline would not relate to both business and personal frames of existence simultaneously, (Kelley & Nahser, 2014;Narasimhan, Bhaskar, & Prakhya, 2010;O'Donohue & Nelson, 2014;Thornhill, 2005), since exchanged knowledge from this perspective can derive only from experience.
Nevertheless, as a barrier to effective innovation strategy, this now becomes a dichotomous proposition, since knowledge does not exist as an independent entity, which can be measured, transferred and evaluated, such as information surrounding any material object might be.
Thus, the positioning is unsustainable since this position suggests that an unknown subject or phenomena, within a normal sphere of reality, cannot be transferred as knowledge, since it does not yet exist as an independent entity. That is to say, it would be impossible to transfer knowledge as underpinning value on the basis that experiential reasoning, for example, surrounding the decisions or expectations of an innovation strategy, determines the validity of the knowledge content.

Structure for Interpretation
If we therefore assume the complex position of knowledge from a healthcare perspective previously discussed, is the universal norm within generalist business management theory (White & Cicmil, 2016), then one could legitimately ask, if the existence of knowledge that in itself depends on the interpretation of a foundational normality is true. Wherein, does the relationship of belief under this premise (Gardenfors, 1986;Narasimhan et al., 2010;Sokolowski, 1992) result from epistemic incongruence by assuming it is either connected or unconnected to the propositional outcome. If this were a collective equilibrium, covering every transfer scenario, then, all knowledge must derive from a consequence of foundational ethics (Depoe, 2007;Glynn, 2013;Klein, 2009), which themselves cannot be refuted by accepted moral norms.
This situation is perplexing to say the least and suggests that knowledge of the real world, particularly in a business context, is fallible and multifariously theory laden and allows several options when revising theory with a similar proposition. Whereby, a willingness to accept presuppositions which is independent of any evidence. That is to say, there is no natural mechanism, which can allow interpretation of variations within innovative knowledge based To assist with this complex interaction, key elements of emphasis around knowledge value can be drawn from a POPC (Philosophical, Organisation, Psychological, Cultural) lens of interpretation (Fascia, 2015), since this approach allows a multi view perspective to interweave between individual and group interpretations within a linear or relativistic frame of reference (Fascia, 2016). This approach allows us to consider that form and location of any knowledge, the indication of knowledge-sharing capability, the relationship between the source and the recipient and the broader environment in which the transfer occurs, are all contributing factors in assessing success (Fascia, 2015).
This view now gives the observer a similar frame of reference to the participating agents, whereby, any revision of a proposition within the reference framework allows interpretation from a predicate. Hence, the standpoint satisfies any necessary axioms, both by contradiction and revision, and at the same time, considers facets of congruence and consistency within the agent's interpretation of the transfer scenario.

Parallelism
From the previous discussion , we can see that the central locus of logical interpretation centres around foundational realism (Depoe, 2007;Glynn, 2013;Klein, 2009 in a business context, as it would appear to be a key factor in understanding useful attributes However, in doing so, this view would ultimately seek to examine various propositions using a single point of view, principally from occidental foci, which in itself is derived from historical concepts of Objectivism (Green, 2012). Therefore, we may consider this myopic interpretive stance as something, which contributes to the incredulity surrounding knowledge and is part of a non-existing logical context when deriving a reality (Stalnaker, 1968;Spohn ,1988). Consequently, the interpretive praxis for a specific knowledge schema could be debated at length as it would appear that there is no single interpretation of something, which could be interpreted as normal knowledge, even within the realms of contemporary thinking around critical realism (Bull & Krister 1984;Rotaru et al., 2014).
Ultimately, when considering or determining knowledge as a useful element within a healthcare organisation, it now seem logical to consider how a position of identifiable knowledge fits within an agent's interpretive overview of formalised knowledge and what is interpreted as useful in that context. That is, we need to consider the reality of how and why an observer of a knowledge transfer scenario would consider sets of closely related realities with differing frames of reference Boutilier (1995). This would result in a formal structure of the agent's belief and the ordering of epistemic propositions (Arlo-Costa & Parikh ,2005).
We can now accept, at least from a healthcare business perspective (or context), when conceiving knowledge as a faculty for distinguishing between truth and falsity of innovation success, any experiential decision would lack the cognitive status traditionally ascribed as reality, and therefore would be considered a priori false. Accordingly, from the standpoint of knowledge value, it is important therefore to consider the evidence of this knowledge when deciding if it is true or not when related to innovation. As such, does the knowledge itself need to be better understood before it can be successfully transferred or is it simply empirical cogency, which has been transferred and innovation is a by-product of the transfer. Clearly, from a business context, this involves philosophical support by paradigms and archetypes overarching business activity and relating to innovation success, but thereby giving knowledge 'value' by this premise alone and not as a justification of any other epistemic principle.

Measurable Impost-Using a Doxastic structure
If we are now able to consider this duality of proposition as a single entity by using both the agent and observers reality, that is to say, to what extent can alignment be validated, in a way that supports corrective knowledge transfer axioms (Jiang, Colakoglu, Lepak, Blasi, & Kruse, 2015), then it becomes a very useful perspective indeed. As such, it this central locus, which becomes the key for interpretation of a knowledge innovation singularity, as it provides a valid frame of reference for both the initiator of the knowledge and the observer of the outcome. This is because both positional inferences presuppose an assumption, in that, they both require interpretive associations from the actors to legitimise any validity regarding knowledge, and thus, inextricably link knowledge and knowledge transfer as the same cognitive process (Dinur, 2011;Jensen, 2010;Thornhill, 2005) This then allows differing actions to align to differing options or operators of necessity, and not simply interpretations of fallible and defeasible evidence as experiential/nonexperiential. This is an important position to adopt, as we can now approach epistemological issues regarding the definition of knowledge and knowledge value from a pragmatic centre of innovation and relate this to a degree of success from whatever perspective suits the stakeholder(s). However, we first need to be able to adopt an axiomatic (Alberto Benítez, 2013;Diaconescu, Metcalfe, & Schnüriger, 2016;Leitgeb & Segerberg, 2007;Liau, 2005) starting point and epistemic principles from which to define knowledge from these multiple perspectives.
The benefit from this interpretation is clear, that is, if we endorse this axiomatic positioning, then we can endorse both hermeneutics (Charalambous & Kaite, 2013;Smebye, Kirkevold, & Engedal, 2012;Stolper, Molewijk, & Widdershoven, 2015) and foundationalism (Coliva, 2010;Laudo Castillo, 2011;Rosenberger, 2017)  To fully debate, this point would be extensive to say the least, however in the caveat of a healthcare in a business or innovation context, we can say that a philosophically identifiable position of knowledge is understood as phenomenon identifiable through interpretation.
However, as a caveat, a phenomenon which may be experienced as a temporal dimension, linked to an agreed outcome, but has to be justified as a true belief before it can be termed valuable. Therefore, we can determine decision-making processes in this regards as a sequence or 'set' of logical consequence (conjunction and disjunction) of each categorical knowledge transfer constituent, linked to innovation.
Thus, if we underpin conditional doxastic structure as fundamental to dynamic innovation based on knowledge transfer structure efficacy, we can deduce that non-beneficial decisions, related to an agreed outcome, or states of information in an investigation, become somewhat redundant within this reality frame. Whereby, epistemically distinguishable facets assume irrelevant features, wherein, ordinal tasks and plausibility evaluations remain evident, but contradicted to the original expected outcome. conventional Kripke frame (Diaconescu et al., 2016;Fernández-Duque & Joosten, 2014;Perkov, 2014) or more commonly referred to as (modal frame) (Jepson, Richards, & Knill).

As such, [W] is now a set and [R]
is subset of the same Cartesian product (Hazelrigg, 2012;Kremer, 2016)  Now, we can easily relate this perspective to elements of innovation and effectiveness of knowledge transfer as a dyadic relationship discussed by (Hazelrigg, 2012;Kremer, 2016) and also perspectives from (Carnovale & Yeniyurt, 2015;Caro, 2008;Jehn et al., 2015;Jensen, 2010). This can be drawn together as an analytical lens within a knowledge based environment (Jensen, 2010;Lakpetch & Lorsuwannarat, 2012;Pietromonaco, Uchino, & Schetter, 2013). Therefore, assume the operation of expectation is concurrent with, and only with, the agent's reality frame of reference at a single point of the decision-making process.
Wherein, any unrelated point reflective of any other point becomes non-conventional valuation and therefore has the possibility to reduce to classical truth.
As such, any new knowledge, related specifically to innovation via a cumulative decisionmaking process (FIGURE 2), and explicitly within an agent's reality frame, becomes an expansion of set [W]. Further, has the potential to develop, but only as a composite understanding of all available knowledge from the agent's frame of reference (reality). In that, the axioms are valid and the rules for interpretation preserve validity of any value related to the know knowledge. Whereby, we can draw differentiated conclusion from either modal result, resulting in triangulation of individualised modality.
Whereby, we can now observe legitimate mechanisms, which establish a belief version of understanding, and show how this positioning translates to numerous abstract hypothesises for revision in a knowledge context in an innovation timeline.
From the perspective of a recognisable domain, this allows framing of reality for any agent and observer (Bennett, 2003;Bonanno, 2007aBonanno, , 2007bCholvy & Hunter, 2003) in the context of either innovation or the knowledge needed to initiate the idea. Whereby, an innovation agent who believes it is possible to reason and represent aspects of beliefs regarding reality from the frame of reference of the observer. Consequently, we can now place propositions of innovation in this discussion within a relative frame of reference and link belief, knowledge and probability, to assume an elemental obligation (Dale & Stacey, 2016;Newlands, 2013;Waibel, Vo, Duchnowski, & Manke, 1996) Prenestini, Lega, & Webb, 2013;Weil, 2003) or develop unnecessarily complex realms around modes of existence.
Effectiveness of the transfer mechanism related to innovation therefore, emerges as changing operations with standard frame correspondences. Interpretation, therefore, becomes a significant premise, since interpretation of this interaction from the agent's perspective could lead to a number of different validity subscriptions. Therefore, logical interpretation of the transfer scenario using a doxastic attitude allows us to recognise versions of experience as elements of knowledge in an agent's interpretation of reality. Appropriately however, predominantly in the region of cooperative problem solving and decision-making with a specific innovative feature or facet.

CONCLUSION
This discussion has focused on outlining and assessment of current and historical knowledge philosophy, theory and positioning, but at the same time, places it within the realms of a business context. In the discussion, we concentrated on a Doxastic attitude and epistemic principle surrounding the use of knowledge in a business context, wherein, we concluded that this combined faced becomes necessary when examining if knowledge is important.
Through reconciliation of foundational and doxastic positions, we explained that we can now view knowledge and knowledge value as a singular construct. Importantly, however, this is characterised through a multitude definition but not as a singular epistemic principle. As such, our discussion explained that to assume any value or relevance to the sender or receiver, the acceptance of the tripartite theory of knowledge, Belief, Truth and Justification (epistemic principle) must also be inferred as a normative of value within the transfer mechanism.
Adoption of this positioning in the decision making process allows justification to the premise surrounding the interaction of an epistemic knowledge principle and is now based on a knowledge transfer practitioner's point of view supported by a doxastic presumption. This new perspective can allow the identification of alternative viewpoints to knowledge and knowledge transfer mechanisms to exist simultaneously with innovation trajectories and an assumption of effectiveness can be easily deduced.
From the perspective of mainstream business management within the speciality of healthcare innovation, and specifically relating to underpinning business practices of success and competitive advantage, this flexibility of interpretation becomes a significant advantage to the business or organisation.