Position of the units in the focus matrix. Based on the degrees of focus on product and process, the positions of the units are depicted in the focus matrix. Four specialty field were studied. Medical oncology (yellow) considered two EU units (1, 2) and four US cases (4 - 6). Orthopedics care and knee implants considered the orthopedic departments (7, 9) and knee implants (8, 10) of a general hospital and orthopedics center in the Netherlands. Cataract care (green) considered one NL (11), one UK (12), and one US (13) case. Elective surgery (blue) considered five centers for low-complex elective surgery in the Netherlands (14 - 18).