# Analyzing the Enablers of Customer Engagement in Healthcare Using TISM and Fuzzy MICMAC
## 5 Discussion  
The TISM model, as exhibited in Figure 2, depicts the interrelationships among the key enablers of customer engagement for branded content in healthcare. The model was formed based on the level partitioning, as shown in Table 3. The eight enablers got placed into five levels. Enablers at the bottom level are the most significant ones and at the top level are the most strategic ones. The bold arrows depict the direct relationship, and the dotted arrows show the indirect relationship among the enablers. These arrows always point upwards. The model demonstrates that informativeness (E4) is the most vital enabler, which derives from all other enablers. The health content that provides all the required information grabs customers' attention. They do not have to go to other sites or pages or contact the service provider to get all the necessary information. Therefore, informative content increases the level of customer engagement. The following vital enabler after informativeness is authenticity (E5). The information provided by a credible source is regarded as authentic. Authentic content comprises information from organizations like WHO, and FSSAI, recommendations from a reputed doctor, physician, etc. Authenticity is key in deriving other enablers in the hierarchy, as the content will be more trusted. Authenticity influences the quality of content. It is often presumed that credible healthcare service providers will post good quality content, free from error. Quality (E7) of content is the next significant enabler in the hierarchy. Good quality healthcare content seeks to engage customers. Also, the Fuzzy MICMAC results clustered the above three enablers, informativeness (E4), authenticity (E5) and quality (E7), as independent enablers that derive other enablers. Content quality increases the usefulness (E8) of the content, as the content, free from any error, aims to solve customers' problems. For example, if the address provided in  
Figure 2: TISM Model (Digraph). the content is wrong or the medicine prescribed is spelt wrong, it will hinder the purpose of the content, and engagement will be low with such content. At the same level of quality (E7) is content design (E3), although an appealing design and content format seek the customer's attention. Visual content is often perceived as more attractive than textual content. However, content design alone is assumed to have less influence in healthcare. When combined with other enablers like informativeness, authenticity, and quality, content design plays a significant role in engaging customers. Similarly, the entertaining value (E2) of content in isolation does not influence customer engagement. However, amalgamation with other enablers' entertaining value has a significant influence. Model results were supported by Fuzzy MICMAC analysis, where design (E3) and entertaining value (E2) were classified as autonomous and did not derive or get derived by other enablers. All the enabler discussed above increases the Shareability (E1) and Co-creation (E6) of the content. When the content is shared more, the customers will get an opportunity to co-create the content by providing their opinions and comments. Likewise, content with more co-creation would be shared more. Customers are more attracted to the content viewed and commented on by others and considered popular and shared widely. Also, shareability (E1) and co-creation (E6) were clustered as dependent enablers, which other enablers are causing. Thus, the enablers discussed above are crucial for engaging customers with branded content in healthcare  
The findings of our study are consistent with [16; 60; 61], where informative content was found to influence customer engagement positively. Our study's findings contrast with [24; 26], where vividness was the most significant factor impacting customer engagement with branded content for the hotel industry. In our study, vividness or content design is a less engaging enabler; it alone is insufficient to engage the customers.