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Innovation management in the healthcare sector has undergone significant evolutions over the last decades. These evolutions have been investigated from a variety of perspectives: clusters, ecosystems of innovation, digital ecosystems and regional ecosystems, but the dynamics of networks have seldom been analyzed under the lenses of entrepreneurial ecosystems (EEs). As identified by Cao and Shi (2020), the literature is silent about the organization of resource allocation systems for network orchestration in EEs. This article investigates these elements in the healthcare sector. It discusses the strategic role played by entrepreneurial support organizations (ESOs) in resource allocation and elaborates on the distinction between sponsored and nonsponsored ESOs in EEs. ESOs are active in network orchestration. The literature explains that ESOs lift organizational, institutional and cultural barriers, and support entrepreneurs' access to cognitive and technological resources. However, allocation models are not yet discussed. Therefore, our research questions are as follows: What is the resource allocation model in healthcare-related EEs? What is the role played by sponsored and nonsponsored ESOs as regards resource allocation to support the emergence and development of EEs in the healthcare sector?

The article offers an explanatory, exploratory, and theory-building investigation. The research design offers an abductive research protocol and multi-level analysis of seven (sponsored and nonsponsored) ESOs active in French healthcare ecosystems. Field research elaborates on semi-structured interviews collected between 2016 and 2022.

This article shows explicit complementarities between top-down and bottom-up resource allocation approaches supported by ESOs in the healthcare sector. Despite explicit originalities in each approach, no network orchestration model prevails. Multi-polar coordination is the rule. Entrepreneurs' access to critical technological and cognitive resources is based on resource allocation modalities that differ for sponsored versus nonsponsored ESOs. Emerging from field research, this research also shows that sponsored and nonsponsored ESOs manage their roles in different ways because they confront original issues about organizational legitimacy.

Beyond the results listed above, the main originalities of the paper relate to the instantiation of multi-level analysis operated during field research and to the confrontation between sponsored versus nonsponsored ESOs in the domain of healthcare-related innovation management. This research shows that ESOs have practical relevance because they build original routes for resource allocation and network orchestration in EEs. Each ESO category (sponsored versus nonsponsored) provides original support for resource allocation. The ESO's legitimacy is inferred either from the sponsor or the services delivered to end-users. This research leads to propositions for future research and recommendations for practitioners: ESO managers, entrepreneurs, and policymakers.

Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.

Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.

Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.

This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.

Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.

The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.

This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.

Business models (BMs) are becoming increasingly crucial for value creation in the healthcare sector. The study explores the conceptualization and application of BM concepts within the healthcare sector and investigates their evolution in emerging economies (EEs) and developed economies (DEs). This study aims to uncover these two contexts' shared characteristics and unique variances through a comparative analysis.

The paper systematically investigates and consolidates the literature on healthcare by employing the antecedents, decisions and outcomes (ADO) framework and finally examines 71 shortlisted articles published between 2003 and 2022.

The recognition of the BM within healthcare is increasing, both in EEs and DEs. EEs prioritize value creation and capture through cost efficiency, while DEs focus on innovation. Key theories employed include a resource-based view, the network theory and the theory of innovation. Case studies are commonly used as a methodology. Further research is needed to explore the decisions and outcomes of BMs.

The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

Beyond comparing and highlighting gaps in BMs between EEs and DEs, benchmarking DE's healthcare business models (HBMs) helps healthcare organizations in EEs align their practices, mitigate risks and establish efficient healthcare systems tailored to their specific contexts. The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

The study analyzes HBMs using an SLR framework perspective and provides practical implications for academicians and practitioners to enhance their decision-making.

The lean startup approach (LSA) is extensively utilized by early-stage entrepreneurs, with “pivot” serving as a key pillar. However, there is a research gap concerning the boundary conditions impacting LSA and pivot decisions, especially when addressing societal challenges, as in the context of transformational entrepreneurship. In this regard, the healthcare sector, further compounded by a lack of research on startups and scale-ups, presents an embraced opportunity to provide multiple contributions for both theory and practice.

The present investigation employs a grounded approach to explore the experiences of the co-founders of a fast-growing Italian e-health startup. A narrative strategy was employed to organize conditions and evolving strategic action/interactions into three different pivoting phases of the startup – before the pivot, its enactment and aftermath – with primary and secondary data collected over a period of one year.

Pivoting in digital healthcare unfolded as a liminal experience marked by factors such as high regulation, multiple stakeholders, technological and symbolic ambivalence, resource-intensive demands and institutional actors acting as pathway pioneers, leading to an information overload and unforeseeable uncertainty to manage. These factors challenge entrepreneurs' ability to attain optimal distinctiveness, presenting the paradoxical need for vertical flexibility for scaling up.

By uniquely illuminating the sector’s constraints on entrepreneurial phenomena, this study provides a valuable guide for entrepreneurs and institutional actors in addressing societal challenges.

This study introduces a process model of transformational information crafting when pivoting, highlighting the role of entrepreneurs' transformational stance and platform-mediated solutions as engines behind strategies involving information breaking and transition, preceding knowledge-driven integration strategies.

Business intelligence (BI) systems and tools are deemed to be a transformative source with the potential to contribute to reshaping the way different healthcare organizations’ (HCOs) services are offered and managed. However, this emerging field of research still appears underdeveloped and fragmented. Hence, this paper aims to reconciling, analyzing and synthesizing different strands of managerial-oriented literature on BI in HCOs and to enhance both theoretical and applied future contributions.

A literature-based framework was developed to establish and guide a three-stage state-of-the-art systematic literature review (SLR). The SLR was undertaken adopting a hybrid methodology that combines a bibliometric and a content analysis.

In total, 34 peer-review articles were included. Results revealed significant heterogeneity in theoretical basis and methodological strategies. Nonetheless, the knowledge structure of this research’s stream seems to be primarily composed of five clusters of interconnected topics: (1) decision-making, relevant capabilities and value creation; (2) user satisfaction and quality; (3) process management, organizational change and financial effectiveness; (4) decision-support information, dashboard and key performance indicators; and (5) performance management and organizational effectiveness.

To the authors’ knowledge, this is the first SLR providing a business and management-related state-of-the-art on the topic. Besides, the paper offers an original framework disentangling future research directions from each emerged cluster into issues pertaining to BI implementation, utilization and impact in HCOs. The paper also discusses the need of future contributions to explore possible integrations of BI with emerging data-driven technologies (e.g. artificial intelligence) in HCOs, as the role of BI in addressing sustainability challenges.

The purpose of this study is to identify organisational homeostasis factors in the context of healthcare organisations and to develop a conceptual model for green transformation.

The organisational homeostasis factors were determined by review of literature study and the opinions of healthcare experts. Scheduled interviews and closed-ended questionnaires are employed to collect data for this research. This study employed “TISM methodology” and “MICMAC analysis” to better comprehend how the components interact with one another and prioritise them based on their driving and dependence power.

This study identified 10 factors of organisational homeostasis in healthcare organisation. Recognition of interdependence, hormesis, strategic coalignment, consciousness on dependence of healthcare resources and cybernetic principle of regulations are the driving or key factors of this study.

The study's primary focus was on the organisational homeostasis factors in healthcare organisations. The methodological approach and structural model are used in a healthcare organisation; in the future, these approaches can be applied to other industries as well.

The key drivers of organisational homeostasis and the identified factors will be better comprehended and understood by academic and important stakeholders in healthcare organisations. Prioritizing the factors helps the policymakers to comprehend the organisational homeostasis for green transformation in healthcare.

In this study, the TISM and MICMAC analysis for healthcare is proposed as an innovative approach to address the organisational homeostasis concept in the context of green transformation in healthcare organisations.

The goal of this article is to provide an overview of healthcare entrepreneurship, both in terms of its current trends and future directions.

The article engages in a systematic review of extant research on healthcare entrepreneurship using the scientific procedures and rationales for systematic literature reviews (SPAR-4-SLR) as the review protocol and bibliometrics or scientometrics analysis as the review method.

Healthcare entrepreneurship research has fared reasonably well in terms of publication productivity and impact, with diverse contributions coming from authors, institutions and countries, as well as a range of monetary and non-monetary support from funders and journals. The (eight) major themes of healthcare entrepreneurship research revolve around innovation and leadership, disruption and technology, entrepreneurship models, education and empowerment, systems and services, orientations and opportunities, choices and freedom and policy and impact.

The article establishes healthcare entrepreneurship as a promising field of academic research and professional practice that leverages the power of entrepreneurship to advance the state of healthcare.

The article offers a seminal state of the art of healthcare entrepreneurship research.

Blockchain technology enhances information management in healthcare supply chains by securing healthcare information and providing medical resource traceability. However, there is no decision framework to support blockchain implementation for managing information, especially in emerging economies’ healthcare supply chains. This paper develops a hierarchical decision model for implementing blockchain technology for information management in emerging economies’ healthcare supply chains.

This study uses 20 health supply chain experts in Ghana to rank 17 decision criteria for implementing blockchain for healthcare information management using the best-worst method (BWM) multi-criteria decision technique.

The results show that “security” and “privacy,” “infrastructural facility” and “presence of training facilities” are the top three critical factors impacting blockchain adoption in the health supply chain for healthcare information management. Other sub-factors are prioritized.

To implement blockchain effectively to enhance information management in the healthcare supply chain, health institutions, blockchain technology providers and state authorities should concentrate on the highly critical factors extracted from the study.

This is the first study that develops a hierarchical decision model for implementing blockchain technology in emerging economies' health supply chains.

In this article, we reflect on how smart technology is transforming service research discourses about service innovation and value co-creation. We adopt the concept of technology smartness’ to refer to the ability of technology to sense, adapt and learn from interactions. Accordingly, we seek to address how smart technologies (i.e. cognitive and distributed technology) can be powerful resources, capable of innovating in relation to actors’ agency, the structure of the service ecosystem and value co-creation practices.

This conceptual article integrates evidence from the existing theories with illustrative examples to advance research on service innovation and value co-creation.

Through the performative utterances of new tech words, such as onlife and materiality, this article identifies the emergence of innovative forms of agency and structure. Onlife agency entails automated, relational and performative forms, which provide for new decision-making capabilities and expanded opportunities to co-create value. Phygital materiality pertains to new structural features, comprised of new resources and contexts that have distinctive intelligence, autonomy and performativity. The dialectic between onlife agency and phygital materiality (structure) lies in the agencement of smart tech–enabled value co-creation practices based on the notion of becoming that involves not only resources but also actors and contexts.

This paper proposes a novel conceptual framework that advances a tech-based ecology for service ecosystems, in which value co-creation is enacted by the smartness of technology, which emerges through systemic and performative intra-actions between actors (onlife agency), resources and contexts (phygital materiality and structure).