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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 COVID-19 pandemic has created a crisis for healthcare systems worldwide. There have been significant challenges to managing public and private health care and related services systems’ capacity to cope with testing, treatment and containment of the virus. Drawing on the foundational research by Frow et al. (2019), the paper explores how adopting a service ecosystem perspective provides insight into the complexity of healthcare systems during times of extreme stress and uncertainty.

A healthcare framework based on a review of the service ecosystem literature is developed, and the COVID-19 crisis in Australia provides an illustrative case.

The study demonstrates how the service ecosystem perspective provides new insight into the dynamics and multilayered nature of a healthcare system during a pandemic. Three propositions are developed that offer directions for future research and managerial applications.

The research provides an understanding of the relevance of managerial flexibility, innovation, learning and knowledge sharing, which offers opportunities leading to greater resilience in the healthcare system. In particular, the research addresses how service providers in the service ecosystem learn from this pandemic to inform future practices.

The service ecosystem perspective for health care offers fresh thinking and an understanding of how a shared worldview, institutional practices and supportive and disruptive factors influence the systems’ overall well-being during a crisis such as COVID-19.

This paper aims to conceptualize and characterize service ecosystems, addressing calls for research on this important and under-researched topic.

The authors draw on four meta-theoretical foundations of S-D logic – resource integration, resource density, practices and institutions – providing a new integrated conceptual framework of ecosystem well-being. They then apply this conceptualization in the context of a complex healthcare setting, exploring the characteristics of ecosystem well-being at the meso level.

This study provides an integrated conceptual framework to explicate the nature and structure of well-being in a complex service ecosystem; identifies six key characteristics of ecosystem well-being; illustrates service ecosystem well-being in a specific healthcare context, zooming in on the meso level of the ecosystem and noting the importance of embedding a shared worldview; provides practical guidance for managers and policy makers about how to manage complex service ecosystems in their quest for improving service outcomes; and offers an insightful research agenda.

This research focuses on service ecosystems with an illustration in one healthcare context, suggesting additional studies that explore other industry contexts.

Practically, the study indicates the imperative for managing across mutually adapting levels of the ecosystem, identifying specific new practices that can improve service outcomes.

Examining well-being in the context of a complex service ecosystem is critical for policymakers charged with difficult decisions about balancing the demands of different levels and actors in a systemic world.

The study is the first to conceptualize and characterize well-being in a service ecosystem, providing unique insights and identifying six specific characteristics of well-being.

The purpose of this paper is to investigate the role of patient loyalty programs in healthcare environment, generally considered as a way to engage patients and potentially increase the perception of service quality of healthcare systems, but not systematically analyzed at the state of the art.

The Service Dominant logic and, in particular, the service ecosystem construct are adopted and integrated with relevant literature references and empirical studies on a sample of patients. Loyalty programs are interpreted as institutions coordinating actors of the healthcare service ecosystem.

A conceptual model linking loyalty programs to patients and healthcare providers’ co-creation practices, engagement, satisfaction, trust, and perception of service quality is build and explained based on literature and a case study, finding that loyalty programs can strengthen the adaptability and the well-being of a healthcare service ecosystem.

This contribution can have a significant impact on the design of new and the evolution of current healthcare service ecosystem, providing interesting insights to practitioners on the topic of loyalty programs, both for their development and their benefits.

The paper revised previous healthcare service ecosystems and highlights the role of the loyalty program institution at each level and between levels of the ecosystem.

Covid has increased the usage of multisided digital platforms. For companies, this has become a business opportunity. Data usage on platforms requires that platform companies co-create services for common customers. In this case, the target is not to make the same value proposition but rather to use the resources such as data, knowledge, technology, or institutions in a complementary manner. Platforms are characterized as a combination of hardware and software including standards, interfaces, and rules making it possible for different ecosystem players to complement and interact in the ecosystem. Current ecosystems include several platforms that do not work without resource integration. The purpose of this study is to increase understanding what do we mean by resource complementarity in service ecosystems.

This study was done via an in-depth qualitative case study in which a health service ecosystem co-creating technological surgery innovation was used as a unit of analysis.

The authors’ findings suggest that key resource capabilities, to enable complementarity in service ecosystems, are motivation, knowledge, skills, data and complementary designed technology components.

The authors’ study increases theoretical understanding of what does one mean by construct of resource complementarity.

From a managerial perspective, it is shown that organizations need to develop adaptive capabilities to utilize internal and external competencies and resources and enable co-creative processes within the service ecosystem.

Very few empirical studies in the marketing literature have focused on multi-sided digital platforms and their resource complementarity in the data-driven healthcare ecosystem settings.

The paper investigates how the engagement of a group of actors (the volunteers), previously unexplored in service ecosystems literature, contributes to generating new co-creation activities and well-being outcomes in the healthcare service ecosystem (HSE). Moreover, the study analyses how the provision and integration of volunteers’ resources help to explain the HSE self-adjustment favouring the re-humanisation of service.

The article zooms in on the volunteers’ activities in an HSE. A qualitative approach is adopted, and an empirical investigation is grounded in data gathered from Kids Kicking Cancer (KKC) Italia, a volunteer association operating in the paediatric oncology ward of Italian hospitals. Data are collected and triangulated through in-depth interviews, volunteers’ diaries and observations. The analysis is conducted by adopting an interpretative thematic analysis technique.

The study provides a conceptual framework explaining how volunteers’ value co-creation activities influence the HSE’s self-adjustment by leading to a re-humanisation of services. The paper also contributes to the state of knowledge by identifying seven categories of volunteers’ value co-creation activities, two of which are completely new in the literature (co-responsibility and empowerment).

The paper contributes to the service research literature by identifying empirically grounded value co-creation activities extending the understanding of self-adjustment and re-humanisation of the service ecosystem.

The purpose of this paper is to propose a typology of institutions enabling or constraining customer centricity and value co-creation in service ecosystems; illustrate the various types of institutions with examples from healthcare; and provide case study evidence on how pharmaceutical companies react to and induce institutional change.

First, a typology of institutions enabling or constraining customer centricity and value co-creation is proposed and illustrated with examples from healthcare. Next, to clarify how companies deal with these institutions by reacting to or inducing institutional change, two case companies from the pharmaceutical industry are described.

The research identifies and illustrates nine types of institutions (culture, structure, processes, metrics, language, practices, IP, legislation and general beliefs) grouped by three levels of analysis (micro, meso and macro). Furthermore, the findings of the two case studies indicate that companies react to, but also proactively induce, institutional change.

The investigation is limited to two case studies.

Organizations need to understand the micro-, meso- and macro-level institutions of their service ecosystem; react to institutional changes imposed by other actors; and proactively change institutions by breaking, making or maintaining them.

Pharmaceutical companies can improve patient well-being by inducing institutional change.

This research develops a mid-range theory of service ecosystem institutions by developing a typology. This typology is empirically examined in a healthcare context.

The aim of this paper is to understand if service innovation (Helkkula et al., 2018), based on artificial intelligence (AI) systems, may guarantee healthcare service ecosystem (H-SES) well-being (Frow et al., 2019; Beirão et al., 2017), taking into account that many doubts relieved in terms of transparency may compromise the patients' perceived quality of health services provided through AI systems.

A literature review on service innovation, detected in terms of value co-creation, and service ecosystem, investigated in terms of well-being, is drawn. To analyze the implications of service innovation on a H-SES well-being, through the technology acceptance degree and predisposition to use by actors, a case study based on TAM-model 3 determinants as categories is carried out.

AI-based service innovation archetypes in healthcare may be considered as antecedents of the service ecosystem well-being conditions as long as they enable actors to co-create value. To make it possible, a patient-driven service innovation is necessary in order to mitigate the risks of its inactivity due to fears in terms of transparency.

Service innovation and service ecosystem well-being may be studied in an integrated way, with a multidisciplinary approach, and are linked by value co-creation, because only thanks a patient-driven service innovation is possible to foster service ecosystem well-being in healthcare.

Despite the abundance of research in open innovation, few contributions explore it at inter-organizational level, and particularly with a focus on healthcare ecosystem, characterized by a dense network of relationships among public and private organizations (hospitals, companies and universities) as well as other actors that can be labeled as “untraditional” player, i.e. doctors, nurses and patients. The purpose of this paper is to cover this gap and explore how knowledge is transferred and flows among all the healthcare ecosystems’ players in order to support open innovation processes.

The paper is conceptual in nature and adopts a narrative literature review approach. In particular, insights gathered from open innovation literature at the inter-organizational network level, with a particular attention to healthcare ecosystems, and from the knowledge transfer processes, are analyzed in order to propose an interpretative framework for the understanding of knowledge transfer in open innovation with a focus on healthcare ecosystem.

The paper proposes an original interpretative framework for knowledge transfer to support open innovation in healthcare ecosystems, composed of four main components: healthcare ecosystem’s players’ categories; knowledge flows among different categories of players along the exploration and exploitation stages of innovation development; players’ motivations for open innovation; and players’ positions in the innovation process. In addition, assuming the intermediary network as the suitable organizational model for healthcare ecosystem, four classification scenarios are identified on the basis of the main players’ influence degree and motivations for open innovation.

The paper offers interpretative lenses for managers and policy makers in understanding the most suitable organizational models able to encourage open innovation in healthcare ecosystems, taking into consideration the players’ motivation and the knowledge transfer processes on the basis of the innovation results.

The paper introduces a novel framework that fills a gap in the innovation management literature, by pointing out the key role of external not R&D players, like patients, involved in knowledge transfer for open innovation processes in healthcare 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.