Identifying Essential Components of a Digital Health Innovation Ecosystem for the Namibian Context: Findings from a Delphi Study

Digital health innovation ecosystems describe the need to incorporate the components of digital health, innovation and digital ecosystems in administering healthcare services. Reviewing the evidence of digital health, innovation and digital ecosystems in both developed and developing countries is therefore crucial in determining the feasibility of implementing a digital health innovation ecosystem. The purpose of this paper was to present the results of a scoping review aimed at identifying the scope and range of digital health, innovation and digital ecosystems literature in developed and developing countries and propose guidelines for implementing digital health innovation ecosystems. The findings of the scoping review reveal that studies on digital health, innovation and digital ecosystems have been conducted in developed and developing countries, providing useful insights on the feasibility of implementing a digital health innovation ecosystem in both developed and developing countries. Guidelines for implementing a digital health innovation ecosystem were also proposed. The findings of the scoping review as well as the guidelines proposed in this study will inform healthcare policy makers in developed and developing countries.

Digital Health Innovation Ecosystems: From Systematic Literature Review to Conceptual Framework

Digitalization has reshaped the way of value co‐creation among innovation subjects, expanded the existing innovation ecosystem theories, and triggered the thinking about the digital innovation ecosystem. How to continuously promote value co‐creation between focal companies and non‐focal subjects within the digital innovation ecosystem to elevate the sustainable development of the system is an urgent issue to be solved. In this paper, we built a model of value co‐creation behavior evolution of focal companies and non‐focal subjects in the digital innovation ecosystem based on the complex network evolutionary game theory. The dynamic decision‐making process and critical factors of value co‐creation behavior of focal companies and non‐focal subjects were explored, and the emergence mechanism from micro‐behavior of value co‐creation to macro‐evolution was studied. The results showed that (1) increasing the variability of digital resources shared by focal companies and non‐focal subjects and the level of digital innovation benefits could promote value co‐creation in the system, but digital innovation ecosystems of different scales have various sensitivities to the variability of digital resources and the level of digital innovation benefits; (2) during the initial construction period of digital innovation ecosystems, the distribution of digital innovation benefits should be dominated by focal companies. With the expansion of the ecosystem, the focus of benefit distribution should gradually shift to non‐focal subjects. (3) In the evolution of the digital innovation ecosystem, focal companies should bear relatively more coordination costs of value co‐creation to promote the stable development of the system. (4) It is necessary to establish a punishment mechanism for opportunistic behavior, and the punishment should be gradually increased as the scale of digital innovation ecosystem expands. This study characterizes the digital innovation ecosystem with scale‐free networks in complex networks and constructs a complex network evolutionary game model to study the dynamic decision‐making process of value co‐creation behavior in the system, which makes up for the limitations of traditional evolutionary game research in which game subjects interact in a uniformly mixed manner and highlights the macroscopic phenomena emerging from the dynamic decision‐making of value co‐creation behavior of micro subjects. The research findings have important implications for the co‐creation of value by focal companies and non‐focal subjects in the digital innovation ecosystem and the sustainable development of the system.

Digital innovation ecosystems (DIEs) are typically conceptualized as core-periphery arrangements coordinated through centralized platforms and keystone firms. Yet contemporary ecosystems increasingly emerge around tech verticals (e.g., HealthTech, FinTech, and GreenTech) that lack a clear architectural core. This dissertation extends the platform-centric assumptions by reconceptualizing these arrangements as rhizomatic digital innovation ecosystems (rhizomatic DIEs). Drawing on Deleuze and Guattari’s New Materialist ontology and the emerging flow-oriented perspective in IS, the dissertation develops a flow-oriented perspective to understand how innovation unfolds without a central orchestrating platform. Methodologically, the dissertation employs Situational Analysis to map the heterogeneous elements, relations, and arenas that compose a single, in-depth case study of a digital venture studio engaged in digital health innovation. Through an extensive corpus of participant observations, interviews, and documents, the study identifies three constitutive flows: (1) vital flows - material phenomena of lived environments that innovation attunes to, captures, and re-patterns, (2) trace flows - selective inscriptions that render phenomena mobile, comparable, and recombinable, and (3) axiomatic flows - codifications that stabilize meaning and action. The dissertation shows that rhizomatic DIEs form and evolve through the dynamic interweaving across these three flows. The core contribution presents seven correspondence dynamics: weaving, diverging, horizoning, liminalizing, condensing, axiomatizing, and temporalizing. Together, these dynamics provide a framework for understanding how ecosystems evolve through distributed and contingent flows. This paper-based dissertation comprises four papers that all develop a flow-based understanding of digital innovation and entrepreneurship. The first paper explores the role of digital technology in digital entrepreneurship by problematizing the foundational assumptions underlying research into New Venture Creation (NVC). By showing that actor-centric assumptions limit our ability to understand temporal phenomena in entrepreneurial timing, the paper contributes an alternative, flow-oriented assumption base and charts future research in this direction. The second paper develops a rhizomatic process view of innovation in ecosystems that lack a coordinating core. The third paper explores how digital ventures territorialize and code fluid, embodied phenomena. It contributes to the conceptualization of long and short-term data plays, namely how data is mobilized to transform immediate interactions with phenomena and how they are societally construed. The fourth and final paper of the dissertation explores how Deleuzo-Guattarian assemblage thinking can help study scalar phenomena that go beyond any bounded locality or temporality. By integrating Deleuzo-Guattarian philosophy with digital innovation research, this dissertation contributes (1) a novel ontological framing of digital innovation ecosystems as coreless and processual, (2) a methodological contribution through the articulation of Situational Analysis as a means to study rhizomatic digital innovation ecosystems, and (3) a theoretical vocabulary for analysing correspondence dynamics in digital innovation.

Purpose In the era of the digital economy, the digital innovation ecosystem is an important vehicle to alleviate enterprises' resource and capability constraints and thus improve their digital innovation performance. Embedding digital innovation ecosystems for survival and development opportunities has become a new strategic choice for enterprises. However, how digital innovation ecosystem embeddedness affects the digital innovation performance of complementary enterprises has not yet been fully revealed. This study examines whether digital innovation ecosystem embeddedness affects the digital innovation performance of complementary enterprises through ambidextrous capabilities (exploration and exploitation) and the moderating role of strategic flexibility. Design/methodology/approach A field survey was conducted in China, collecting survey data from 578 complementary enterprises in advanced manufacturing industries embedded in digital innovation ecosystems. This study applies multiple regression analysis to verify the relevant hypotheses. Findings The results confirmed that (1) digital innovation ecosystem embeddedness has a significant positive effect on complementary enterprises' digital innovation performance; (2) Ambidextrous capabilities play a partial mediating role in the relationship between digital innovation ecosystem embeddedness and complementary enterprises' digital innovation performance. (3) Strategic flexibility positively moderates the effect of digital innovation ecosystem embeddedness on ambidextrous capabilities and digital innovation performance. Practical implications The findings, intended to guide enterprises that complement the digital innovation ecosystem to achieve digital innovation and performance improvement, highlight the importance of eco-embedded strategies, ambidextrous capabilities and strategic flexibility. Originality/value The finding enriches antecedent research on digital innovation performance and provides practical insights for firms to embed themselves in digital innovation ecosystems to improve performance.

Potential Stakeholders and Perceived Benefits of a Digital Health Innovation Ecosystem for the Namibian Context

A framework for discovering and classifying ubiquitous services in digital health ecosystems

In an era marked by the rapid ascension of the global digital economy, the digital innovation ecosystem has emerged as a vital conduit for businesses to pursue digital innovation endeavors and enhance their core competitiveness. This paper marries the theoretical discourse and empirical analysis of digital innovation ecosystem theory with modular theory, systematically expounding the concepts of digital innovation ecosystems and modularity, as well as elucidating the design principles of a modular digital innovation ecosystem. It delves into the characteristics and design processes of modularity and dissects the collaborative mechanisms underpinning the Apollo digital innovation ecosystem. Moreover, employing a modular perspective, it empirically scrutinizes the Apollo digital innovation ecosystem to clarify the framework constituted by modularity, the symbiotic operation among the ecosystem modules, and the collaboration within the system’s internal modules. This study embarks from the vantage point of digital innovation ecosystems and modularity to offer an in-depth explanation of the collaborative mechanisms within the Apollo digital innovation ecosystem. It not only broadens the methodological horizons for research on digital innovation ecosystem theory but also delineates, from a practical application standpoint, the modes of collaboration between the ecosystem’s modules. In the process of exploring the collaborative mechanisms of the Apollo digital innovation ecosystem, this research integrates global autonomous driving technology with the digital innovation ecosystem in a modular analysis. The innovative contribution of this paper lies in the construction of a collaborative mechanism for the Apollo digital innovation ecosystem from a modular viewpoint.

Based on the panel data of 30 provinces in China from 2013 to 2022, this paper constructs a measurement index system for the symbiotic level of digital innovation ecosystems from three dimensions: the symbiosis of digital innovation subjects, the digital innovation environment, and digital innovation interaction. This paper applies the entropy weight TOPSIS method, Dagum Gini coefficient decomposition, and spatial convergence analysis to empirically examine the symbiotic levels, regional disparities, and spatial convergence of China’s digital innovation ecosystem. The results are as follows: (i) At the national level, the symbiotic level of China’s digital innovation ecosystem has generally increased, creating a spatial distribution pattern that is “high in the east, flat in the middle, and low in the west”. (ii) From a regional perspective, the major disparities between regions are the primary factors contributing to the overall difference in the symbiotic level of China’s digital innovation ecosystem. (iii) From the perspective of σ convergence, regional disparities in the symbiotic level of the digital innovation ecosystem are constantly expanding, and uneven regional development is intensifying. (iv) From the perspective of absolute β convergence, regions with lower levels of symbiosis in the digital innovation ecosystem have a faster growth rate of symbiosis than regions with higher levels of symbiosis, and there is a certain spatial spillover effect. (v) From the perspective of conditional β convergence, economic structure and innovation application can accelerate the spatial convergence of China’s digital innovation ecosystem symbiosis to a certain extent.

PurposeThe purpose of this paper is to analyze the symbiotic evolution decisions of digital innovation enterprises, research institutes and the government in the digital innovation ecosystem.Design/methodology/approachBased on innovation ecosystem theory and an evolutionary game model, this study constructs a tripartite symbiotic evolution game model of digital innovation ecosystems with digital innovation enterprises, research institutes and the government as the main bodies and analyzes the influencing factors as well as the evolution paths of the different behavioral strategies of each subject through numerical simulation.FindingsThe research shows that the digital innovation ecosystem has the characteristic of self-organization, which requires the symbiotic cooperation of each subject. The government plays an active role in any stage of symbiotic evolution, and the system cannot enter symbiosis under a low level of subsidies and penalties. Only when the initial willingness to cooperate of digital innovation enterprises and scientific research institutes is at a medium or high level is the system likely to become symbiotic. While digital innovation enterprises are more sensitive to government subsidies and punishments, scientific research institutes are more sensitive to the distribution proportion of cooperation income.Originality/valueThis study includes government regulation into the research scope, expands the research mode of the digital innovation ecosystem and overcomes the difficulties of empirical research in collecting dynamic large sample data. It vividly and systematically simulates the symbiotic evolution process of the digital innovation ecosystem, which provides a theoretical and practical reference for digital innovation ecosystem governance.

Purpose This study explores how the high-end equipment manufacturing industry (HEMI) achieves intelligent development through the digital innovation ecosystem. While this industry urgently needs to achieve intelligent development through innovation breakthroughs, existing research lacks a deep analysis in conjunction with the digital innovation ecosystem. Considering the sophisticated nature of HEMI and the unique characteristics of the digital innovation ecosystem, this paper aims to uncover the innovation potential and synergetic development opportunities that arise from their integration. Design/methodology/approach This study uses Dynamic Qualitative Comparative Analysis (QCA) to explore the evolving relationship between the digital innovation ecosystem and intelligent development in HEMI enterprises. Data from 60 HEMI enterprises were collected from 2015 to 2022, and the study window was divided into two-year intervals for analysis. Compared to traditional QCA methods, this approach overcomes the limitations of cross-sectional analysis, fully accounting for time’s influence on causal relationships for more accurate results. Findings The study reveals that the digital innovation ecosystem of HEMI drives intelligent development through the coordinated interactions of its elements within each time window. Configuration paths and key driving factors evolve dynamically, reflecting the complexity of the ecosystem’s role in driving intelligent development. The study suggests that enterprises dynamically adjust their strategies to different stages, enhancing the effectiveness of intelligent transformation. Originality/value The paper proposes and validates a digital innovation ecosystem framework for HEMI, systematically exploring its role in driving intelligent development. The study fills a research gap and extends innovation ecosystem theory by identifying core driving factors and their evolutionary trends through Dynamic QCA. It offers a new perspective on the dynamic role of digital innovation ecosystems in intelligent transformation.

Digital technology has given the innovation subject a new way of value creation, expanded the existing innovation ecosystem theory, and triggered scholars' in-depth thinking on the digital innovation ecosystem. Based on the event system theory and taking Haier's hope platform as a vertical case study, this paper deeply explores the research mechanism of value creation of platform enterprises in the digital innovation ecosystem, and reveals the role and impact of digital innovation ability, openness, and business innovation model on the process of co-creation. The research results show that: in the open connection stage, the platform solves the problem of weakening the advantages of the platform, and improves the innovation efficiency of enterprises by continuously improving the digital innovation ability; in the interactive and iterative stage, the platform carries out open innovation, breaks through the difficulties of platform expansion, and realizes the benign expansion of the platform. In the co-creation stage, the user experience is blocked, and the platform adopts the platform community business model to connect the user relationship and improve the user experience. In the digital innovation ecosystem, platform enterprises gradually form self-organization and self-circulation value co-creation through internal self-construction and external cooperation, and form a data-driven co-creation model.

Food waste significantly contributes to the overexploitation of natural resources and the hospitality sector is responsible for a considerable portion of this waste. This study analyses the effects, both individually and in combination, of hotel digital capability and innovation ecosystem coopetition on digital innovation and food waste reduction. The data were collected from 200 Brazilian hotels via a questionnaire and analysed by PLS-SEM. The results indicate that, individually, both hotel digital capability and innovation ecosystem coopetition positively affect digital innovation. Furthermore, when combined, they promote an additional effect on digital innovation. Our results also reveal that digital innovation has a negative effect on food waste reduction. We contribute to the Dynamic Capabilities Theory by empirically demonstrating that complementarity between internal and external capabilities produces synergy and helps in the co-creation of value. To be used effectively, knowledge needs to be integrated and shared; this is especially the case for complex innovations, such as digital innovation, that require high levels of skill. Therefore, managers must be aware of the different internal knowledge needs and, above all, open to establishing partnerships with different multi-agents in their ecosystem.

PurposeIn the digital economy era, digital platforms are vital infrastructure for innovation subjects to perform digital innovation activities. Achieving efficient and smooth knowledge transfer between innovation subjects through digital platforms has become a novel research subject. This study aims to examine the knowledge transfer mechanism of digital platforms in the digital innovation ecosystem through modeling and simulation to offer a theoretical basis for digital innovation subjects to acquire digital value through knowledge-sharing and thus augment their competitive advantage.Design/methodology/approachThis study explores the optimal symbiotic interaction rate between different users based on the classic susceptible-infected-removed (SIR) model. Additionally, it constructs a knowledge transfer mechanism model for digital platforms in the digital innovation ecosystem by combining the theories of communication dynamics and symbiosis. Finally, Matrix Laboratory (MATLAB) software is used for the model and numerical simulation.FindingsThe results demonstrate that (1) the evolutionary path of the symbiotic model is key to digital platforms' knowledge transfer in the digital innovation ecosystem. In the symbiotic model, the knowledge transfer path of digital platforms is “independent symbiosis—biased symbiosis (user benefit)—reciprocal symbiosis,” aligning with the overall interests of the digital innovation ecosystem. (2) Digital platforms' knowledge transfer effects within the digital innovation ecosystem show significant differences. The most effective knowledge transfer model for digital platforms is reciprocal symbiosis, whereas the least effective is parochial symbiosis (platform benefit). (3) The symbiotic rate has a significant positive impact on the evolutionary dynamics of knowledge transfer on digital platforms, especially in the reciprocal symbiosis model.Originality/valueThis study's results aid digital innovators in achieving efficient knowledge transfer through digital platforms and identify how symbiotic relationships affect the knowledge transfer process across the ecosystem. Accordingly, the authors propose targeted recommendations to promote the efficiency of knowledge transfer on digital platforms.

Objective: To map the digital technologies that make up the Digital Health ecosystem in Brazilian nursing.Methods: Technological prospecting protocol, drawn up in 2023, guided by four phases.Question: What are the characteristics of the technologies that make up the digital health ecosystem in Brazilian nursing?As strings: "Nursing" and "Nursing Care", in Portuguese and English, at the World Intellectual Property Organization, the National Institute of Industrial Property and app stores.Inclusion criteria: technologies on nursing work.Selection will be by independent peers.The information will be extracted according to the Joanna Briggs Institute and submitted to Categorical Thematic Analysis.The results will be presented in texts and tables.Implications for health and nursing practice: advancing the digital ecosystem on professional nursing practice and facilitating access to educational/health services.Expected results/ conclusion: The protocol, once implemented, will aim to alleviate the methodological difficulties faced by researchers in health, technology and nursing.