Ecosystem disruption and regulatory positioning: Entry strategies of digital health startup orchestrators and complementors

Alessio Cozzolino and Susi Geiger

Research Policy, 2024, vol. 53, issue 2

Abstract: Through a multiple case study of six digital startups in the healthcare ecosystem, we develop a framework of entry through innovation in a regulated ecosystem. The framework reveals the interplay of two dimensions that have not been examined in conjunction so far: 1) the degree of ecosystem disruption brought by the entrant's innovation; 2) the impact of regulation/policy on the entrant's innovation. Based on these two dimensions, our data reveal four scenarios for entrants: dual constraint; regulatory-enabled orchestration; regulatory-constrained complementation; and dual enablement. The paper provides several contributions to ecosystem research, including a new definition of ecosystem disruption, the joint consideration of two key dimensions of ecosystem entry, and an emergent framework illustrating specific strategies, governance mechanisms, and the likelihood of success for each entry scenario. We show that start-up entrants can be successful orchestrators if they are enabled by regulation, that they can shift their positioning to seize enabling regulations, and that being an orchestrator or a complementor is a strategic choice related to an entrant's ecosystem disruption strategy.

Keywords: Ecosystem disruption; Orchestrators; Complementors; Regulation; Digital health; Startups; Healthcare; Multiple case study (search for similar items in EconPapers)
Date: 2024
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S004873332300197X
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:respol:v:53:y:2024:i:2:s004873332300197x

DOI: 10.1016/j.respol.2023.104913

Access Statistics for this article

Research Policy is currently edited by M. Bell, B. Martin, W.E. Steinmueller, A. Arora, M. Callon, M. Kenney, S. Kuhlmann, Keun Lee and F. Murray

More articles in Research Policy from Elsevier
Bibliographic data for series maintained by Catherine Liu ().