Innovation ecosystems have mainly been studied from a focal actor perspective, while complementors have been rarely in focus, especially how a complementor can become a focal complementor, inducing and supporting the value co-creation of other complementors. This paper explains how a peripheral complementor characterized by scarce resources and poorly aligned capabilities, such as an entrant to a mature innovation ecosystem, can overcome these obstacles through co-creation with other complementors and the ecosystem’s focal actor. Through a qualitative case study approach, we show how the product-centric company, the automotive firm Polestar, entered a mature innovation ecosystem centered on the digital platform Android Automotive OS, thereby enhancing Polestar’s onboard app development during the period 2018-2022. Using a thematic analysis based on an ecosystem functions framework, the paper shows and explains how a complementor can become a focal complementor by creating and enabling a sub-ecosystem within a mature innovation ecosystem, characterized by aligning complementors to co-create value while exploiting the focal actor’s resources. The paper explains how the three mechanisms of strategic focus, agile practices, and capability building align the focal complementor with complementors and the focal actor, allowing it to maintain internal and external legitimacy and mobilize resources. © 2026 The Authors. Published by Elsevier Ltd.

The literature has played scant attention to how entrepreneurial action transforms ecosystems. This chapter shows how this transformation takes place by drawing on the Austrian theory of capital, which portrays the capital structure as a changing structure of means–ends relationships shaped by entrepreneurial action aiming to satisfy human needs for a profit. New capital resources, such as new tools, create opportunities for new resource combinations, but only some combinations are technically and economically feasible. The extent of this multiple specificity, together with the extent to which entrepreneurs can abstract knowledge by using a tool, will be a powerful factor concerning whether the ecosystem will remain or shift into a hierarchy or market-based value system. © The Editors and Contributors Severally 2025.

Technologies such as district heating (DH), district cooling (DC) and heat pumps are essential for improving heating and cooling efficiency and supporting decarbonization goals. Although advancements such as nextgeneration DH promises lower temperatures and increased flexibility, these technologies are insufficient to reach such targets in isolation. While there is ongoing convergence between DH, heat pumps, and energy storage, the literature pays scant attention to how actors innovate by combining and integrating these technologies. Thus, there is a significant need for a greater understanding of the innovative efforts of DH firms. This study explains how seven European DH firms innovated to create and deliver value by changing their organizational, technological, and interfirm engagements. By analysing the cases through the lens of platform literature, our analysis reveals a shift away from traditional incumbent value systems and the emergence of new platform-based value systems that incorporate platform envelopment of gas and heat pumps into DH. The changes consist of three distinct innovation pathways. First, incumbent DH firms are improving traditional systems by refining customer interfaces and integrating digital services within their established firm boundaries. Second, smaller collaborative entrants engage with incumbents to form platform-based systems downstream of the incumbents. Third, larger disruptive entrants establish independent platforms with localized, network-connected heat pumps and storage, directly challenging incumbent value systems by offering alternative heating and cooling solutions. The study demonstrates that district heating is no island, but part of an interconnected and evolving ecosystem where innovation emerges through technological integration and inter-firm collaboration © 2025 The Authors.

Artificial intelligence (AI) is revolutionizing healthcare by introducing novel treatments and applications, thereby transforming the sector. However, the complexity, ambiguity, and inherent risks associated with AI can create tensions for healthcare workers that may result in stress, anxiety, and discomfort when they make decisions. These tensions are paradoxical in nature as they may present conflicting demands that can persist over time and develop into seemingly irrational situations. Understanding how these paradoxical tensions affect healthcare workers' responses to AI is crucial in addressing their concerns. This study investigates the role of paradoxical tensions and the paradoxical mindset in shaping healthcare workers' responses to AI. The study examines how these two factors influence individuals' intention to adopt AI systems and tools and evaluates the users' satisfaction with them. Using a quantitative survey design, data were collected from 357 healthcare workers. The results, based on regression analysis, indicate that paradoxical tensions positively influence both individuals' intention to adopt AI systems and tools and their satisfaction with the current use of AI systems and tools. The results also indicate that the paradoxical mindset positively mediates these relationships. © 2024 The Authors

Purpose: Eye-tracking technology offers significant potential in healthcare by enabling hands-free interactions that reduce physical contact and infection transmission risks. However, its adoption remains suboptimal due to barriers including unfavorable cost-benefit perceptions, digital literacy gaps and workflow disruption concerns. This study explores value co-creation interactions between technology providers and healthcare professionals that facilitate eye-tracking adoption in digitalized healthcare settings.

Design/methodology/approach: The study employs a qualitative approach drawing on exploratory and semi-structured interviews with eye-tracking technology providers and physicians who use eye-tracking in clinical practice and research. Data analysis follows a thematic analysis approach.

Findings: The findings reveal two distinct but interconnected dimensions of value co-creation interactions that enable eye-tracking adoption. Value co-production-enabling interactions encompass aligning technology capabilities with user needs, co-developing manuals and guidelines and collaboratively interpreting regulatory frameworks. Value-in-use-enabling interactions focus on aligning technology performance with end-user experience, co-developing implementation strategies and collaborative data interpretation and analysis.

Originality/value: This study contributes to healthcare digitalization literature by examining how collaborative interactions between technology providers and healthcare professionals enable complex technology adoption. Unlike previous research focusing primarily on patient-provider relationships, this study demonstrates how technology providers actively participate in healthcare value chains beyond traditional product delivery. The findings extend value co-creation theory by identifying specific interaction mechanisms within value co-production and value-in-use dimensions, contributing to understanding how collaborative approaches may support hands-free healthcare technology integration. © Luis Irgang, Wiktor Zborowski, Ernesta Stakionyte, Henrik Barth and Magnus Holmen.

Recent advancements in connectivity and automation driven by artificial intelligence (AI) is leading to trans-formative changes in the healthcare sector. This study investigates physicians' experience of AI-based technologies in healthcare. To achieve this objective, we gathered responses through open-ended essays from 326 physicians working in Swedish healthcare. These respondents have experience in using AI technologies for distinct tasks, which include prediction, diagnosis, medical image analysis, text generation, analysis, chatbots, wearable devices, telemedicine and robot assistance. The data was analyzed by thematic coding. The findings show that the physicians' perception towards use of AI in healthcare is influenced by drivers and barriers that are present at macro, organizational, system and personal level. The identified drivers include work task changes, functional aspects, organizational aspects, system characteristics and personal motivators. The barriers include legal and ethical dilemma, organizational readiness, system limitations and personal demotivators. This study leverages paradox theory as a framework to deepen the understanding of the complexities and interconnections between perceived barriers and potential solutions related to AI in healthcare as a contribution to the literature. © 2025 The Authors. Published by Elsevier Ltd.

The project Open and Self Organizing Mechanisms for Sustainable Mobility as a Service (OSMaaS) ran between 2020 and 2024, hosted by Halmstad University and funded by The Knowledge Foundation. The project was a collaboration between researchers from service design, design ethnography, business model innovation, and intelligent systems, and the companies Volvo Cars, WirelessCar, Polestar, and Devoteam. One of the project’s outputs is the OSMaaS Service Design Framework that integrates research from the different activities in the project into a toolkit for service designers. This booklet provides a guide for how to apply the framework. Each canvas can be used standalone or in any order, but our experience is that the framework is most powerful when following the design process presented here. The canvases can be downloaded from the OSMaaS webpage and are free to use. 

A growing and aging population provides challenges for the healthcare sector, generating higher healthcare costs, and ineffective work process that results in long patient queues and problems with recruiting and retaining healthcare professionals. Artificial intelligence (AI) is considered as one means to provide efficient processes for healthcare professionals, e.g. in diagnostics and treatment recommendations. However, research has shown that there are many obstacles to successfully introducing and using AI applications in healthcare, especially by focusing on the organizational level. However, individual healthcare professionals have an important role to play in the transition towards information driven healthcare. 

Therefore, we address the healthcare professionals' perception of the usefulness and value of AI applications, as well as challenges and considerations of this new technology. 

The study is based on an exploratory approach with more than 350 healthcare professionals in Sweden, carried out beginning of 2024. The questionnaire includes perceptions of the use of AI and identifies potential challenges that need to be addressed. The respondents include doctors (92%) and nurses (8%). The sample consists of answers from 221 (62%) male and 136 (38%) female respondents. Most of the respondents work in public hospitals (54%) and health centers (20% public and 14% private). Several AI applications are used by healthcare professionals, spanning from administrative work reduction to new insights in the analysis of complex cases.

Thematic analysis is conducted to create a model of perception of usefulness, values and problems (barriers). The analysis includes a stepwise analysis to identify patterns and themes.

The  results from the project provide insights into how the introduction of AI applications in healthcare changes the work of healthcare professionals and the perceived challenges that need to be addressed to improve their work by using AI. To some extent, implementation and use is based on healthcare professionals’ interest in using new advanced technology but for others the decision to adopt AI is primarily based on formal decisions within the organization. Respondents that have been using AI for at least six months, indicate AI supports decision making, with the main benefit consisting of a more effective and faster work process, while other respondents do not perceive any changes. A surprising result is that healthcare professionals have identified the possibility to test and evaluate new ideas and more complex cases. One interpretation is that AI has made the workload easier, which may allow for more innovative work. Another interpretation is that their experience-based knowledge is augmented by AI, and this makes it possible for them to handle more complex cases.   However, others experience a learning paradox – challenging to find time and learn how to use the technology, while at the same time adopting by testing AI applications.

Conclusions drawn from the ongoing study provide insights on the transformation phase towards implementing and using AI applications in healthcare.