Open innovation in digital healthcare start-ups: how partner and complementary assets configurations affect their performance

Abstract

Purpose Digital health start-ups often depend on external assets to access business opportunities and achieve scalability. Open innovation facilitates collaboration and asset exchange within and across organisational boundaries. However, the configuration of partners and complementary assets that can boost the financial performance of digital healthcare start-ups remains insufficiently examined. This study aims to address this gap by exploring how different configurations of the start-up partners and complementary assets enhance the financial performance of digital healthcare start-ups. Design/methodology/approach A multiple-case study was conducted involving 12 digital healthcare start-ups in Lithuania. Data were collected through in-depth interviews and secondary sources such as PitchBook databases and start-up websites. A qualitative content analysis, supported by MAXQDA software, was used to identify configurations of partners and complementary asset exchanges in relation to financial performance outcomes. Findings A unique differentiating pattern in open innovation behaviour was identified across the 12 digital healthcare start-up cases. The configuration of partners and complementary assets differs according to ownership structure, which shapes how start-ups combine these elements. Originality/value This study shows how ownership structure is associated with digital healthcare start-ups’ engagement in open innovation while operating in a highly regulated environment. Our findings suggest that start-up performance is linked to how firms combine and integrate complementary assets with selected partners, rather than relying on a single dominant partnering approach. We also observe that more than one combination of partners and complementary assets can be associated with similar financial performance outcomes among digital healthcare start-ups.