Business model innovation is becoming a central research topic in management. However, a lack of a common understanding of the nature of the business model leads to disregarding its multifaceted structure when analyzing the business model innovation process. This article proposes a more detailed understanding of the business model innovation process by drawing on existing knowledge from new product development literature and examining the front-end and the back-end of business model innovation of three leading Danish newspapers. We studied how changes introduced during the development of digital news production and delivery have affected key components of these business models, namely value creation, proposition, delivery and capture in the period 2002–2011. Our findings suggest the need to distinguish between front-end and back-end business model innovation processes, and to recognize the importance of organizational learning when incumbents are faced with disruptive technologies.

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Specialized stroke units offer optimal treatment of patients with an acute stroke. Unfortunately, their installation is limited by an acute lack of experienced neurologists and the small number of stroke patients in sparsely populated rural areas. This problem is increasingly being solved by the use of telemedicine, so that neurological expertise is made available to basic and regular care. It has been demonstrated by national and international pilot studies that solidly based and rapid decisions can be made by telemedicine regrading the use of thrombolysis, as the most important acute treatment, but also of other interventions. So far studies have only evaluated improvement in the quality of care achieved by networking, but not of any lasting effect on any economic benefit. Complementary to a medical evaluation, the qualitative economic assessment presented here of German and American concepts of telemetric care indicate no difference in efficacy between various ways of networking. Most noteworthy, when comparing two large American and German studies, is the difference in their priorities. While the American networks achieved targeted improvements in efficacy of care that go beyond the immediate wishes of the doctors involved, this was of only secondary importance in the German studies. Also, in contrast to several American networks, the German telemetry networks have not tended to be organized for future growth. In terms of economic benefits, decentralized organized networks offer a greater potential of efficacy than purely local ones. Furthermore, the integration of inducements into the design of business models is a fundamental factor for achieving successful and lasting existence, especially within a highly competitive market.

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