“…Productive relationships need to be managed as part of this complex system, and interactions among various actors allow to "produce valuable, new, and unpredictable capabilities that are not inherent in any of the parts acting alone" (Plsek and Wilson, 2001, p. 746). Healthcare ecosystems have been experiencing a shift from a centralised and sequential model of value creation to a more distributed and open model (Bowser et al, 2019;Chen et al, 2019;Cobianchi, 2020b;Gordon, Perlman, and Shukla, 2017;IBM, 2013;Siemens, 2018), where citizens and patients are co-creators of their own wellbeing (Batalden et al, 2016;Bessant, Moeslein, and Kunne, 2012;Biancuzzi et al, 2020b;Dal Mas et al, 2019a;Dal Mas, Paoloni, and Lombardi, 2019;Dal Mas andPaoloni, 2019, 2020). The healthcare ecosystems usually involve a vast number of parties (patients, physicians, clinical researchers, nurses, policymakers) that share their innovation processes to incorporate knowledge flows originated from or co-produced with external stakeholders (universities, research centres, industries, governmental agencies, NGOs, public institutions) (Ardito and Messeni Petruzzelli, 2017;Cobianchi, et al, 2020a;Dal Mas et al, 2018;Gassmann, Enkel, and Chesbrough, 2010;Huizingh, 2011;Renaudin et al, 2018).…”