This chapter discusses how responsible start-ups are met in the health sector. Through following three companies, Voco, Cora and Medicus, we acquire insight into the world of challenges the entrepreneurs have when they introduce their technology/service to the healthcare sector. Using institutional theory, we look at the regulative, normative and cognitive dimension of the institutional framework. We use the term ‘institutional wall’ to denote a dense network of formal laws and regulation, informal norms and knowledge and beliefs that act as barriers for the entrepreneurs to access the market. We find that while there is a positive development in the regulative dimension: both the regulative and the normative dimension are set up to favour larger companies. The founders’ responses to the cognitive dimension indicate a lack of belief in Norwegian technology and thus tough access to finance.

This chapter explores the concept of responsible innovation, examines its limitations and links it to the discussion of firm innovation process. In this chapter we first provide an overview of the field, followed by the discussion of purpose, process and outcome of innovation. Innovation is described as a complex process in the context of uncertainty where design space occupies an important role. We argue that with the high levels of uncertainty involved in radical or disruptive innovations, there is a need to keep design space open, allowing anticipation and reflexivity to happen to achieve a responsible solution.

In this chapter we provide an overview of the different healthcare contexts across countries in which the rest of our chapter’s cases are situated. We elaborate on the relationship between different stakeholders in healthcare and debate the role of patients in the healthcare sector from an innovation point of view. The chapter concludes with proposing a method for categorizing patients’ innovation behaviour in light of ongoing digitization of healthcare and society in general.

This chapter summarizes the different aspects of responsible innovation that have been presented throughout the chapters. We remind about three key themes of this book – digital healthcare risks opening up a digital divide, concept of ‘design space’ and responsible innovation, and the role of the patient in the innovation process. We discuss these themes referring to chapters of this book, and conclude by pointing that RI matter and its employment in innovation processes might help economic actors to achieve a better fit with market. We debate some challenges of RI that are beyond the scope of single actors and should be addressed on policy level.