The emergence of health technology organizations among institutional healthcare and economic actors

  • M. BeaulieuEmail author
  • P. Lehoux


Few studies have considered the creation of health technology organizations where the entrepreneurs seize opportunities, create their entrepreneurial organization and provide it with legitimacy, and examined the triggers, constraints and pressures involved in this process. To study the emergence of such firms, we performed semistructured interviews with 20 entrepreneurs and strategic partners involved in the development and commercialization of health technologies. For each stage of the firm emergence process, we identified triggers and enablers, as well as barriers and constraints encountered by entrepreneurs, and pressures originating from institutional actors. We found that each stage of startup emergence had triggers where the entrepreneur faced a conflicting situation in the form of boundary misalignment, competing technologies, poor performances, and resource asymmetry. Each topic is examined in the light of neo-institutional theory and finally replaced within a larger process in which the entrepreneur addresses market and healthcare system needs and interacts with other actors. In each stage, we identified a predominant institutional process taking place, whether it was decoupling, organizational field influence or legitimation seeking. The present study aimed at understanding the process by which an opportunity is seized, an organization is created and an institution as big as a healthcare system is approached. The results may help entrepreneurs and decisionmakers understand the strategies engaged following pressures from the healthcare organization. Likewise, it could increase investors’ awareness of the emergence process of health tech businesses and stimulate mutual understanding between entrepreneurs, and economic and healthcare actors.


Innovation in health Institutional entrepreneurship Opportunities Neo-institutional theory Health technologies Competitive actions Social construction 



I thank the anonymous reviewers for their careful reading of our manuscript and their many insightful comments, as these comments led to an improvement of the manuscript.

Authors’ contributions

I have full contributions to this manuscript. The author read and approved the final manuscript.

Compliance with ethical standards

Competing interests

The author declares that there are no competing interests.


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Authors and Affiliations

  1. 1.Department of Health Management, Evaluation and PolicyInstitute of Public Health Research of University of Montreal (IRSPUM)QuebecCanada

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