Beyond the land of the living death: early-stage transformational entrepreneurs in digital healthcare as liminality navigator
International Journal of Entrepreneurial Behavior & Research
ISSN: 1355-2554
Article publication date: 26 April 2024
Abstract
Purpose
The lean startup approach (LSA) is extensively utilized by early-stage entrepreneurs, with “pivot” serving as a key pillar. However, there is a research gap concerning the boundary conditions impacting LSA and pivot decisions, especially when addressing societal challenges, as in the context of transformational entrepreneurship. In this regard, the healthcare sector, further compounded by a lack of research on startups and scale-ups, presents an embraced opportunity to provide multiple contributions for both theory and practice.
Design/methodology/approach
The present investigation employs a grounded approach to explore the experiences of the co-founders of a fast-growing Italian e-health startup. A narrative strategy was employed to organize conditions and evolving strategic action/interactions into three different pivoting phases of the startup – before the pivot, its enactment and aftermath – with primary and secondary data collected over a period of one year.
Findings
Pivoting in digital healthcare unfolded as a liminal experience marked by factors such as high regulation, multiple stakeholders, technological and symbolic ambivalence, resource-intensive demands and institutional actors acting as pathway pioneers, leading to an information overload and unforeseeable uncertainty to manage. These factors challenge entrepreneurs' ability to attain optimal distinctiveness, presenting the paradoxical need for vertical flexibility for scaling up.
Social implications
By uniquely illuminating the sector’s constraints on entrepreneurial phenomena, this study provides a valuable guide for entrepreneurs and institutional actors in addressing societal challenges.
Originality/value
This study introduces a process model of transformational information crafting when pivoting, highlighting the role of entrepreneurs' transformational stance and platform-mediated solutions as engines behind strategies involving information breaking and transition, preceding knowledge-driven integration strategies.
Keywords
Acknowledgements
We express our gratitude to the cofounders, Fabio, Emma and Marco, for their significant contributions. Their commitment demonstrated throughout the interviews and over the course of a year, coupled with their talent, passion and expertise, played a key role in the successful completion of this research. We also wish to acknowledge the valuable feedback received during the PDW “Examining the Entrepreneurial Revolution in Healthcare,” hosted at Parthenope University of Naples on May 15, 2023. Furthermore, we extend our gratitude to our associate editor and the two anonymous reviewers whose insightful comments enhanced the quality of this paper. Lastly, this research was conducted while Edoardo Trincanato was a PhD student, and he acknowledges that his doctoral fellowship (2021–2024) was financed by The MIUR Department of Excellence Project 2018–2022 (University of Ferrara, Department of Economics and Management).
Citation
Trincanato, E. and Vagnoni, E. (2024), "Beyond the land of the living death: early-stage transformational entrepreneurs in digital healthcare as liminality navigator", International Journal of Entrepreneurial Behavior & Research, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/IJEBR-02-2023-0207
Publisher
:Emerald Publishing Limited
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