Introduction:In recent years, inter-organisational collaboration between healthcare organisations has become of increasingly vital importance in order to improve the integration of health service delivery. However, different barriers reported in academic literature seem to hinder the formation and development of such collaboration.Theory and methods:This systematic literature review of forty studies summarises and categorises the barriers to integrated care in inter-organisational settings as reported in previous studies. It analyses how these barriers operate.Results:Within these studies, twenty types of barriers have been identified and then categorised in six groups (barriers related to administration and regulation, barriers related to funding, barriers related to the inter-organisational domain, barriers related to the organisational domain, barriers related to service delivery, and barriers related to clinical practices). Not all of these barriers emerge passively, some are set up intentionally. They are not only context-specific, but are also often related and influence each other.Discussion and conclusion:The compilation of these results allows for a better understanding of the characteristics and reasons for the occurrence of barriers that impede collaboration aiming for the integration of care, not only for researchers but also for practitioners. It can help to explain and counteract the slow progress and limited efficiency and effectiveness of some of the inter-organisational collaboration in healthcare settings.

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Purpose The creation of a new venture is at the heart of entrepreneurship and shares parallels with project-based organizing: embedded in an institutional context, founders have to assemble a team that works on specified tasks within a strict time constraint, while the new venture undergoes various transitions. The purpose of this paper is to explore parallels between both streams of research and an increasing projectification of entrepreneurship. Design/methodology/approach The study is based upon a case study of the Berlin start-up ecosystem including the analysis of interviews (n=52), secondary documents, and field observations. Findings The paper reveals that – shaped by their institutional context – patterns of project-like organizing have become pertinent to the new venture creation process. It identifies a set of facets from the entrepreneurial ecosystems – more specifically different types of organizational actors, their occupational backgrounds, and epistemic communities – that enable and constrain the process of new venture creation in a way that is typical for project-based organizing. Originality/value This study thus elaborates on how institutional settings enforce what has been called “projectification” in the process of new venture creation and discuss implications for start-up ecosystems.

Multi-sided platforms in healthcare often focus their business model on standardizing care for wide-spread, chronic diseases. However, there is a lack of knowledge surrounding platform business models enabling individualized care coordination for patients with rare diseases. This paper analyses the development of a complex platform business model addressing Amyotrophic Lateral Sclerosis, a severe neurological disease that requires the coordination of a diverse network of medical specialists, care, and equipment providers. A longitudinal case study examines the platform’s development, focusing subsequently on qualitative and efficient care coordination, care research, and active and direct involvement of patients, as well as establishing two business models, namely, care coordination and care research. We reconstruct how these complex platform business models were configured to improve patient care and care research, thereby creating immediate value for patients and insights for long-term care improvements. The ongoing platform development carefully balances value generation for diverse stakeholders and economic sustainability.

PurposeMany health systems face challenges such as rising costs and lacking quality, both of which can be addressed by improving the integration of different health care sectors and professions. The purpose of this viewpoint is to present the German health care Innovation Fund (IF) initiated by the Federal Government to support the development and diffusion of integrated health care.Design/methodology/approachThis article describes the design and rationale of the IF in detail and provides first insights into its limitations, acceptance and implementation by relevant stakeholders.FindingsIn its first period, the IF offered € 1.2 billion as start-up funding for model implementation and evaluation over a period of four years (2016–2019). This period was recently extended to a second round until 2024, offering € 200 million a year as from 2020. The IF is triggering the support of relevant insurers for the development of new integrated care models. In addition, strict evaluation requirements have led to a large number of health service research projects which assess structural and process improvements and thus enable evidence-based policy decisions.Originality/valueThis article is the first of its kind to present the German IF to the international readership. The IF is a political initiative through which to foster innovations and promote integrated health care.