Governing digital innovations for responsible outcomes – the case of digital healthcare and welfare services

This paper explores how digital innovation in healthcare and welfare services addresses emerging challenges through the lens of responsible innovation (RI). Drawing on longitudinal case studies of six digital startups, we investigate how stakeholder and user inclusion shape innovation processes. Startups engage in both limited and substantive participation. While non-participation and symbolic participation are common in early ideation and launch phases primarily attract funding, legitimacy and visibility, they can also catalyse strategic reflection. This challenges the dominant view in RI literature that only deep engagement yields responsible outcomes. In contrast, engaged participation throughout enables iterative adaptation and alignment with user and stakeholder needs. These modes of participation serve complementary functions in fostering responsible innovation. However, startups with limited resources face barriers to deliberate inclusion. Intermediary organisations, such as living labs, incubators and accelerators, can help bridge these gaps. We conclude with policy recommendations to strengthen support for inclusive innovation in early-stage ventures.