Healthcare faces multiple challenges. Besides a raging pandemic have the number of people struggling with mental illness and chronic illnesses increased. Service innovation is a possible way of meeting these problems. However, service innovation is a scattered concept, with many different conceptualizations and schools of thought, all providing vital research aspects. Research has unraveled three elements that form different approaches for service innovation research. Healthcare also offers a complex context for conducting change and service innovation, containing prerequisites challenging previous understanding and conceptualizations of service innovation.

To study service innovation in healthcare and to clarify research, this thesis aims to develop a framework for service innovation that relates and differentiates three approaches and their key characteristics and to determine how the prerequisites for healthcare relate to this framework, and finally to study, test, and illustrate the framework in the empirical context. 

The thesis builds upon three studies and four individual papers. The studies consist of one literature review, providing the conceptual groundwork for constructing the framework, and two empirical studies assessing and further developing the framework. The individual papers uses the empirical studies and depart from the different approaches to service innovation and healthcare prerequisites, providing key insights and clarifying the different approaches' strengths and weaknesses. The proposed framework recognizes the need for multiple service innovation research approaches since no single approach is enough to study the multifaceted service innovation phenomena in healthcare. The individual papers also contribute to the growing literature stream addressing service innovation in healthcare by describing social entrepreneurs' motivation during the service innovation process and explaining some of the effects of different service innovation types.

There is an urgent need for service innovation in healthcare, and further research and knowledge supporting healthcare organizations' efforts for service innovation are essential. Simultaneously, service innovation is a fuzzy concept and is growing in diverse directions. This thesis aims to create a framework for service innovation encompassing healthcare's prerequisites and, by empirical studies, provide valuable insights for service innovation research and healthcare practice. In doing so, the thesis offers conceptual clarity to the concept of service innovation, where different service innovation approaches unravel previous preconceptions of research, together forming a framework for service innovation. The empirical findings show that service innovation is highly beneficial for healthcare organizations, leading to organizational performance and customer satisfaction. Furthermore, the findings illustrate that there is much to gain for healthcare organizations not to undertake service innovation alone, as healthcare customers and other actors' participation play a crucial role in reaching these desirable effects.