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PROJECT Nº H2020 - 731391 Cross4Health
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Deliverable 4.1
First Crossover Value Chain and Spill-over Achievements Report
* Dissemination Level: PU ** Deliverable Type: R
Date: 31 05 2019 Distribution: WP4
Editors: Edit Sebestyen, Joanna Lane Contributors: HCN + Consortium partners
* Dissemination Level: PU= Public, CO= Confidential, only for members of the Consortium (including the Commission services), EU-RES= Classified information: RESTRAINT UE (Commission Decision 2005/444/EC), EU-CON= Classified Information: CONFIDENTIEL UE (Commission Decision 2005/444/EC), EU-SEC= Classified Information: SECRET UE (Commission Decision 2005/444/EC)
** Deliverable Type: R= Document, DEM= Demonstrator, pilot, prototype, DEC= Website, patent filling, videos, etc., OTHER, ETHICS= Ethics requirement
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DISCLAIMER
The work associated with this report has been carried out in accordance with the highest technical
standards and CROSS4HEALTH partners have endeavoured to achieve the degree of accuracy and
reliability appropriate to the work in question. However, since the partners have no control over the
use to which the information contained within the report is to be put by any other party, any other
such party shall be deemed to have satisfied itself as to the suitability and reliability of the
information in relation to any particular use, purpose or application.
Under no circumstances will any of the partners, their servants, employees or agents accept any
liability whatsoever arising out of any error or inaccuracy contained in this report (or any further
consolidation, summary, publication or dissemination of the information contained within this
report) and/or the connected work and disclaim all liability for any loss, damage, expenses, claims or
infringement of third party rights.
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Executive Summary
The Cross4Health project seeks to move beyond the state-of-the-art practice for regional clusters by
unlocking the collaborative potential of SMEs from Aerospace, Creative Industries and Energy sectors
working with those from the Biotechnology, ICT and Medical Devices sectors. This composite market
segment (ACEBIM) is nurtured by generating innovative solutions, business models and workflows
that enhance patient-centred personalised care for societal challenges in health, delivered through
collaborative crossover value chains/networks.
The purpose of this report is to identify and understand better the barriers, indicators and potential
actuators for SMEs taking part in crossover collaboration for ACEBIM in Europe. It also summarizes
the results achieved and benefits realised by SMEs taking part in the 1st Acceleration cycle run by
Cross4Health.
We used an adapted ‘lite’ version of the Enterprise Ireland Innovation Health Check tool to baseline
innovation practice and performance of the companies taking part in the 1st Acceleration Cycle. This
adapted tool was a better fit to the maturity of our start-ups and young SMEs. The following table is
a simple summary of how our companies scored when compared against a benchmarking database.
IHC segment Position
1. Innovative Culture
Little better than average
2. Understanding the business
Average
3. Strategy
Better than average
4. Structure
Better than average
5. Capability & Resources
Better than average
6. Processes
Better than average
This was complemented by asking the companies to assess their innovation ecosystem using a set of
indicators approved by our S3 contacts.
The Innovation Health Checks informed targeted service innovation support provided by
Cross4Health partners and accredited third-party experts during the 1st Acceleration cycle. Results
from the ecosystem assessments are provided to cluster partners to review against current policies
and practices to support crossover collaboration between sectors/borders and by start-ups and
young SMEs.
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Table of Contents
EXECUTIVE SUMMARY 3
TABLE OF CONTENTS 4
LIST OF FIGURES 7
LIST OF TABLES 7
1 INTRODUCTION 9
1.1 BACKGROUND 9
2 HOW WE ASSESS THE EXTERNAL AND INTERNAL OPERATING ENVIRONMENTS OF SMES 11
2.1 MEASURING THE EXTERNAL OPERATING ENVIRONMENT 11
2.1.1 THE CROSS-OVER VALUE CHAIN INDICATOR PACKAGE 11
2.2 MEASURING THE INTERNAL OPERATING ENVIRONMENT 12
2.2.1 THE INNOVATION HEALTH CHECK ANALYSIS AND BENCHMARKING TOOL 13
2.3 KEY PERFORMANCE INDICATORS 15
2.4 HOW THE DATA WAS COLLECTED 15
3 PROFILE OF COMPANIES & CROSSOVER COLLABORATIONS SUPPORTED 16
3.1 HOME COUNTRY, SIZE, YEAR OF ESTABLISHMENT, AND TURNOVER OF THE COMPANIES 16
3.2 THE OFFERINGS AND ANNUAL SALES 17
3.3 CROSSOVER COLLABORATIONS 17
4 RESULTS 18
4.1 GENERAL OVERVIEW OF HOW THE EXTERNAL OPERATING ENVIRONMENT IS ASSESSED 18
4.1.1 CROSSOVER VALUE CHAIN INDICATORS RANKING 22
4.2 RESULTS FROM INNOVATION HEALTH CHECK OF THE INTERNAL OPERATING ENVIRONMENT 31
4.2.1 GENERAL INNOVATION CAPACITY AND PERFORMANCE OF THE SMES 31
4.3.2 MAIN STRENGTHS AND WEAKNESSES OF THE SMES IN THE ACCELERATION PROCESS 33
4.2.3 SPECIFIC NEED AND SUPPORT OF SMES 35
4.3 WEBINARS TO STIMULATE AND INFORM CROSSOVER COLLABORATION 36
5 DISCUSSION 36
6 LIMITATIONS 38
7 CONCLUSIONS AND EXPECTATIONS 39
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List of Authors
Partner Authors
HCN Joanna Lane
HCN Edit Sebestyén
Document History Date Version Editors Status
02 April 2019
0.1 Edit Sebestyén, Joanna Lane
Draft
27 April 2019
0.2 Joanna Lane, Edit Sebestyén
Draft
31 May 0.3
Joanna Lane, Edit Sebestyen
Final
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List of Figures
Figure 1: Average ratings of cross over value chain indicators Figure 2 a: Ratings of cross over value chain indicators by SMEs/countries (Group1) Figure 2 b: Ratings of cross over value chain indicators by SMEs/countries (Group 2) Figure 3: Overview of the ratings of indicators across countries for the 12 indicators Figure 4: Overall position against the benchmarking database Figure 5: Innovative Business Practices and Innovative Environment Practices against the Innovative Performance Figure 6: Most frequently identified strengths and weaknesses
List of Tables
Table 1: Cross-over value chain indicators and statements
Table 2: Themes and items in the full IHC questionnaire (52 items) Table 3: Themes and items in the lite version of the IHC questionnaire (18 items) Table 4: An IHC question example Table 5: Size and year of establishment of the companies Table 6: Annual turnover of the companies Table 7: Assessment of push or pull technology development across countries (CVC 6) Table 8: Assessment of new business model experimentation across countries (CVC 1) Table 9: Assessment of open innovation networks across countries (CVC 8) Table 10: Assessment of using living labs across countries (CVC 9) Table 11: Public procurement practice supporting crossover innovation across countries (CVC 7) Table 12: Assessment of social capital for networked value creation across countries (CVC 11) Table 13: Collaboration between younger SMEs and R&D and other knowledge institutions across countries (CVC12) Table 14: Assessment of SME absorption capacity across countries (CVC 10) Table 15: Assessment of support for accessing public funds across countries (CVC 3) Table 16: Assessment of favourable regulations across countries (CVC 2) Table 17: Assessment of collaborative business across countries (CVC 5) Table 18: Assessment of support for accessing private capital across countries (CVC 4) Table 19: Position of innovation segments and components against the benchmarking database Table 20: Summary of webinars delivered in the 1st Acceleration cycle
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Glossary Acronym Meaning
C4H Cross4Health
CVC Crossover value chain
SME Small and Medium Enterprise
Consortium ACRONYM FULL NAME
AV Aerospace Valley
BIOTECYL Cluster de Salud de Castilla y Leon
EUROB EUROB Creative
(S)HCN Health ClusterNET until 31/01/19 and then Stichting Health ClusterNET
IS Innovation Skåne
NHT Norway Health Tech (Coordinator)
ZENIT ZENIT GmbH
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1 Introduction
The purpose of this report is to identify and understand better the barriers, indicators and potential
actuators for SMEs taking part in crossover collaboration for ACEBIM in Europe. It also summarizes
the results achieved and benefits realised by SMEs taking part in the 1st Acceleration cycle run by
Cross4Health.
The acceleration cycles are reported elsewhere but include innovation support services provided by
consortium members and a validated voucher list of external experts. They also include a series of
interactive webinars for each acceleration cycle, the results of which are included in this report.
In its final iteration (D4.3) the report will also have a dedicated section reporting on the significant
spill-over results (e.g. other funds leveraged as a result of Cross4Health support), new collaborations,
impacts beyond the Cross4Health project, and forecasts of the longer-term effects of Cross4Health
on the start-ups and new SME collaborations initiated.
1.1 Background
In May 2018, the results of a survey with cluster partners identified barriers to and current practice
to enable crossover value chains in partner regions (D4.3). That report covers: cluster focus and
crossover innovation characteristics, barriers and solutions to crossover value chains, and indicators
for assessing crossover collaboration. Critically, a range of factors that affect crossover collaborations
were identified:
DRIVERS (the leading ones identified by partners are: digital transformation, service
innovation)
BARRIERS (the 3 priorities identified by partners are: regulatory, development dynamics and
business models)
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ACTIONS (the three actions rated most important by partners are: industry-end user
dialogue, clinic-industry-investor collaboration and innovative financial support).
Importantly, this exploratory work helped to identify potential indicators for crossover collaboration
that can be used to inform assessment of project impacts in the two acceleration cycles of the
Cross4Health project. Specifically, to help SMEs identify issues in their operating environment that
could affect their own innovation practice and performance in getting a new product closer to
market; and so would need attention from intermediary organisations in their ecosystem.
To complement the information we gathered on the external operating environment in which the
SMEs are working, the internal innovation processes of the SMEs were also examined. We looked at
how to improve innovation performance by being more competitive, more strategic, and more
innovative at the SME level. For this, a baseline Innovation Health Check was carried out among the
supported SMEs of the 1st acceleration programme.
In summary, three groups of indicators have been measured to inform how the crossover
collaborations supported by Cross4Health can demonstrate the cost-effectiveness and synergies that
are being achieved by the emerging ACEBIM industry and its less-linear value chains:
Ecosystem indicators for assessing operating environment and ecosystem practice and
performance for crossover collaboration (Cross over value chain indicators - CVC) (2.1 and
4.1 below)
Innovation Health Check tool with 18 indicators previously piloted elsewhere and focusing
on internal SME innovation capacity, practice and performance (2.2 and 4.2 below)
Key Performance Indicators on the competitiveness of supported SMEs; these indicators
were set in the Cross4health application (2.3 and 3 below).
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2 How we assess the external and
internal operating environments of SMEs
2.1 Measuring the external operating environment
The innovation ecosystem is defined as a complex network of people, organisations, institutions,
government policy and regulations that support and promote innovation. It includes the interactions
between people in order to take an idea and turn it into a marketable process, product or service.
In order to assess this external operating environment in EU countries and regions, and to
understand how this environment supports or hinders crossover collaboration from the SMEs’
perspective, a set of indicators were identified and measured to monitor and improve factors that
might affect crossover practice and performance. The objective was to address differing
circumstances for the Cross4Health accelerator programme in partner regions while generating
evidence that is comparable and provides a basis for identifying appropriate assessment options
(strategic and operational).
Altogether 12 ecosystem indicators have been identified based on the findings of the baseline survey
among the partner clusters and subsequent discussion with S3 contacts. Specifically, they are driven
by findings in D4.3 Section 3 ‘Cluster focus and characteristics in partner regions’, Section 4
‘Crossover innovation characteristics’, and Section 5 ‘Barriers and solutions to CVC’. The reason for
offering these indicators was to monitor and improve factors that might affect crossover practice and
performance by Cross4Health funded SMEs in partner regions. It does this in ways that address
differing circumstances for the Cross4Health accelerator programme in partner regions while
generating evidence that is comparable and provides a basis for identifying appropriate assessment
options (strategic and operational).
2.1.1 The Cross-over value chain indicator package
The indicator package contains 12 indicators (see Table 1) shared with our S3 contacts to review and
validate it. The measurement of each indicator was done by using a 1-5 point Likert scale in the
format of a short questionnaire discussed as part of an online meeting moderated by the KAM.
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Table 1: Cross-over value chain indicators and statements CVC INDICATOR CVC STATEMENTs Scale 1-5
(From Strongly disagree to Strongly agree)
Is this indicator active or inactive in the region?
Important points of the discussion
CVC 1 NEW BUSINESS MODEL EXPERIMENTATION
Collaborative value chains work best where the business models embrace collaboration, a modular approach to technology and build new business processes around both
CVC 2 FAVOURABLE REGULATIONS Current regulations in our region/country make it easier to set-up and run a new business based on crossover collaboration
CVC 3 SUPPORT FOR ACCESSING PUBLIC FUNDS
Fast-track procedures are in place to support applications by SMEs to available public funding
CVC 4 SUPPORT FOR ACCESSING PRIVATE CAPITAL
Private investors understand the needs of crossover collaborations and offer a range of funding options
CVC 5 COLLABORATIVE BUSINESS Stakeholders (industry, end users, investors, regulatory bodies) work well together to help get crossover products to market faster
CVC 6 PUSH OR PULL TECHNOLOGY DEVELOPMENT
Talking with end-users is essential in understanding market-pull factors for our product/service
CVC 7 PUBLIC PROCUREMENT PRACTICE SUPPORTING CROSSOVER INNOVATION
Public procurement practice disincentivises access to a potentially lucrative market
CVC 8 OPEN INNOVATION NETWORKS Open innovation networks are a useful way of promoting collaboration across sectors
CVC 9 USING LIVING LABS A living lab is a resource efficient way of testing our product/service
CVC 10 SME ABSORPTION CAPACITY We have enough capacity to absorb new ideas, technologies and processes from other sectors and outside of our region
CVC 11 SOCIAL CAPITAL FOR NETWORKED VALUE CREATION
We are working in a knowledge-rich location characterised by network spill-overs.
CVC12 COLLABORATION BETWEEN YOUNGER SMES AND R&D AND OTHER KNOWLEDGE INSTITUTIONS
Local universities and other R&D institutions provide a collaboration pipeline that younger SMEs can use to access resources (researchers with new ideas/tech, access equipment for a small fee etc.) to grow the business
The package also contains a discussion guide for the KAMs including (i) cross-reference of each
indicator to earlier findings in the D4.3 report, (ii) validation questions to facilitate deeper discussion
of the indicator with the SME and/or within the relevant Cross4Health partner cluster/intermediary,
and (iii) the indicator rationale providing a brief theoretical background for the indicator.
2.2 Measuring the Internal operating environment
In order to get an insight into the internal operating environment of the SMEs supported in the Cross4Health 1st acceleration cycle, the Innovation Health Check Tool was used to collect baseline
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data. The objective was to assess the innovation potential of the SMEs complementing the data and information gathered with the help of the ecosystem indicator package.
2.2.1 The Innovation Health Check analysis and benchmarking tool
The Innovation Health Check is a Needs Analysis & Benchmarking Tool for the Innovation Process that helps establish how ‘Innovation’ oriented a company is as it is designed to evaluate the innovation process. The complete IHC Tool contains 6 segments and 52 questions/themes (See Table 2). The questionnaire structure is broken down into 2 sections with 3-3 fields:
Innovation Business: (i) Innovation Culture, (ii) Understanding the Business, and (iii) Strategy. Innovation Environment: (i) Structure, (ii) Capability & Resources, and (iii) Processes.
Each section has both ‘Practice questions’ and ’Performance questions’. ‘Practice’ refers to the processes that an organisation has in place to design, manufacture, deliver, and measure its products and services. ‘Performance’ refers to what is achieved, with emphasis on operational aspects including product/service quality, cost, delivery, innovation and sustainability.1
Table 2: Themes and items in the full IHC questionnaire (52 items)
Practice & Performance questions
1. Innovative Culture
1.01 Innovative Environment & Motivation
1.02 Ambition to Grow
1.03 Leadership
1.04 Management Style
1.05 Openness & Attitude to Change
1.06 Learning from Successes & Mistakes
1.07 Risk Tolerance
1.08 Reward and Recognition
2. Understanding
the business
2.01 Understanding the Customer
2.02 Customer Information
2.03 Capturing Customer Feedback
2.04 New Technologies / Developments in the Market
2.05 Segmenting the Market
2.06 How Does the Company Market its Products & Services?
2.07 Customer Potential
2.08 Competitor Information
2.09 Analysing Competitive Advantage
2.10 Service Innovation
3. Strategy
3.01 Company Objectives and Goals
3.02 Future Market Focus
3.03 Defined Business Model
3.04 Strategic Planning
3.05 Innovation Strategy in Business Plan
3.06 Use of Strategic Tools in Innovation
3.07 Commitment to Ideas Generation
3.08 Project Outcome vs Targeted Gain
1 Source: https://www.leanbusinessireland.ie/about-us/are-you-an-enterprise-ireland-client/innovation-health-check/
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4. Structure
4.01 Cross-Functional Teams
4.02 Ownership / Empowerment
4.03 Organisation of Resources
4.04 R&D Structure
4.05 Knowledge Capture and Sharing
4.06 Effective Communication & Use of Tools
4.07 Intellectual Property (IP) Management
5. Capability & Resources
5.01 Staff Innovation Skills
5.02 Managing the Capability Gaps
5.03 Discipline
5.04 Fire Fighting
5.05 Innovation Budget
5.06 Devolved Responsibility for Small Projects
5.07 Projects - on Time and Within Budget
6. Processes
6.01 New Idea Generation
6.02 Project Screening & Selection
6.03 Implementation & Commercialisation
6.04 Measurement Innov. Success
6.05 “Time to Market” Performance
6.06 Continuous Improvement
6.07 Balance - Projects & Resources
6.08 R&D Linkages
6.09 Use of Business Tools in Innovation
6.10 Idea Management System
6.11 Effective Project Management
6.12 Post Project Review
Previous experience with the IHC tool shows that start-ups and younger SMEs are not yet mature enough to answer all of the 52 questions. So, a ‘lite’ version of the tool was created with only 18 indicators (See Table 3). This included revisions to those indicators being used as performance indicators to make them more appropriate for start-ups and younger SMEs.
Table 3: Themes and items in the lite version of IHC questionnaire (18 items)
The way Enterprise Ireland (the Tool developer) presents the Tool is that each IHC question displays 3 statements that portray ‘best practice' (in the right column) and something not as good as ‘best practice' (in the middle and left columns) (See Table 4). SMEs needed to choose the statement which is the closest to their current situation in their business. After discussion, the most appropriate score was recorded from 1 to 5. There is no ‘pass’ or ‘fail’ – the intention is to help the business to identify strengths and opportunities for improvement.
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Table 4: An IHC question example
2.3 Key performance indicators The third group of indicators that are being measured focuses on the impact of the project on
changes in the competitiveness of supported SMEs as presented in the original C4H application: the
number of employees; the number of products, services, processes; the number of sales, annual
turnover, and international collaborations of the SMEs. This supplements the set of project
performance indicators being measured by WPs 2/3/5/6/7 and reported elsewhere (e.g. periodic
report).
2.4 How the data was collected
Data was collected as part of an online meeting between the KAM and SME representatives from the
supported teams of the 1st Cross4Health Acceleration programme, in autumn 2018. During an
approximately 2 hours discussion moderated by the KAM data and information was gathered with the help of the ecosystem indicator/KPI questionnaire and the Innovation health Check questionnaire to assess the external and internal operating environments of the SMEs and to examine their impact on innovation.
The online calls were organised with a team of 3-4 people representing the SMEs. The objective was to have an appropriate mix of staff & the value of having a broad opinion base as possible. The selected team members should have covered all the business areas and levels of responsibility. We tried to avoid having only 2 people in the teams unless the company was very small to avoid bias.
The SMEs got the questionnaires in advance to make some preparations; however, the point was to generate an exploratory discussion with the team members instead of providing ready-made answers to the KAMs.
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3 Profile of companies & crossover
collaborations supported
Five project teams are supported in the 1st acceleration programme. The 5 teams comprise 2 to 4 SMEs, altogether 16 SMEs. Out of the 16 companies, 10 provided data on the ecosystem and 13 carried out the Innovation Health Check at the time of this report. One company decided not to take part in IHC as they went through a similar assessment in the recent past, so they considered another IHC as a sort of duplication. They shared their earlier report with their KAM. Two SMEs decided not to participate in the data collection at all. They are part of a 4-member team. The KPIs were collected for 10 companies as well.
3.1 Home country, size, year of establishment, and turnover of the companies
The countries from which the participating SMEs are from are Portugal, Austria, Spain, Italy, France, and Norway. The engaged SMEs were established 9,6 years ago on average. However, one of them is only working a year ago, while the oldest one was established 21 years ago.
Table 5 shows the size of the companies and when they were established.
Most of the companies are micro size companies. The average number of full-time employees in the SMEs is 9,5. The biggest SME employs 46 people full time. The majority of the SMEs have less than 10 employees. Eight of them have been operating for 10 years or even more.
Table 5: Size and year of establishment of the companies
Company size
Established N=13
1-6 years
10-11 years
15=< years
Micro (staff headcount < 10) 5 3 1 Small (staff headcount < 50) 0 2 2 Medium sized (staff headcount < 250) 0 0 0
The SMEs in Cross4Health are not only small in size, but the majority also has an annual turnover that clarifies them also as micro size companies (between 255 and 550k). Only 1 SME had an annual turnover little above 2 million (2,2 m) euros. (Table 6)
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Table 6: Annual turnover of the companies N=10
Turnover
No
Medium-sized ≤ € 50 m 0
Small ≤ € 10 m
1
Micro ≤ € 2 m 9
3.2 The offerings and annual sales
The supported SMEs are providing various products, services or processes on the market (on average
2-4 products/services/SME). The highest number of product is 8 provided by one single company.
The most services (10 and 11 services) are offered by two SMEs. Provided processes are rare, only 2
are offered by one company. Examples of products are Cirsa-Routing: optimization of more than
4,000 visits to customers; Mentor: operational management platform for handling operators; RENFE
interconnection-UAB bus shuttle: warns the bus driver when the next train will arrive thanks to the
information provided by the users of their position; BusosUAB: information on arrival times in real
time of geopositioning buses. It is used in the UAB; BiciUAB: management of parking spaces and
lockers for bicycle users. It is used in the UAB; ITV-UAB management: time reservation for the mobile
ITV service provided at the UAB; Espai4you: development for anaesthetists of Otraforma (R + D + i of
Hypnos) to reserve spaces and equipment for surgeons to carry out interventions in private hospitals;
cliniK; Kover; iWalkU.
Examples of services are optimization service for land fleets physiotherapy; preoperative assessment;
intraoperative anaesthesia; pregnant analgesia; diagnosis aid; scans anaesthesia; training of
anaesthesia specialists; and access to information system.
The number of sales is obviously very much depends on the type of product, service, process, so the
average numbers of sales cannot be meaningfully compared. Data was available for 8 SMEs. The
numbers of sales vary between 5 and 145000.
International collaborations are also present in the everyday work of the Cross4Health SMEs. On
average they are involved in 7 international projects (min. 1, max. 20).
3.3 Crossover collaborations
In the 1st Acceleration programme 5 projects are supported. Their cross-country and cross-sectoral
teams are representing 8 countries: Italy, France, Spain, Portugal, Finland, Norway, Austria, Belgium,
and 6 main sectors: aerospace, energy, biotechnology, biomedics, ICT, design in cooperation with
medicine and health care.
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3,6
4,5
4,2 4,1
3,9 3,9 3,8
3,7 3,6
3,3
3,0
2,8 2,8
1
1,5
2
2,5
3
3,5
4
4,5
5 1-12 Indicator rating - average
Push or pull technology development(CVC6)
New business model experimentation(CVC1)
Open innovation networks (CVC8)
Using living labs (CVC9)
Public procurement practice supportingcrossover innovation (CVC7)
Social capital for networked valuecreation (CVC11)
Collaboration between younger SMEs andR&D and other knowledge institutions(CVC12)SME absorption capacity (CVC10)
Support for accessing public funds (CVC3)
Favourable regulations (CVC2)
Collaborative business (CVC5)
Support for accessing private capital(CVC4)
4 Results
4.1 General overview of how the external operating environment is assessed
As described in the D4.3 report, the review and assessment of the external innovation environment
with the help of the 12 ecosystem indicators provides a baseline of SME perceptions of barriers to
crossover innovation in a SMEs local operating environment.
The assessment done by 10 SMEs is shown in Figure 1. Overall, the average of the rating is 3,6 across
the 12 indicators which suggests that there are several segments in the innovation ecosystem that
need improvement and development.
Figure 1: Average ratings of cross over value chain indicators N=10 SMEs
The strongest area is Push and Pull Technology Development. Most of the SMEs who responded
agree that talking with end-users is essential in understanding market-pull factors for their product/
service. However, we don’t know if this really happens or is acknowledged as something that should
happen. There are 4 factors identified which seem to be the weakest ones. The SMEs are uncertain
that private investors understand well the needs of crossover collaborations and they believe they
don’t really offer a range of funding options. Besides, SMEs are also uncertain that current
regulations in their region/countries make it easier to set up and run a new business based on a
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crossover collaboration. SMEs tend to think that stakeholders don’t work well together to help get
crossover products to market and don’t think that enough fast track procedures are in place to
support project applications. (See in detail in chapter 4.1.2)
The overall rating of the 12 indicators is 3,6 showing that the general picture about the innovation
ecosystem is not really positive.
If we look at the responses at the country/SME level, quite differing circumstances can be detected.
The characteristics of the innovation ecosystem seem to vary not only across countries but also SMEs
from the same country2 can judge the same factors very differently being perceived more favourable
or less favourable for supporting or promoting innovation. (See Table 7 a & b) The spider graphs
show clearly the weakest and strongest segments of the innovation ecosystem and at the same time
the divergent views of the respondent SMEs.
For example, the 3 Italian SMEs rated very differently several indicators. (Figure 2 a) There was no
agreement for any of the factors among the three of them. The fields of Push and pull technology
development, New business model development, and the SME absorption capacity statements were
rated the highest by 2 Italian SMEs, but the 3rd Italian company had a different opinion in each case
and rated these indicators much lower. The situation is a bit better for Portugal and Spain. (Figure
2b)
The Portuguese and the Italian SMEs had similar ratings for at least a few fields. The 2 Portuguese
SMEs had similar opinions about the field of Support for accessing private capital and agreed that
private investors understand the needs of crossover collaborations and that they offer a range of
funding options (4 on the 1-5 scale). They also agreed that the Collaborative business field is weak
where stakeholder cooperation in order to get crossover products to market faster doesn’t really
work (2 on the 1-5 scale).
The 3 Spanish SMEs also had a common understanding in 3 fields out of the 12. (Figure 2 b) They
think the regulations are not really favourable to set-up and run a new business based on crossover
collaboration (2 on the 1-5 scale), and all of them completely agreed that Using living labs is a
resource efficient way of testing products and services (5 on the 1-5 scale). There were also two
more areas where the opinions of the Spanish companies were quite similar: Support for accessing
private capital is lacking as well as talking with end-users is essential in understanding market-pull
factors for their product/service as part of the Push or pull technology development field.
2 Portugal, Italy, and Spain were represented by 2 and 3 SMEs in the sample.
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Figure 2 a: Ratings of cross over value chain indicators by SMEs/countries (Group1)
1
2
3
4
5Push or pull technology development (CVC8)
Open innovation networks (CVC6)
New business model experimentation (CVC1)
Using living labs (CVC9)
Collaboration between younger SMEs and R&D and otherknowledge institutions (CVC12)
Public procurement practice supporting crossoverinnovation (CVC7)
SME absorption capacity (CVC10)
Social capital for networked value creation (CVC11)
Support for assessing public funds (CVC3)
Favourable regulations (CVC2)
Collaborative business (CVC5)
Support for assessing private capital (CVC4)
Austria- SME3
Italy - SME7
Italy - SME8
Italy - SME9
France - SME10
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Figure 2 b: Ratings of cross over value chain indicators by SMEs/countries (Group2)
1
2
3
4
5Push or pull technology development (CVC8)
Open innovation networks (CVC6)
New business model experimentation (CVC1)
Using living labs (CVC9)
Collaboration between younger SMEs and R&D and otherknowledge institutions (CVC12)
Public procurement practice supporting crossoverinnovation (CVC7)
SME absorption capacity (CVC10)
Social capital for networked value creation (CVC11)
Support for assessing public funds (CVC3)
Favourable regulations (CVC2)
Collaborative business (CVC5)
Support for assessing private capital (CVC4)
Portugal - SME1
Portugal - SME2
Spain - SME4
Spain - SME5
Spain - SME6
22
Figure 3 provides an overview of the ratings of all indicators across countries. The figure shows well
that several fields were rated very low for each country. This suggests that some dimensions of the
innovation ecosystem are far from supporting and act as barriers and strong actions to support
innovations are also lacking or are not efficient enough. (See each indicator in detail in 4.1.2)
Figure 3: Overview of the ratings of indicators across countries for the 12 indicators
4.1.1 Crossover value chain indicators ranking
In this sub-section the 12 CVC indicators are presented in the order by which they were ranked –
from high to low ranking.
R1 PUSH OR PULL TECHNOLOGY DEVELOPMENT (CVC 6)
Statement: Talking with end-users is essential in understanding market-pull factors for our
product/service.
This indicator is examining (i) the factors that influence the development of crossover ideas through
new products/services, (ii) how the SMEs engage with end-users in the development of
new/products services, (iii) how efficient is the SMEs' management of field testing/trialling/
prototyping if they follow a user-centred design process to achieve efficiency, and that (iv) what
SMEs do to manage product launches for new crossover products.
This was the highest rated indicator (4,5 on a 1-5 scale) out of the 12. The SMEs strongly agree with
the importance of engaging with end-users when developing a new product or service to be able to
1,0
1,5
2,0
2,5
3,0
3,5
4,0
4,5
5,0
Portugal Austria Spain Italy France
New business model experimentation (CVC1)
Favourable regulations (CVC2)
Support for assessing public funds (CVC3)
Support for assessing private capital (CVC4)
Collaborative business (CVC5)
push of pull technology development acrosscountries (CVC6)
Public procurement practice supportingcrossover innovation (CVC7)
Open innovation networks (CVC8)
Using living labs (CVC9)
SME absorption capacity (CVC10)
Social capital for networked value creation(CVC11)
Collaboration between younger SMEs and R&Dand other knowledge institutions (CVC12)
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understand the factors influencing the market for their own product or service. However, we know
little about how this is happening in practice.
If we look at the country differences in ratings in Table 7, we can see that the indicator was rated the
highest in Austria, and the lowest in France, although the difference is small.
Table 7: Assessment of push or pull technology development across countries (CVC 6)
R2 NEW BUSINESS MODEL EXPERIMENTATION (CVC 1)
Statement: Collaborative value chains work best where the business models embrace collaboration, a
modular approach to technology and build new business processes around both
This indicator examined (i) if traditional value chains are obsolete and if yes, why is that, (ii) to what
extent collaboration combined with new technologies (Internet of Things, smart mobile wearable
devices, social networks, virtual augmented reality, 3D printing, robotics etc.) that builds new paths
to value creation are helping the crossover collaboration of the SMEs, (iii) if health care providers in
the SME’s region are open to business model experimentation, and if yes, what has helped this to
happen, and (iv) how different will be the market pull in urban and rural areas, and what are the
implications of this for business modelling if we look to the future.
The SMEs rated this indicator as the second highest (4,2 on a 1-5 scale). With the exception of 2
SMEs, they agree or even strongly agree that crossover value chains need new business models
and a modular approach to technology development also as a response to our differing and
changing societies. Yet, it was also underlined that the necessary know-how is often lacking.
If we look at the country differences in ratings in Table 8, we can see that the indicator was rated the
highest in Italy and Spain, and the lowest in Austria, where the SME seemed uncertain in this
question, and neither agreed nor disagreed with the statement.
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
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Table 8: Assessment of new business model experimentation across countries (CVC 1)
R3 OPEN INNOVATION NETWORKS (CVC 8)
Statement: Open innovation networks are a useful way of promoting collaboration across sectors
This indicator examined (i) the main characteristics of any open health innovation networks
operating in the SMEs’ region, e.g. networking, collaboration between key stakeholders, business
entrepreneurship, proactive IP management that creates markets for crossover technology, (ii) how
confident are the SMEs or other SMEs in their region in using external and internal knowledge/ideas,
(iii) possible case example where key stakeholders worked together to solve a problem by developing
and testing a new innovation product, and (iv) changes made in the management and use of IP
locally to maximise innovation opportunities.
The SMEs rated the third highest this indicator (4,1 on a 1-5 scale) out of the 12. They think that
open innovation networks can be a useful way of promoting collaboration across sectors. The
majority of the SMEs may have positive experiences with innovation networks with challenges to
tackle.
If we look at the country differences in ratings in Table 9, we can see that the indicator was rated the
highest in Portugal, and the lowest in France. The French SME seemed uncertain, neither agreed nor
disagreed with the statement, which may mean negative or no experience with open innovation
networks yet.
Table 9: Assessment of open Innovation networks across countries (CVC 8)
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
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R4 USING LIVING LABS (CVC 9)
Statement: A living lab is a resource efficient way of testing our product/service.
This indicator examined (i) if there are any Living Labs operating in the SME’s regions, (ii) how novel
innovation activities in those Living Lab(s) are coordinated, (iii) if the SMEs in the region continue to
use the traditional project model, (iv) the benefits and/or problems that the SMEs or others have
experienced in setting-up, joining or running a Living Lab, and (v) the SMEs’ plans for using a living lab
to service crossover innovations that can benefit the health sector from.
The SMEs rated this indicator close to 4 (3,9 on a 1-5 scale). Most of the SMEs had a positive
opinion about the living labs; however, 2 SMEs disagreed as they see the implementation as
problematic due to various factors.
If we look at the country differences in ratings in Table 10, we can see that the indicator was rated
the highest in Spain with a strong agreement, and the lowest in Italy, with score 3, again similar to
earlier lowest ratings, being neutral in the question.
Table 10: Assessment of using living labs across countries (CVC 9)
R5 PUBLIC PROCUREMENT PRACTICE SUPPORTING CROSSOVER INNOVATION (CVC 7)
Statement: Local public procurement practice does not make working with health care providers very
appealing.
This indicator examined (i) the processes in place to improve local SME access to public procurement
opportunities, (ii) how public procurement in the SME’s region/country help to develop and maintain
open health innovation ecosystems; (iii) pre-commercial public procurement in place for procuring
R&D services and how that works, and (iv) methods in place to overcome risk aversion in the use of
public procurement budgets by health care supply chain managers in the region.
The SMEs rated this indicator also close to 4 (3,9 on a 1-5 scale). With a few exceptions, the SMEs
did see the local public procurement practice as a barrier to work with health care providers, and
bureaucracy is highlighted as an obstacle when the public sector is involved in a process.
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
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Table 11: Public procurement practice supporting crossover innovation across countries (CVC 7)
If we look at the country differences in ratings in Table 11, we can see that the indicator was rated
the highest in Italy and Portugal, and the lowest in France and Spain, where the responses were
neutral. This may suggest different country practices which not necessarily hinder innovation
procurement.
R6 SOCIAL CAPITAL FOR NETWORKED VALUE CREATION (CVC 11)
Statement: We are working in a knowledge-rich location characterised by network spill-overs.
This indicator examined (i) how the SMEs build productive social ties with health care providers,
patients, suppliers, other industry in their sector plus other sectors, (ii) the external connections that
open innovation relies on (the ability to make and manage relationships with other firms, health care
providers who might buy their products, patients and end-users as co-producers) and how they are
built and maintained, (iii) the plans SMEs have for expanding and/or improving external connections
in the next 3 years, (iv) the working location e.g. characterised by network spill-overs, or a
knowledge-rich or poor location, and (v) if crossover value chains and/or networks in which the SMEs
are engaged is based on sufficient levels of trust and flexibility that allows members working
together to be responsive and adaptable to new opportunities.
The SMEs rated this indicator a bit lower than 4 (3,8 on a 1-5 scale) suggesting that their working
location is not necessarily knowledge rich or the crossover value chains or networks are not
flexible enough, or simply for micro size companies it is difficult to build the necessary social
capital which could be a strong resource to work effectively with the key actors in the health care
field.
If we look at the country differences in ratings in Table 12, we can see that the indicator was rated
the highest in Italy, and the lowest in Spain.
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
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Table 12: Assessment of social capital for networked value creation across countries (CVC 11)
R7 COLLABORATION BETWEEN YOUNGER SMES, R&D & OTHER KNOWLEDGE INSTITUTIONS (CVC 12)
Statement: Local universities and other R&D institutions provide a collaboration pipeline that younger
SMEs can work with and access resources (researchers with new ideas/tech, access equipment for a
small fee etc.) to grow the business.
This indicator examined (i) any collaboration of the SMEs with universities and other R&D
organisations that can improve business model makeover process, (ii) if local innovation clusters act
as matchmakers between researchers and younger SMEs whose field of work matches that of the
researcher, (iii) if governments (or local universities) run a ‘Knowledge Transfer Partnership’ scheme
to place a skilled academic inside the SMEs’ business to help with a specific project, (iv) if SMEs took
part in a university placement scheme providing internships and projects for students.
The SMEs rated this indicator also less than 4 (3,7 on a 1-5 scale). The SMEs may agree with the
idea and the importance of looking for collaborations with universities and R&D institutions,
however, there can be obstacles, e.g. bureaucratic ones that can hinder innovation processes.
Though, a positive example was also given where the SME was created as a result of a successful
project at a university.
If we look at the country differences in ratings in Table 13, we can see that ratings are very close to
each other for each country.
Table 13: Collaboration between younger SMEs and R&D and other knowledge institutions
across countries (CVC12)
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
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R8 SME ABSORPTION CAPACITY (CVC 10)
Statement: We have enough capacity to absorb new ideas, technologies and processes from other
sectors and outside of our region.
This indicator examined (i) the SMEs’ capacity to absorb new technologies, processes and
innovations that can help improve their competitiveness, (ii) if SMEs regularly monitor trends within
and outside their region to identify new opportunities for exploitation e.g. using technology
surveillance, (iii) the SMEs’ practices to keep up with the market and competitors and to what extent
they can control and manage the operating environment to their own advantage, (iv) what
improvements in ITC have SMEs and other potential crossover innovation stakeholders made in the
last 3 years in order to improve the flow of information externally and internally, and (v) the ability to
innovate to improve competitiveness e.g. by expanding the portfolio of new products and services.
The SMEs rated this indicator well below 4 (3,6 on a 1-5 scale). Except for a few SMEs, most of the
companies rated this indicator lower which shows the difficulties with the absorption capacity.
Although there are good case examples, like e.g. a newly built start-up with a team with specific
skills and knowledge, there can be problems with the absorption capacity at certain fields, and for
very small size companies.
If we look at the country differences in ratings in Table 14, we can see that the indicator was rated
the highest in Spain, and the lowest in France, Italy, and Austria.
Table 14: Assessment of SME absorption capacity across countries (CVC 10)
R9 SUPPORT FOR ACCESSING PUBLIC FUNDS (CVC 3)
Statement: Fast-track procedures are in place to support applications by SMEs to available public
funding
This indicator examined (i) fast track procedures in place regionally or nationally to facilitate
applications by SMEs in crossover collaborations to relevant national and EU Funding instruments,
(ii) if SMEs are able to get access to funding in their region/country to support preparation of
national and EU (Horizon 2020 and ESIF) funding applications, (iii) what prevents or stimulates local
SMEs to become involved in partnerships with SMEs or third parties in other sectors (e.g.
universities, public research centres or health care providers) in order to access national and EU
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
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Funds, (iv) what have National Contact Points for national and EU Funding instruments put in place to
promote awareness of these instruments and access to advice on how to secure funds, (v) the
experience of use of EU Funds in the SMEs’ region/country e.g. examples of wasteful use on projects
driven by lobbies without accountability for economic growth and employment.
The SMEs rated this indicator quite low, close to 3 (3,3 on a 1-5 scale). Despite positive examples,
half of the SMEs think that not enough support is in place to help to get public funding while they
are experiencing difficulties in seeking and obtaining financing.
If we look at the country differences in ratings in Table 15, we can see that the indicator was rated
the highest in Italy and Austria, and the lowest in Spain.
Table 15: Assessment of support for accessing public funds across countries (CVC 3)
R10 FAVOURABLE REGULATIONS (CVC 2)
Statement: Current regulations in our region/country make it easier to set-up and run a new business
based on crossover collaboration.
This indicator examined (i) the current regulations in the SMEs’ region/country that can make it more
or less easy to set-up and run a new businesses based on crossover (sector and/or border)
collaboration, (ii) how regulations stimulate entrepreneurship and create space for experimentation
in crossover collaboration, (iii) the specific law/regulation/policy on technology transfer between
sectors active in the SMEs’ region, (iv) if current regulations act as a barrier or enabler to clinic-
industry collaborations in the SMEs’ region.
The SMEs rated this indicator 3 on average (3,0 on a 1-5 scale). This suggests that the majority of
the SMEs think regulations are less favourable to set-up and run a new business based on
crossover collaboration and do little to help stimulating entrepreneurship and creating space for
experimentation.
If we look at the country differences in ratings in Table 16, we can see that the indicator was rated
the highest in France, and the lowest in Spain and Austria.
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
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Table 16: Assessment of favourable regulations across countries (CVC 2)
R11 COLLABORATIVE BUSINESS (CVC 5)
Statement: Stakeholders (industry, end users, investors, regulatory bodies) work well together to help
get crossover products to market faster
This indicator examined (i) if national governments or regional authorities actively work on policies
that support cross-border and cross-sectoral value chains, (ii) the possible fragmentation between
regulatory work and research investment in the SMEs’ region/country that breaks crossover value
chains by creating obstacles to getting access for new innovation products to markets, (iii) possible
future plans (in the next 3-5 years) to further improve the interaction between stakeholders
(researchers, complementary innovators, industry, health care providers, clinicians and patients) in
these and other crossover value chains.
The SMEs rated this indicator as one of the lowest (2,8 on a 1-5 scale) out of the 12. The SMEs
believe the collaboration between stakeholders (industry, end users, investors, and regulatory
bodies) is not strong enough to help get crossover products to market faster. The difficulties to
work with the public sector were highlighted.
If we look at the country differences in ratings in Table 17, we can see that the indicator was rated
the highest in Italy, and the lowest in France and Portugal.
Table 17: Assessment of collaborative business across countries (CVC 5)
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
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R12 SUPPORT FOR ACCESSING PRIVATE CAPITAL (CVC 4)
Statement: Private investors understand the needs of crossover collaborations and offer a range of
funding options
This indicator examined (i) what stringent requirements, including personal guarantees, do SMEs in
the region report having to provide in order to obtain financing from credit institutions, (ii) what
actions have been taken at national level to regulate the financial industry in ways that explicitly
protect and stimulate effective lending to the real economy, in particular to SMEs, (iii) what
partnerships are in place between banks and other operators involved in SME financing (accountancy
professionals, business or SME associations or chambers of commerce), (iv) what specific
programmes are available e.g. equity (such as business angels, crowdfunding and multilateral trading
facilities), quasi-equity (such as mezzanine finance) or debt instruments (such as small-ticket
company bonds, guarantee facilities and platforms).
The SMEs rated this indicator as the second lowest (2,8 on a 1-5 scale). With a few exceptions, the
SMEs think private investors don’t understand far enough the needs of crossover collaborations
and do not offer enough funding options.
If we look at the country differences in ratings in Table 18, we can see that the indicator was rated
the highest in Italy and Portugal, and the lowest in Spain.
Table 18: Assessment of support for accessing private capital across countries (CVC 4)
4.2 Results from innovation health check of the Internal operating environment
The information gathered on the innovation ecosystem was complemented by the use of the short
version of the Innovation Health Check tool to identify and track the SMEs in-house innovation
capacity and performance.
4.2.1 General innovation capacity and performance of the SMEs
Figure 4 shows the overall average Innovation Position of 13 Cross4Health SMEs against the IHC
benchmarking database. The spider graph shows how the SMEs are performing relative to the
1,0 2,0 3,0 4,0 5,0
Portugal
Austria
Spain
Italy
France
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database comparison group in each of the six innovation segments. The SMEs position is represented
by the 'blue' line, the database strong' position is green, the 'average' is orange and the 'weak' is red.
The outcome of the innovation benchmark indicates for the 13 Cross4Health SMEs an overall
position only a little bit below the database strong which is very positive. A significant area of
strength for the Cross4Health SMEs is Capability and resources which helps to achieve the
companies’ goals, to identify gaps and establish appropriate skills. The other strong field is the
Innovative culture which is important to implement and sustain a proactive innovative approach to
company growth.
Figure 4: Overall position against the benchmarking database N=13
The weakest segment is Structure which, if it is appropriate, helps to achieve strategic goals.
However, even if this is the weakest segment, the position on this area is still slightly better than the
database average. The other 3 areas are also better than average: (1) Strategy, which is crucial in
order to have a clear view of how the company will grow and focus its resources to maximise its
return, (2) Processes which give structure to the innovation process and to evaluate outcomes in a
timely manner, and (3) Understanding the business which is about clear understanding of all aspects
of the business and how they impact on performance. Table 19 summarises these results together
with listing each component of the segments.
Table 19: Position of innovation segments and components against the benchmarking database
Components Position
1. Innovative Culture
1.01 Innovative Environment & Motivation
Little better than average 1.03 Leadership
1.06 Learning from Successes & Mistakes
2. Understanding the business
2.01 Understanding the Customer Average
2.08 Competitor Information
2.09 Analysing Competitive Advantage
0,0%
20,0%
40,0%
60,0%
80,0%
100,0%
1. Innovative Culture
2. Understanding the business
3. Strategy
4. Structure
5. Capability & Resources
6. Processes
Overall Position
DatabaseWeak
DatabaseAverage
DatabaseStrong
CompanyScore
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3. Strategy
3.01 Company Objectives and Goals Better than average 3.03 Defined Business Model
3.04 Strategic Planning
4. Structure
4.03 Organisation of Resources Better than average
4.05 Knowledge Capture and Sharing
4.07 Intellectual Property (IP) Management
5. Capability & Resources
5.01 Staff Innovation Skills Better than average
5.02 Managing the Capability Gaps
5.07 Projects - on Time and Within Budget
6. Processes
6.01 New Idea Generation Better than average
6.03 Implementation & Commercialisation
6.11 Effective Project Management
The IHC Tool furthermore highlights that in order to improve a company's performance, it is necessary to focus on strengthening the weaker practice segments as holding a good average and balance in all segments is better than being very strong in one or two segments.
Figure 5 shows the Cross4Health SMEs’ Innovative Business Practices against their Innovative Business Performance and their Innovative Environment Practices against their Innovative Environment Performance. Above we saw that in all segments, both in the business area and in the environment area the SMEs are better or even much better than average. This balanced achievement leads to a performance that is also better than average for the 13 SMEs, which is a very positive finding.
Figure 5: Innovative Business Practices and Innovative Environment Practices against the Innovative Performance N=13
4.3.2 Main strengths and weaknesses of the SMEs in the acceleration process
One of the key steps in IHC data analysis is to select the strengths and weaknesses of a company by studying the company scores on each item and examine (i) their position against the IHC benchmarking database strong, average, and weak positions and (ii) their deviation from the database average and strong position.
Below in Figure 6 these identified strengths and weaknesses are summarized for the 13 SMEs.
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Figure 6: Most frequently identified strengths and weaknesses N=14
The most frequently identified STRENGTHS are 1.01 Innovative environment & Motivation (7),
2.01 Understanding the customer (6), 3.01 Company objectives and goals (7), and 5.01 Staff
innovation skills (8). These strong fields are about to develop an environment for innovation
including motivation and ambition to grow, where staff and management can actively exploit new
ideas, where these ideas are encouraged, supported and funded. It is also about ensuring that formal
and informal mechanisms are used to identify customer issues, where customers' views and ideas
are actively sought throughout the business and acted on. These also support that a company
strategy is developed with clearly defined objectives and goals, which are communicated,
understood and acted upon by all employees, as well as is regularly reviewed and modified to match
the changing environment. Last but not least the company harnesses existing staff innovation skills,
and invests in staff learning & development and innovation management structures are in place
The most frequently identified WEAKNESSES were 1.06 Learning from successes & mistakes,
2.08 Competitor information, as well as 5.07 Projects on time and within the budget. These
weaknesses prevent the companies to learn from past projects and their problems to help avoid
similar problems in the future. In positive cases, companies' learning outcomes are incorporated into
innovation management procedures and a database of previous problems and solutions is
maintained. These weaknesses also suggest that the companies do not necessarily know well their
main competitors meanwhile it is recommended that competitor information is gathered and
analysed in a structured manner. Finally, if projects are not managed in time and within the budget,
the costs can escalate significantly instead of terminating unviable projects early on with good
project management.
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14
1.01 Innovative Environment & Motivation
1.03 Leadership
1.06 Learning from Successes & Mistakes
2.01 Understanding the Customer
2.08 Competitor Information
2.09 Analysing Competitive Advantage
3.01 Company Objectives and Goals
3.03 Defined Business Model
3.04 Strategic Planning
4.03 Organisation of Resources
4.05 Knowledge Capture and Sharing
4.07 Intellectual Property (IP) Management
5.01 Staff Innovation Skills
5.02 Managing the Capability Gaps
5.07 Projects - on Time and Within Budget
6.01 New Idea Generation
6.03 Implementation & Commercialisation
6.11 Effective Project Management
Strengths
Weaknesses
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4.2.3 Specific need and support of SMEs
With the help of the IHC tool which puts innovation into a wider context and looks at how the
innovation process operates from the outset, the SMEs had the opportunity to examine their
everyday practice and performance very closely in small steps i.e. capturing customer needs (stated
and unstated), idea generation, concept development, product/service development up to the
commercial realization stage and all steps in between.
The Tool identified the weaker points within these big areas helping the KAMs and the SMEs to work
together to specify the main points for future development and to set the direction of support from
Cross4Health and third-party services, which was summarized together with the data in an individual
IHC report.
In these reports, the themes ‘Structure’, ’Strategy’, and ‘Understanding the business’ came up as
main overarching themes when discussing the necessary developments to be put on the future
agenda of the SMEs. The recommended fields where specific support or assistance could be useful
were the following:
Company (structure/objectives & goals)
Leadership & culture
New ideas (generating & implementing)
Management (staff, projects & finances)
Resource (management & planning)
Processes (evaluation of services)
Business modelling/business plan development
Competitor information (e.g. managing & gathering competitor information)
Intellectual Property management
Communication (developing formal communication strategy across the organisation)
Networking & partnering.
It also worth to examine in Figure 6 that except 5.01 Staff innovation skills and 6.01 New idea
generation, all fields are identified both as weaknesses and strengths. Fields which are weaknesses
for some of the SMEs at the same time can be strengths for the others. Sixteen out 18 themes of the
questionnaire appear at least in a few cases either in a positive or a negative manner proving that
SMEs have considerably diverse backgrounds as far as their knowledge, practice and performance is
concerned in relation to innovation. This suggests that any kind of support for the SMEs need to be
specific and personalised. The engaged SMEs differ from one another considerably having different
starting points in terms of their innovation orientation level and innovation potential, i.e. the level of
their innovative processes that are in place which supports and underlines the importance of
providing needs-led innovative support for the SMEs.
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4.3 Webinars to stimulate and inform crossover collaboration
Table 20: Summary of webinars delivered in the 1st Acceleration cycle
A webinar series to stimulate and inform crossover value chains (T4.2) were put together to help the
start-ups and younger SMEs in the 1st Acceleration cycle to reflect on how better to develop and
bring their product/service/process closer to market.
As with the IHC exercise, this series complemented the consortium services and voucher list services
provided as part of WP5. Webinars lasted between 1.5 and 2.5 hours with the most positive
evaluations for those that were highly interactive. (See Table 20)
5 Discussion
The innovation ecosystem assessments and the Innovation Health Checks informed targeted service
innovation support provided by Cross4Health partners and accredited third-party experts during the
1st Acceleration cycle. They also inform the review of policies and practices relevant to weaknesses in
the operating environment identified by SMEs and if needed, actions to remove or better manage
those weaknesses. With the help of this activity, we have an overview of how SMEs perceive their
working environment, which is also valuable feedback for the regional clusters to act upon at
regional and at SME level.
Examining the innovation ecosystem in which the participating SMEs are working we can conclude
that the characteristics of the external innovation environment seem to vary not only across
countries but also SMEs from the same country judge the same factors very differently. Only two
SME assessed its own environment very positively (4,5 on average); the others were more critical.
The highest rated area is ‘Push and Pull technology development’ meaning that most of the SMEs
highly agree that talking with end-users is essential in understanding market-pull factors for their
product/service, although we don’t know if this really happens or how is achieved. The weakest fields
are related to support for accessing public funds, regulations, collaborative business and support for
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accessing private capital. There is uncertainty if private investors understand really the needs of
crossover collaborations, and it is perceived that there are not many funding options available from
this sector. Besides, current regulations in the region/countries are criticised as they don’t help much
to set up and run a new business based on a crossover collaboration. SMEs were also critical about
the stakeholders who should work together to help get crossover products to market and it was also
highlighted that not enough fast track procedures are in place to support project applications.
Comparing the assessments of each country:
Spain - 5 indicators were rated as the lowest among the 5 countries: Public procurement
practice supporting crossover innovation, Social capital for networked value creation, Support
for accessing public funds, Favourable regulations, and Support for accessing private capital.
France - also 5 indicators got the lowest ratings: Push or pull technology development, Open
innovation networks, Public procurement practice supporting crossover innovation, SME
absorption capacity, and Collaborative business.
Austria - three fields were rated very low: New business model experimentation, SME
absorption capacity, and SME absorption capacity.
Italy and Portugal both had only two low rated fields: Using living labs and SME absorption
capacity, as well as Collaboration between younger SMEs and R&D and other knowledge
institutions and Collaborative business.
The ‘lite’ version of the Innovation Health Check was developed to help start-ups and younger SMEs
to improve (i) competitiveness or competitive advantage, (ii) own products / services, (iii) processes
manufacturing & or service processes, (iv) to develop new appropriate products / services, (v) to get
quicker to the market, (vi) to create new markets or new channels to market, and (vii) to add value to
all activities across the entire business spectrum.
Despite specific concerns, those start-ups and SMEs in the 1st Acceleration cycle meet the necessary
expectations exceptionally well. They were strong performers in several innovation segments and
have an achievement above average in quite a few fields. Doing relatively well on IHC is a very
positive learning about the supported SME group showing that even if a small group of SME teams
was funded in the 1st open call, most of them are at a higher level as far as their internal innovation
capacity is concerned. This is a very good base to build on. Good outcomes and valuable learning are
expected with regards to the crossover collaborations in the ACBEIM sectors. We also believe that
the results of this baseline IHC assessment act as a marker to help guide further development and
eventual commercialisation of their product/service/process.
The presence of weaknesses i.e. the fields in which these SMEs were weaker than the database
average is natural despite the positive overall picture. The companies need to manage many
elements of the whole spectrum of the internal innovation capacity which is very challenging. For
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start-ups and the younger SMEs this is a big challenge. Meanwhile, older, well-established companies
may be too rigid, and too large to be responsive to these new challenges.
This process with the IHC and ecosystem tools also prove that SMEs need informed personalized
support to develop and this is the main idea behind the acceleration cycle. However, beyond
identifying where the companies need future help, the further benefit of IHC was that it allowed the
companies to continue a discussion on structural issues regarding where the company is at the
moment and where it wants or need to grow. It may have stimulated processes and helped to reflect
in broader terms on what and how to do, and to what direction to proceed. This discussion
generated by IHC seemed to be exceptionally useful.
The Tool will also be used at the end of the acceleration period for a follow-up to identify any change
is practice and progress/performance.
6 Limitations
The developed 12 ecosystem indicators try to encompass the whole spectrum of factors affecting the
innovation ecosystem. To be able to make careful judgement and assessment of the innovation
ecosystem in a country or a region with the help of these indicators requires a comprehensive
knowledge from the field. In some cases, the discussions with the SME representatives were very
informative providing examples illuminating the specific regional circumstances. However, in other
cases, the discussions were less intense which may be due to the lack of enough practical experience
or knowledge of the various segments of the innovation ecosystem, or the lack of understanding of
some examined aspects. Becoming involved in an innovation process for a small start-up or young
company doesn’t mean automatically becoming knowledgeable in regulations, funding
opportunities, business models and so on. This is why the gathered information should be
interpreted cautiously and somewhat reservedly even if the perceptions of the SMEs based on own
experiences, provide valuable learning and very important evidence, and points for reference for the
partnership and the clusters themselves to act upon. We managed to understand more about how
innovation ecosystem is working in the partners’ countries, how it affects the work and efforts of the
SMEs, however, we can hardly generalize to the European context. The small sample size also gives
this warning.
Using the IHC questionnaire was also challenging. The Innovation Health Check Tool mostly works
well with well-established companies. Even the lite version, where the indicator number is reduced
to a minimum can be overwhelming to small, young companies. For the very young, small SMEs,
start-ups being in an early developmental stage it was a challenge to answer some of the questions.
Using the lite version of the IHC questionnaire and selecting only 18 questions out of the 52 also
makes the summary and interpretation of data a bit distorted, but still, it has generated a lot of
important information, learning, and value.
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KAMs had various experiences during the data collection. Some of the SMEs tended either overrating
or underrating themselves when scoring certain questions which may have resulted in that the
dataset of these companies is biased a bit. The reason behind this can be numerous, like for example
trying to comply with the – actual or imaginary — standards or expectations for showing success at
the innovation field or cultural factors like being very critical with own performance which, for the
long run, may positively affect business performance.
7 Conclusions and expectations
This small scale data collection was carried out as part of Work Package 4 which is focussing on
practical actions to support ACEBIM crossover value chains to (re)combine in generating innovative
solutions that help improve patient-centered care. Earlier work for the Cross4Health baseline
analysis done in the first months of the project explored the potential barriers to crossover
collaboration and value chains, as well as current and future solutions that can be supportive to
start-ups and younger SMEs. Our 2nd data collection, involving SMEs in the 1st Acceleration cycle,
reinforced that these factors very much affect crossover collaborations and either help or hinder
processes, interact with each other, and most of all, differ across regions and countries. Certain
drivers can become barriers and vice versa if they are not favourable for attracting and retaining
business but instead, they prevent the smooth running of innovative processes.
One of the main aims of the project is to overcome the barriers affecting SMEs’ everyday work and
wider working environment, as well as support drivers for crossover collaboration and supporting
actions. The Open Innovation Spaces organised by the cluster organisations and their ecosystem
partners show that they enable dialogue between stakeholders (SMEs, Clusters, Investors) to identify
these barriers and seek solutions. The Webinars sharing leading-edge knowledge at the innovation
field applicable to create new crossover ideas and projects are also organised to stimulate and
inform crossover value chains. The knowledge acquired from the acceleration programme in general
by the working personnel of the SMEs in the joint projects funded by Cross4Health should
successfully make its way back to the host organizations or become pillars in a newly created entity.
Practical support for start-ups and younger SMEs engaged in crossover collaborations focused on
their own internal innovation capacities as well as the innovation ecosystem that surrounds them.
The support actions themselves via WPs 2/3/5 will ensure that funded crossover teams can
demonstrate the cost-effectiveness and synergies achievable by the emerging ACEBIM industry and
its crossover value chains. Case studies will be collected on newly learnt techniques, synergies with
potential entities aligned to the teams, and identify how new funding is leveraged for the project
beyond Cross4Health support to sustain and develop further the products and services in the market.