Entrepreneurial design of a digital health business

Software startups are an important source of innovation and wealth creation. Startups must develop and release software quickly to gain early cash flow and legitimacy for firm survival. They must search and identify a suitable market in a tight time frame. A ambiguity in the quality of the novel software designed can further intensify uncertainty for startups. Also, the entrepreneur-investor relationship is a critical conduit for financial and social resources, yet the investors’ influence on software design is understudied. This leads to the following research question: How does the entrepreneurial context in which the startup operates affect software design process and product in the early years? Given the exploratory nature of the research question, I drew on an eighteen-month, participant-observation case study of a three-year-old, digital healthcare startup, HealthCom. HealthCom designed a software to facilitate knowledge transfer between nurses and patients. I leveraged the attention-based view (ABV) as an organizing framework for analysis. By looking at how the environmental context influences the designers’ attention and actions, researchers can begin to understand the rationale behind design decisions. The findings illustrate how the attention of the designers were directed by financial-focused and quality-focused attention drivers. Financial-focused attention drivers originated from players (e.g. clients and investors) that intensified pressures for funding and led to the reframing of software as an enabler of funding. This contradicted quality-focused design alternatives grounded in user requirements and software design rules. It underlined the move from attention to designs that accommodated user requirements towards those that captured emerging business opportunities. Designers had to balance the tensions between financial and quality-focused design decisions that could lead to inhibition of future growth, compromises in quality or over-optimization of quality. Designers simplified and coupled requirements throughout the design process and postponed investments of design resources to meet client-imposed deadlines. The design product became disposable, quick to build, limited in adaptability, spartan, and vulnerable, and it enabled the startup to capture the business opportunities amidst time constraints, financial pressures, and high uncertainty.Information, Risk, and Operations Management (IROM