In Chesbrough’s terminology, health care organisations are so-called “innovation missionaries”, not creating service innovations for profit, but to serve a cause. Traditions and organisational culture in health care has appointed the physician as the expert on the patient’s disease with almost full control of knowledge, treatment and services. In this sense, health care organisations clearly employ closed innovation principles. These principles have only recently been challenged by, for example, the patient empowerment movement, and approaches like evidence-based design and public display of treatment results. We argue that “classic” open innovation principles could be applied also to open service innovation in health care. In the paradigm of open service innovation, every patient is an expert on his or her disease and should be perceived as such by physicians and other professions in health care. Patients have access to knowledge about the disease from, for example, patient guides on the Internet or patient communities engaging in interaction via social media. Not only should evidence-based knowledge be valued in health care but also patients’ idiosyncratic experiences from health care services, and “subjective” effects of treatment and lifestyle changes. Accordingly, the patient should be regarded as a co-designer and innovator of health care services.

The purpose of the study is to describe and discuss how principles from open innovation, which are primarily derived from commercial product development, could be applied to open service innovation in non-profit health care organisations. To evaluate the opportunities and challenges of such innovation, we conducted interviews with physicians from the medical specialty of rheumatology. The main opportunity of open innovation was considered to be the abilities of “the empowered patient”, with a good knowledge of his or her disease. Challenges to open innovation were the lack of meeting places for patients, inertia in local health care service delivery, and an organisational culture which not promotes learning and innovations. From now on, there is an opportunity for health care organisations to change their current culture of closed innovation, implying that only physicians have valid knowledge about patients’ diseases. However, necessary prerequisites for implementing open innovation principles are support from management and structures of financial control which encourage innovations.