Purpose: The purpose of this paper is to analyse how digital technologies trigger changes in the business process of manufacturing small and medium-sized enterprises (SMEs) in the Apulia Region (South Italy). As SMEs play an essential role in the process value creation of industries and countries, the article examines the enablers of Industry 4.0 in a regional contexts characterized by delay in research and development and innovation performances where the companies' competitiveness is based on limited knowledge and technological assets.Design/methodology/approach: The case study of Smart District 4.0, an ongoing project aimed to promote the digitalization of SMEs operating in the Agri–Food, Clothing–Footwear and Mechanics–Mechatronics in the Apulia Region (South Italy) is analysed. The project has been financed by the Italian Ministry of Economic Development with the final aim to sustain the digital transformation of SMEs in South Italy.Findings: The results introduce a four levels approach of engagement of SMEs in the adoption of digital technologies, namely,digital awareness, digital enquirement, digital collaboration and digital transformation.Furthermore, for each level of engagement the study describes and discusses some relevant variables that could be used by managers and entrepreneurs to assess the level of readiness for utilization of digital technologies and how to digitalize some processes.Practical implications: Practical implications regard the definition of a roadmap useful to assess and manage the level of digital transformation of SMEs. Limitations of the study regarding the temporal dimension of the evidences associated to the Smart District 4.0 as well as to the regional context was analysed.Originality/value: Originality resides in the definition of a roadmap for the digital transformation of SMEs in a region where the profile of companies' digital maturity is still low.

Purpose: Despite the abundance of research in open innovation, few contributions explore it at inter-organizational level, and particularly with a focus on healthcare ecosystem, characterized by a dense network of relationships among public and private organizations (hospitals, companies and universities) as well as other actors that can be labeled as “untraditional” player, i.e. doctors, nurses and patients. The purpose of this paper is to cover this gap and explore how knowledge is transferred and flows among all the healthcare ecosystems’ players in order to support open innovation processes.Design/methodology/approach: The paper is conceptual in nature and adopts a narrative literature review approach. In particular, insights gathered from open innovation literature at the inter-organizational network level, with a particular attention to healthcare ecosystems, and from the knowledge transfer processes, are analyzed in order to propose an interpretative framework for the understanding of knowledge transfer in open innovation with a focus on healthcare ecosystem.Findings: The paper proposes an original interpretative framework for knowledge transfer to support open innovation in healthcare ecosystems, composed of four main components: healthcare ecosystem’s players’ categories; knowledge flows among different categories of players along the exploration and exploitation stages of innovation development; players’ motivations for open innovation; and players’ positions in the innovation process. In addition, assuming the intermediary network as the suitable organizational model for healthcare ecosystem, four classification scenarios are identified on the basis of the main players’ influence degree and motivations for open innovation.Practical implications: The paper offers interpretative lenses for managers and policy makers in understanding the most suitable organizational models able to encourage open innovation in healthcare ecosystems, taking into consideration the players’ motivation and the knowledge transfer processes on the basis of the innovation results.Originality/value: The paper introduces a novel framework that fills a gap in the innovation management literature, by pointing out the key role of external not R&D players, like patients, involved in knowledge transfer for open innovation processes in healthcare ecosystems.