Toward a Governance-Embedded Innovation Framework for Digital Health: Theoretical Foundations of the Value-Based Digital Health Innovation Canvas (VDHIC)

Digital health innovations hold transformative potential for healthcare systems worldwide, yet the majority fail to achieve sustainable implementation and scale. This desk review synthesizes theoretical and empirical literature across strategic management, design thinking, implementation science, responsible innovation, and healthcare quality improvement to establish the scholarly foundation for the Value-Based Digital Health Innovation Canvas (VDHIC), a structured visual tool designed to guide digital health innovators through the complete innovation journey while ensuring governance integration and value-based outcomes. Through a systematic review of peer-reviewed literature and grey literature spanning 1981–2024, this paper identifies critical gaps in existing innovation frameworks when applied to healthcare contexts and demonstrates how the VDHIC addresses these gaps. The framework synthesizes multidisciplinary perspectives into an actionable canvas anchored by the Quintuple Aim (population health, patient experience, provider satisfaction, cost reduction, and health equity) and contextualized for Indonesia's digital health ecosystem. Findings indicate that no existing innovation framework simultaneously integrates governance-by-design, comprehensive value orientation, and healthcare-specific contextual requirements—a gap that the VDHIC is purpose-built to address.