Organizing Vision in Ecosystems: The Case of Circular Digital Health

As a response to the rising environmental concern, the digital health sector and its ecosystem are looking towards the circular economy to reduce waste and extend product life. This paper explores this emerging transition through an analysis of how an organizing vision for the circular digital health ecosystem in the EU is being shaped. Drawing on 57 interviews from diverse stakeholder groups, we extend Swanson and Ramiller’s (1997) theory of organizing vision from intra- and inter-organizational settings to an ecosystem by showing how actors interpret, legitimate, and mobilize circular digital health through competing narratives shaped by regulation, patient safety concerns, economic incentives, and technological design. We introduce the concept of nested visions to describe how diverging interpretations emerge simultaneously at technological, operational, and institutional levels, and we identify a selective mobilization paradox, whereby some actors discursively recognize the systemic nature of circularity yet mobilize through closed-loop, firm-centric initiatives.