Towards a Dynamic Cross-Sector Alignment for Sustainability in Healthcare Ecosystems

Healthcare ecosystems face significant challenges in achieving long-term sustainability while addressing public health and social service needs. This paper conceptualizes purpose-aligned systems as a framework for sustainable healthcare, emphasizing cross-sector alignment in governance, financing, data sharing, and stakeholder collaboration. By integrating concepts from the Actor-for-Actor approach, we illustrate a cyclical process of engagement, resource integration, and collective action that reinforces sustainability. The study explores the complex healthcare ecosystem, which includes healthcare practice, public health, and social services, and examines different pathways for achieving cross-sector alignment to improve population health and reduce disparities. The absence of continuity in governance, financial stability, and stakeholder trust presents a key obstacle to sustainability. Leveraging systems theory and service science, the paper argues that sustainability requires both purpose-driven design and effective purpose aligned collaboration, ensuring that healthcare ecosystems evolve dynamically rather than remain static. Using the Actor-for-Actor approach, we emphasize how healthcare system sustainability can be fostered through shared purpose, collaborative governance, and strategic resource allocation. Our proposed model highlights a cyclical value co-creation process, demonstrating how purpose-aligned healthcare ecosystems can optimize decision-making, enhance interoperability, and strengthen systemic resilience. Ultimately, the findings set the stage for further research on sustainable healthcare models, offering a conceptual foundation for continued exploration of sustainable healthcare ecosystems.