The use of ICT resources in healthcare has been growing since the 2000s because can lead to cost saving, time saving, errors reduction, improvement of medical practice. In Italy, Mission 6 of the National Recovery and Resilience Plan (M6-PNRR) allocates 8.6 billions for disseminating telemedicine strengthening the healthcare system’s information and digital tools. Considering the theories on ecosystem innovation in healthcare, this study, using a mixed-method approach, investigates the gaps between ideas and design by the policymakers and the correspondences by the side of health operators. Our results confirm that, a huge problem in the health sector is not innovation per se, but the dissemination of innovative concepts. Service innovation in healthcare is successful only if it can satisfy users’ needs. A fundamental role has been found in the GPs, seen as strategical promoters. Another important aspect has been found in Covid health crisis as a buster of digitalization, thus confirming previous research. But another important aspect has been found in the need of “educating/training” patients, thus revealing the importance of really creating a co-production scheme for developing a real effective digitalized system. The commitment and active participation of patients represents indeed a prerequisite for obtaining high adherence, but if users are culturally not keen in contributing to the process, the potential of digitalization remains unexploited.