Background Demographic trends, technological advancements, and fiscal constraints make elderly care a major issue. Innovations in devices, process and care models have been introduced. It however appears that innovations are adapted slowly or haphazardly. This study apply an ecosystem perspective - an area of activity needs to be seen as the totality of players that affect the elderly and their safety, regardless of if they have administrative or trading relationships, or employ voluntary resources. An ecosystem includes one or several ecosystem leaders that aim at structuring the system through rules, platforms and resource flows.

Methods We study the city of Hyvinkää. The problems within the field can be defined as spanning between quality – adjusted productivity The objective is to achieve more and/or better with fewer resources by adding different stakeholders related to the elderly safety. A qualitative method with a value process mapping technique is applied.

Results The city is managing a multi-actor environment aiming to increase the safety of the elderly as part of the elderly care. The city is thus developing a contemporary governance model, i.e. the rules according to which explicit or implicit contracts between ecosystem players are made, monitored and enforced, including regulators, public professional organisations, for-profit corporations, third-sector players, volunteers, local communities, and relatives.

Conclusions Cities need to develop a “healthpathway” thus taking on a role as a public ecosystem leader coordinating the efforts among elderly care and safety. This means that the city creates market segmentation and matches this segmentation with private and public actors. Such segmentation allows for the creation of a public service platform through which actors can be governed and coordinated in increasing elderly safety.