This chapter presents a preliminary review of the literature on institutional innovations linked to hospital patients, delineates the main concepts involved, and presents a research agenda. Patients’ knowledge of their health conditions has improved due to better education and information access. Trends towards peer-to-peer innovations and customer-driven innovations suggest there is a potential for patient-initiated innovations at a time where electronic health records (EHRs) are disseminated to patients. Based on the literature on how patients contribute to innovations and our interviews in a large Norwegian hospital region, we expect an increase in the number of patient-initiated innovations. Recommendations in the literature on ‘responsible innovations’ ensures that these innovations benefit patients and contribute to economic and/or non-economic performance indicators of hospitals. We identify three questions for future research: What kind of relationship is there between the release of EHRs and patient feedback? How do patient-initiated innovations influence hospital performance? And, what are the most important contextual factors?