The need to develop systems that comprise medical equipment and services to improve healthcare service efficiency and availability has become a pertinent concern in developed countries, as governments continue to focus on controlling healthcare expenditure. This research intends to explore value co-creation with multiple stakeholders at early stage new product-service system (PSS) development in regulated industries such as the medical equipment industry. This paper identifies the literature gap of stakeholder involvement in the process of new PSS development and compares the identified gap with the experience of industry practitioners. The fields relevant to the research focus are described and the characteristics of a new PSS are proposed as the basis of the research. This paper concludes with an initial proposition, that there is a need for an holistic approach to new PSS development and to have early multiple stakeholder input.