This chapter focuses on the research part of the health system and its innovation from a supply-driven toward a needs-oriented system by means of active patient involvement. It presents the activities of one of the pioneers in patient involvement in health research in the Netherlands: the Netherlands Lung Foundation (NLF). The chapter also presents another important pioneer in this area: ZonMw. It discusses the various other activities involving patient involvement in health research in the Netherlands as a manifestation of niche-level initiatives that may lead to a system innovation. Furthermore, the most important features of the health research system are described based on literature study, document analysis, interviews, informal conversations and observation. The chapter also discusses various strategies based on insights from transition management studies that may provide a way forward, including processes of "deepening", "broadening" and "scaling up". The chapter explains the regime features that form a barrier for patient involvement.