Healthcare industry has to face many significant challenges continuously in order to provide optimal performance. In order for Malaysia to achieve a developed nation status, improvements in term of healthcare services are required. Therefore, a quality management initiative is needed to achieve their goals. Six Sigma (SS) is clearly and proved as one of quality management initiatives for process changes. The abilities of organization to be innovative in industry give great impact to organization. In addition, process innovation can provide the additions of quality improvement toward product or service. Process innovation had been seen assist SS practices to achieve performance improvement. Thus, the purpose of this study is to review structural analysis between SS practices and process innovation. Examination of the research literature shows that there is a lack of empirical research that systematically examines the relationship between SS practices and process innovation. Therefore, this concept paper tries to examine how the SS can contribute on development of process innovation in healthcare industry. Next, the hypothesis has been developed based on the literature and the proposed research model for Malaysian healthcare industry also provided. For the future agenda, Structural Equation Modelling (SEM) techniques will used in order to get the empirical result.