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Small and medium-size enterprises (SMEs) in the healthcare IT industry must have innovative technology and, at the same time, be able to commercialize this technology in order to have sustainable growth, as enterprises in any other industry do. However, due to the lack of resources of SMEs, many studies focus on effective and innovative strategies based on a resource-based view. To be more effective, some SMEs collaborate with other companies in the manufacturing process, not as a closed, but rather as an open innovation. However, this collaboration is difficult and bears risks. Additionally, as an external factor, the government certification system attempts to help SMEs. Therefore, in this study, we performed a multiple regression analysis centered on firms’ resources and strategies. Three results were obtained. First, in terms of the firms’ resources, the higher the quality of patents that measure firm capacity, the higher the firm performance. Second, regarding the firms’ strategies, cooperation with external companies in the manufacturing process has a positive effect on firm performance. Third, receiving government certification (InnoBiz certification), as a form of cooperation with the government, has a negative impact on firm performance. In other words, the present government policy to support the R&D of SMEs needs to be adjusted. SMEs can develop high-quality patents, and strategies for cooperation with external companies can enhance the innovation performance of enterprises.