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Trusted Health Ecosystems: Our project approach

Dr. Sebastian Schmidt-Kaehler
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Dr. Inga Münch
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The digital age is impacting our lives in ways we’ve never experienced before, and it’s doing so at an accelerating pace. This rapid change, coupled with the disruptive effects it brings, places considerable demands on society in terms of adaptability. Digital platforms are at the forefront of this change, as they supply the essential infrastructure and services driving this transformation.

Through their platforms, digital ecosystems have fundamentally altered entire sectors of the economy. They have changed how people interact and communicate with each other, how goods and services are marketed, and how educational and informational resources are accessed. Platforms are not only impacting the world of work, they have disrupted the media landscape and upended the power dynamics of the mobility industry. So why should healthcare be any different?

New power dynamics

Global tech companies are venturing into the healthcare sector, offering immense potential for a modern, patient-centered and continually evolving healthcare system. While network effects and economies of scale present impressive growth opportunities, they also pose risks to the principle of solidarity that finances our healthcare system. One thing is certain: Digital platforms will profoundly reshape the power dynamics within healthcare systems. It is our responsibility to harness and direct their innovative and guiding influence for the greater good (see video: Managing the risks of platform economy).

Platform strategies for national healthcare systems

The time has come for public and civil society actors to create their own platforms and take the lead in shaping the foundational digital infrastructure, defining value-based guidelines for the future of digital healthcare. National healthcare systems need to formulate their own platform strategies to carve out a position for themselves in the emerging healthcare market. With our “Trusted Health Ecosystems” project, we are paving the way forward to achieve this and developing a concrete vision of a future national healthcare platform. We thus aim to illustrate the potential benefits that can arise from collaborative efforts involving government, civil society and the private sector (see Conceptual considerations: an overview).

Promoting health literacy

The focus of our product concept is to provide patients personalized information and services. By doing this, we confront the enduring problem of health literacy, with more than half of the German population indicating significant struggles in accessing, understanding, appraising and applying health-related information (see Health literacy: challenges of the future). Without health literacy, patients find it difficult to make informed decisions about their health and actively participate in their treatment process. By consolidating and intelligently disseminating curated information, the platform could help streamline how information is handled and reshape the information landscape within the healthcare sector.

Inspiration

The Bertelsmann Stiftung cannot and will not implement and operate this platform itself, because merely providing a digital infrastructure would fall far short of the mark. To cultivate a digital ecosystem that benefits all participants, it requires more than a legal foundation; but also the insight and collective will of all relevant actors in the healthcare system. Therefore, as a foundation, we see our role to inspire those who can collaboratively bring this vision to fruition.

International context

Digital ecosystems have networked the world more tightly than ever before. While these platforms adapt to national circumstances, they often extend beyond borders. This presents challenges that can no longer be effectively tackled solely at the national level. International collaboration and coordination are thus imperative if we are to mitigate risks and seize the opportunities inherent in this transformation. We have therefore positioned our vision of a national healthcare platform within an international framework from the outset, engaging with international organizations in Europe and beyond. This applies in particular to the quality, safety and interoperability standards associated with such a platform (see InfoCure: Making quality visible).

Real-time project results

Since the advent of AI-powered language models, we have seen just how rapidly digital transformation is reshaping our lives. Given the exponential pace at which things are changing, we have we’ve chosen to release our project findings as they develop – in “real time” – rather than holding off until the project has concluded. This concept is a living document and as we move forward, this concept will undergo continual refinement through contributions and the addition of new sections, all aimed at further shaping the vision of the national healthcare platform.

Authors

Dr. Sebastian Schmidt-Kaehler serves as the co-director of the Healthcare Program at the Bertelsmann Stiftung. Before this, he held the position of managing partner at Patientenprojekte GmbH, a consultancy focused on organizational management with a specialization in patient communication. From 2011 to 2015, he assumed the role of national director at Germany’s Unabhängige Patientenberatung (UPD). He is also currently a member of the expert committee for the National Action Plan Health Literacy in Germany.

Dr. Inga Münch is a health researcher and co-lead of the “Trusted Health Ecosystems” project at the Bertelsmann Stiftung.  Most recently, she has been involved in various projects that merge patient-centered care with digital health solutions. Her PhD thesis centered around the concept of health-literate organizations. Through her work on a variety of scientific projects, Dr. Münch has conducted research in areas encompassing health education, patient-oriented care and health systems.

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    The transformative nature of digital ecosystems

    Dr. Matthias Naab
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    Dr. Marcus Trapp
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    Offering numerous benefits to everyone involved, the collaborative nature of digital ecosystems and platform economies has led to significant transformations in various domains of life. This overview highlights the appealing aspects of digital ecosystems and their platforms and explores ways to harness their innovative potential.

     

    Digital ecosystems ...

    ... are appealing

    Delivering real added value is the only way digital ecosystems can succeed in convincing independent participants to get involved. One major advantage of these ecosystems is the access they offer to a diverse community of participants, each contributing to the system either as suppliers or consumers, depending on their role. This diverse and geographically dispersed community can generate various additional advantages. To ensure widespread participation, digital ecosystems typically maintain an inclusive approach and strive to attract as many individuals, organizations, and companies as possible. As a result, access to their ecosystsems is rarely restricted (Choudary 2017).

    The appeal of digital platforms for providing and consuming ecosystem services lies in their high-level harmonization, user-friendly interfaces, and excellent user experiences. These factors enable efficient access to a wide range of ecosystem participants. Initiators and operators of digital platforms invest significant time and resources to achieve this harmonization, encompassing various aspects such as business models, technical standards (e.g., standardized access via APIs), and legal frameworks (e.g., standardized contractual relationships), particularly for commercial ecosystems. This harmonization is reflected in functions like payments, search capabilities, and data transformations. Not-for-profit ecosystems follow a similar approach, although their goals are not profit-oriented. Users often don’t realize the effort invested in creating seamless processes due to the smooth and enjoyable experiences provided. However, it is important to recognize that the simplicity and elegance of a digital ecosystem’s services do not imply a lack of complexity in its design.

    Digital ecosystems offer bundled online services, eliminating the need for users to extensively research individual service providers. The added value lies in the integration of the digital platform and the active participation of the community members, which results in a combined power that enhances the services provided. To attract users, a digital ecosystem must ensure seamless interaction between its platform and community.

    ... are scalable

    Digital ecosystems present operators with significant opportunities to develop innovative business models. By becoming a central point of contact for a large number of participants, organizations can strategically reposition themselves in the market or sector and expand their influence. The scalability and high growth potential of digital ecosystems are facilitated by their ability to provide services in a purely digital form.  As the ecosystem attracts more participants, network effects come into play, generating increased business activity within the ecosystem. This growth opens up avenues for further expansion of the platform and services, enhancing the overall attractiveness of the ecosystem as a whole.

    ... are disruptive

    A digital ecosystem doesn’t exist in isolation or simply emerge out of nowhere. Instead, it is intricately woven into a landscape that involves multiple stakeholders and their interconnected relationships. We refer to an established network of partners and value chains in an industry as a domain ecosystem.  Today, we witness the constant emergence of new digital ecosystems, each catering to specific needs and offering unique services. When these ecosystems thrive, they disrupt existing business relationships within their respective domains. The introduction of a new digital ecosystem and the involvement of its participants bring about changes in the dynamics and positions of various stakeholders within the domain ecosystem (Trapp 2020).

    Multiple digital ecosystems can coexist within the same domain ecosystem, and they can either compete or complement each other. It is also possible for an actor to participate in multiple digital ecosystems simultaneously, assuming different roles in each. In the mobility industry, for instance, there are various digital ecosystems such as Uber and Lyft that offer services in the realm of personal transportation. Flixbus, as a digital ecosystem, has transformed and harmonized the market for long-distance bus travel. Additionally, there are numerous other digital ecosystems focused on mobility services, including those involved in capturing and providing telematic data from vehicles manufactured by different companies.

    ... are only lucrative n the long term

    Creating a digital ecosystem is a complex and time-consuming process that requires more than just developing a software system. It involves a holistic and well-coordinated design approach to continually attract and engage participants.

    This process typically unfolds over several years and starts with gradual growth, which gains momentum as network effects come into play. Looking at successful digital ecosystems like Amazon and Airbnb, we can see that it takes around ten to fifteen years for them to reach a substantial size and become self-sustaining operations. During the building phase, significant investments are made to fuel growth, and it’s only in the later stages that the ecosystem becomes self-sustaining. Therefore, building a successful digital ecosystem requires long-term commitment and a willingness to invest resources. In other words, digital ecosystems cannot be expected to generate a positive return on investment within a short period, like 18 months.

    ... are diverse

    While the provision of ecosystem services is a fundamental principle shared by all digital ecosystems, it doesn’t mean they are all the same. In fact, they can vary significantly in terms of the providers and consumers involved and the assets they focus on, ranging from accommodations to vehicle data or even initiating contacts. Digital ecosystems can adopt various business models, whether they are nonprofit or profit-oriented. They can facilitate business-to-business matchmaking (B2B), serve as intermediaries between private individuals (C2C), or operate with a combination of different relationship types. Government agencies can also play a role in these ecosystems

    The design possibilities for digital ecosystems are nearly limitless, as long as they remain attractive to participants and secure sufficient funding to navigate the startup and growth phases. This is why there is still ample space for the emergence of new digital ecosystems.

    ... are powerful

    Despite all the potential benefits, digital ecosystems can also entail risks, depending on how you look at them. These risks primarily stem from the self-reinforcing network effects that occur when digital ecosystems achieve success and attract a growing number of participants. On the one hand, this can lead to a concentration of power in the hands of the ecosystem operator. On the other hand, it often results in a limited number of successful competing ecosystems, typically only one to three direct competitors. Consequently, profits become centralized within the ecosystem service provider, potentially creating a situation where local providers become highly dependent on the ecosystem.

    Bibliography

    Choudary S (2017). Die Plattform-Revolution im E-Commerce: Von Airbnb, Uber, PayPal und Co. lernen: Wie neue Plattform-Geschäftsmodelle die Wirtschaft verändern.

    Trapp M (2020). Digitale Ökosysteme und Plattformökonomie: Was ist das und was sind die Chancen? https://www.informatik-aktuell.de/management-und-recht/digitalisierung/digitale-oekosysteme-und-plattformoekonomie.html

    Authors

    Dr. Matthias Naab and Dr. Marcus Trapp

    Dr. Matthias Naab and Dr. Marcus Trapp, co-founders of Full Flamingo, an eco-tech startup, aim to leverage the platform economy to maximize sustainability impact.  Before 2022, they held senior executive positions at Fraunhofer IESE, where they played a pivotal role in developing and overseeing the field of “Digital Ecosystems and the Platform Economy.”

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      Ecosystem design: Benefits for all

      Dr. Marcus Trapp
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      Dr. Matthias Naab
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      To thrive in today’s market, digital platform operators need to consider the interests of all ecosystem participants. By delivering benefits and creating advantages for everyone involved, they can unlock the potential of network effects and scalability. This principle holds true even for a non-profit national health platform.

      In successful systems, the user journey or customer journey is designed to ensure optimal satisfaction at every interaction. Each touchpoint is intentionally crafted to meet users’ needs as much as possible. It’s no surprise, then, that successful providers tend to prioritize user and customer orientation when developing a new system or service.

      When examining new digital business models that operate on platform-economy principles, determining the precise identity of can be challenging. Digital ecosystems like Airbnb, Uber and Schüttflix serve as virtual marketplaces that facilitate the exchange of various “assets” such as overnight accommodations, transport and bulk goods by ecosystem operators. More often than not, these platforms function as multi-sided marketplaces, commonly comprising two sides and occasionally incorporating three or more.

      In each digital ecosystem, some ecosystem partners (providers) offer products and services (assets), while others consume these assets (consumers). For example, Airbnb brokers the exchange of overnight accommodations (asset) between private hosts (providers) and travelers (consumers), while Uber brokers transportation services (assets) between private drivers (providers) and passengers (consumers). The vision of a national health platform presented here follows a similar principle, enabling the brokerage of digital information and services between providers and patients.

      For ecosystem designers, the diversity of participants and multi-sided marketplaces involved in such an environment can have far-reaching implications. It’s easy to focus solely on the consumer journey, but they would do well to pay just as much attention to providers as to consumers and equally prioritize their respective needs. The very thing that attracts consumers to a digital ecosystem is its large number of providers; conversely, an ecosystem’s attractiveness for providers will also grow as the number of consumers increases.

      Balancing participants' interests

      Patients take center stage in the national health platform presented here. In other words, benefits for patients will always be the highest priority. Through the curation and consolidation of information and services, the platform seeks to foster health literacy, streamline information management and empower patients to actively engage in their treatment journeys.

      However, the only way to actually achieve these vital patient-centric benefits is to make certain that providers of healthcare information and digital services also actively participate in the ecosystem.  Consequently, ecosystem operators must ensure an optimal provider journey, one that is as seamless and beneficial as possible. This inclusive approach treats all partners equally, fostering incentives for every participant within the ecosystem.

      Voluntary, not coerced participation

      The importance of generating benefits for all participants within an ecosystem stems from the fact that participation is voluntary and no one can be forced to join. Even if it were possible to enforce participation, such as through government authority, experience has shown that this approach is generally ineffective. Those individuals and/or entities forced to participate often find ways to delay processes or obstruct them in some other manner. Conversely, when all participants derive benefits from their participation, this usually leads to good outcomes.

      The benefits gained from the ecosystem need not be solely monetary in nature. Other advantages, such as access to a larger market, increased visibility of products and services, and access to key data and analytics, can sometimes be more valuable to participants than short-term financial gains. In a best-case scenario, the advantages accrued by one participant would lead to further benefits for patients. For example, healthcare service providers would greatly benefit from accessing contextual information, enabling them to customize their services to better meet the needs of their target groups.

      Holistic digital ecosystem design

      When digital ecosystems emerge, they typically don’t introduce entirely new services, but rather utilize their own digital ecosystem service to offer a vastly improved experience in ways that revolutionize entire industries. They usually achieve this improvement by cleverly exploiting digital opportunities in ways never seen before in that sector.

      For instance, digital platforms for booking accommodations existed prior to Airbnb’s launch, and transportation services were already being organized before Uber was founded. However, Airbnb and Uber have offered participants so many advantages and so much added value that they have both significantly transformed their respective markets.

      The art of creating a digital ecosystem lies in implementing a holistic design that takes into account the interests of everyone involved. As these ecosystems usually enter an already established market in its respective business domain, it is important to carefully consider which benefits can be created for all relevant participants so that they are sufficiently motivated to participate in the ecosystem. This step is critically important when considering the design of a national health platform, especially given the partially regulated nature of the healthcare market and the presence of strong, established players.

      The introduction of a new ecosystem will undoubtedly transform existing healthcare structures and processes. It’s important to acknowledge that not all changes will be universally beneficial, and some market participants may perceive them as disadvantages. Additionally, there is a risk that the governing organization may exploit its position of power, seeking exclusive benefits from the platform. Such a scenario would undermine the motivation of all other participants and thus endanger the platform’s success.

      Ecosystem design in practise

      In developing the vision for the digital ecosystem presented here, we adopted a methodological framework that ensures a holistic design and integrates the interests and needs of all participants. In order to gain an overview of the status quo, our first step was to assemble and prioritize the actors relevant to the ecosystem. After that, we conducted anonymous interviews with representatives of these participants. We also reviewed publications and analyses and obtained expert assessments, all in an effort to gain a better understanding of the needs, issues and challenges facing individual actors.

      In order to ensure that the ecosystem outlined here generates sufficient benefits to motivate potential participants to actively engage with the system, we created a so-called Motivation Matrix (Nass, Trapp, Villela 2018).  (Nass, Trapp, Villela 2018). Our first step was to examine what benefits each individual actor would garner from the introduction of the national health platform, but also to determine how they could contribute and/or what role they could play in the ecosystem. In addition to benefits and incentives, we also discussed the possible disadvantages that individual actors might encounter as a result of the implementation of the ecosystem and its platform, including disadvantages both real and imagined.

      As mentioned above, a benefit analysis highlights more than just monetary gains, chiefly because the idea of benefits can take on so many forms. By drawing on the Motivation Matrix throughout the entire concept-development process, we were able to determine the extent to which the anticipated expectations of various actors interested in participating in the ecosystem could be fulfilled. If and when the expectations of key actors were not met, we redesigned the ecosystem accordingly in an iterative process. The result is a benefit model associated with the national health platform presented here. This model makes one thing quite clear: even in a healthcare system characterized by diverse authorities, significant diversity and special interests, it is possible to craft a vision that generates added value for all participants while also creating tangible benefits and generating welfare effects

      Tangible Ecosystem Design (TED) method

      Digital ecosystems are significantly more complex than software systems operating under the control of a single company. The implications stemming from technology, business, and legal aspects are notably harder to anticipate when designing products and services that will be exchanged across multiple companies and sectors

      The multitude of diverse participant categories results in complex relationships, making it challenging to assess the impact of even the slightest change on the entire ecosystem. This is what makes it so challenging – especially in the design phase – to get a “big-picture” overview of the ecosystem. The big picture, however, is the most important tool when communicating with potential participants about diverse aspects (business, technology, legal) and seeking to form a common understanding as quickly as possible.

      The “Tangible Ecosystem Design” method takes on precisely these challenges and encourages cooperation in the process of defining, designing and analyzing a digital ecosystem. Participants take part in workshops where they model a digital ecosystem using Playmobil® toys and other templates, all of which serve to make the concept more tangible and provide hands-on experience in the true sense of the word.

      Bibliography

      Nass, C, Trapp, M, Villela, K (2018). Tangible design for software ecosystem with Playmobil®. NordiCHI ’18: Proceedings of the 10th Nordic Conference on Human-Computer Interaction. September 2018. 856–861.

      Koch, M, Krohmer, D, Naab, M, Rost, D, Trapp, M (2022). A matter of definition: Criteria for digital ecosystems. Digital Business 2, 100027.

      Authors

      Dr. Marcus Trapp and Dr. Matthias Naab, co-founders of Full Flamingo, an eco-tech startup, aim to leverage the power of the platform economy for the greatest possible impact on sustainability. Before 2022, they held senior executive positions at Fraunhofer IESE, where they played a pivotal role in developing and overseeing the field of “Digital Ecosystems and the Platform Economy.”

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        Creating vs. brokering editorial content: Where does the content come from?

        Prof. Dr. Laura Schulte
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        The vision of a national health platform outlined in the “Trusted Health Ecosystems” project raises questions about the origin of the content and services offered there. A demand-driven offering requires a diverse range of information and services, which a single provider may struggle to fulfill alone. However, the platform operator does not have to create the content on their own. The following considerations explore whether the platform operator should generate their own information or focus on facilitating third-party information.

        The challenge

        The dissemination of information involves certain legal requirements that differ in principle depending on who authors the content. The question of attribution depends on the perception formed by users of an information offering regarding the authorship or responsibility for the content. Relevant legal requirements in this context may involve preventive obligations to verify the accuracy of content, obtaining permission for third-party content, provider identification obligations, and the removal of unlawful content.

        For most information offerings, it is assumed that there is no obligation to check the accuracy and legality of third-party information in advance. However, the provider may be required to do so if there are indications of a potential violation of the law. The situation is different when the provider adopts third-party content as its own, especially if it appears that the provider has independently verified the information or deemed it correct on another basis.

        In addition to these liability considerations, the trade-off involved with generating one’s own content versus relying on third-party content and service offerings is also relevant with respect to the legal justification of the proposed national health platform. It’s important to take into account that opting to create original content, especially by a primarily publicly funded operator, could affect the range of opportunities available to private sector actors and potentially put market-active companies at a disadvantage. State information initiatives are always subject to the condition that they must serve a governmental purpose, among other requirements (see The state as a provider of information).

        The distribution of quality-monitored health-related information is clearly in the interest of health education and, by extension, in the interest of state healthcare policy. However, as of today, there is no state-issued mandate or explicit legal assignment of tasks regarding the operation of a national information hub in Germany.

        Background

        The first question that arises – irrespective of copyright attribution issues – involves identifying who is responsible for the information provided through an external entity. This can include a legal entity that has obtained the information through a licensing agreement or other arrangements with third parties, for example.

        From a German legal perspective, online information offerings are classified as telemedia services and are subject to the regulations specified in the German Telemedia Act (TMG). According to § 5 TMG, all telemedia services are required to disclose the provider’s information in an imprint or legal notice. To the extent that a telemedia service offers journalistic or editorial content, it is required to appoint an individual who will be held legally responsible for the content, separate from the information platform itself.

        These transparency obligations serve to identify an institution or individual against whom claims can be pursued in the event of legal disputes. However, being a provider doesn’t necessarily imply that all information or content must originate from that same provider. Being identified as a provider is initially a formality designed to to ensure that the responsibility for each telemedia offering is clearly delineated. It is crucial to distinguish between responsibility for the technical platform and responsibility for the content disseminated on that platform. Although a single entity may be held legally responsible for both aspects, this is not mandatory.

        Providers, as defined under the German Telemedia Act, can include institutions or individuals who have had no substantive influence on the information and merely offer it as third-party content. The provider thus serves as the primary point of contact for their own as well as third-party content. However, variations emerge in terms of responsibility, including the ability to claim removal or seek damages in cases involving the publication of unlawful or false content.

        In principle, the entity responsible for creating the content, such as the author of a text or the organization behind a study or figure, should assume primary responsibility for it. From a legal standpoint, the operator of an information offering is not directly liable for third-party content. Initially, liability applies only to their own content, not to third-party content.

        From a legal point of view, the distinction between one’s own and third-party content depends on how the content is visibly attributed. Authorship is not relevant in this context; what matters is how users encounter the information. If there is no clear distinction in an information offering, users typically assume that all information either originates from the platform provider or that the provider adopts third-party content as their own.

        Third-party content is considered as such only when users can clearly recognize that the online content does not originate from the provider and that the provider does not wish to assume responsibility for it. A reference to its third-party nature can be made by exercising transparency in indicating a different contact or an external source for specific content.

        Past experience shows that private or civil society actors are indeed capable of generating and disseminating relevant information themselves. Given this, it seems advisable for the national healthcare platform to make health-related information from third-party providers easily accessible to the public while leveraging both state and private sector or civil society resources. In sum, the platform operator should not create and disseminate their own content.

        “The national health platform should limit itself to bundling and organizing third-party content.”

        Prof. Dr. Laura Schulte

        From a practical perspective, it will be important to consider how third parties can be motivated to make their content available for further distribution on the platform. Presumably, third parties could be enticed to contribute their content if they are provided a high-quality environment in which they are credited as the source of the information.

        Moreover, a clear definition of guidelines for the inclusion of content and general procedures is crucial. This includes determining how the information should be presented and how frequently updates should occur. In such an environment, offering multiple equivalent options or information can provide users with a comprehensive and unbiased selection to choose from.

        Conclusion

        Aside from legal issues, the decision to adopt and offer information as proprietary content is primarily a strategic one. Providing one’s own information usually involves more significant effort, whether this means creating or acquiring relevant content. Handling third-party content requires less production-oriented effort but involves considerable effort in terms of coordination and alignment activity. The desired quality level is thus essential.

        From the perspective of competition law, adopting an open market approach and offering third-party content is preferable to claiming it as proprietary or creating it from scratch. This approach helps prevent potential infringements on the fundamental rights of information providers (see The State as a Provider of Information). The national health platform should therefore focus on bundling and organizing third-party content and refrain from engaging in the thorough examination of specific content, modifying content, or granting extensive usage and exploitation rights to the platform operator.

        Fact or value judgment?

        The responsibility for editorial content depends, among other things, on whether the content is classified as factual information or a value judgment – both of which are fundamental to the national health platform. Factual information is objectively true or false, which means the provider bears the risk of disseminating information that is factually incorrect. There is no legitimate interest worthy of protection in spreading false information. Such content must therefore be promptly removed or corrected once so identified. Value judgments, on the other hand, are not subject to objective evaluation. They are subjective opinions that cannot be labeled as “true” or “false.” This gives information providers more leeway in terms of managing content on the platform.

        Challenges arise when dealing with mixed forms, especially when opinions are based on verifiable facts. Information providers must therefore carefully monitor the content on their platform and address complaints appropriately (Hofmann, 2022).

        Providing information to the public always involves the risk that some information may, at a later date, be found false or misleading. This risk applies to both self-generated content and information obtained from third parties. In order to manage this risk effectively, precautions can be taken for both self-produced and third-party content.

        (Published on 27.09.2023. The statements in this article refer exclusively to the legal situation in Germany. They represent a guideline and not individual legal advice that goes beyond the Trusted Health Ecosystems project.)

        Bibliography

        Hofmann F (2022). Lauterkeitsrechtliche Haftung von Online-Plattformen. Die neuen Transparenzvorgaben im UWG 2022 im Kontext lauterkeitsrechtlicher Plattformregulierung. in: GRUR Gewerblicher Rechtsschutz und Urheberrecht, Volume 124, June 2, 2022 (11/2022), pp. 780 et seq.

        Author

        While completing her doctoral studies, Prof. Dr- Schulte gained experience in the field of constitutional law as a research assistant. Her doctoral thesis focused on data protection law, and she conducted further research on this subject at various institutions, including the Queen Mary School of Law in London. From 2020 to 2023, she was employed as an attorney at BRANDI Rechtsanwälte in Bielefeld, specializing in IT and data protection law. Since August 2023, she has held the position of professor of business law at the Hochschule Bielefeld.

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        Ownership: Public or private?

        When establishing a national healthcare platform, it is crucial to identify a suitable legal structure that fulfills all the necessary requirements and effectively supports the ecosystem in which it operates. In terms of ownership, a number of different options are available, each involving a variety of advantages and disadvantages. The first question to arise at this point is whether the platform should be operated by a public or a private-sector actor.

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        To contact our project team, please use our form. We look forward to your message and will get back to you as soon as possible.


          Ownership: Public or private?

          Prof. Dr. Laura Schulte
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          When establishing a national healthcare platform, it is crucial to identify a suitable legal structure that fulfills all the necessary requirements and effectively supports the ecosystem in which it operates. In terms of ownership, a number of different options are available, each involving a variety of advantages and disadvantages. The first question to arise at this point is whether the platform should be operated by a public or a private-sector actor.

          The challenge

          The tasks and services involved in a national health platform are complex and diverse. It is therefore absolutely essential that the platform ecosystem be set up in such a way that it can address each task and manage each service in a flexible manner, including any future tasks and services not yet identified today. Herein lies the challenge associated with finding the optimal legal structure for such an ecosystem. In any effort to do so, the following aspects must be taken into account:

          Requirements

          Alignment with the common good

          In principle, the ecosystem should not be commercially oriented. Instead, it should operate on a not-for-profit basis. All forms of revenue generated within the ecosystem should be used to extend the system itself and develop it further.

          Flexibility

          The ecosystem needs to be able to perform as yet unidentified tasks. It should therefore be open to ongoing development and innovation. In addition, both state and non-state actors should be able to work together side-by-side in the ecosystem.

          Transparency

          The actions, decisions and financing of the ecosystem, particularly when it fulfills a legal or public service mandate, should be transparent to the general public.

          Considering these requirements, two key questions arise regarding the organizational form of the ecosystem:

          1. Should an existing legal structure be utilized or should a new legal structure be created?
          2. Should the legal structure be rooted in public or private law?

          While utilizing an existing legal structure is a possibility, creating new legal structures would be more appropriate, given the need for innovation and multifunctionality within the ecosystem. Regardless of whether the ecosystem is governed by public or private law, it is important to distinguish between legal forms with and without legal personality. Legal forms organized under public law, which include the type of public institution known in Germany as an Anstalt des Öffentlichen Rechts, are privileged in a number of ways, for example with regard to their financing. On the other hand, they are also subject to stricter legal obligations than companies organized under private law, for example, in terms of the transparency of their decision-making. In addition, enterprises organized under public law are only permitted to integrate private actors uinder certain instances, which would make it even more difficult to achieve the goal of implementing the most inclusive ecosystem possible. With public enterprises, the focus is also generally on the realization of a public-oriented goal or public-service mandate, which contrasts significantly to primarily for-profit enterprises.

          Irrespective of the question as to whether the ecosystem’s structure should come under public or private law, we can generally distinguish between legal forms that have their own legal personality under the law and those that do not. Legal forms that do not have their own legal personality include, for example, partnerships (Personengesellschaften) and those municipal agencies known in Germany as Regiebetriebe, which are publicly owned and operated. Considering the allocation of multiple complex tasks within an ecosystem, it becomes apparent that legal forms lacking independence are unlikely to be suitable as potential ecosystem structures. This is particularly important as stakeholders need the ability to independently undertake legal actions, including entering into contracts with service providers. On the other hand, corporations (Körperschaften) are recognized as independent legal entities with the capacity to hold rights and obligations. The legal capacity to hold rights and obligations will thus constitute an indispensable prerequisite for the structure of the ecosystem.

          Background

          In principle, a distinction can be made between two forms of legal association: on the one hand, partnerships – e.g. the civil-law partnership – and, on the other hand, corporations – e.g. the association with legal capacity, the stock corporation or the limited liability companies. In general, there are two forms of legal association, namely partnerships (e.g., a Gesellschaft bürgerlichen Rechts or “GbR” under the German Civil Code) and corporations (Körperschaften), which include associations that have been granted legal capacity, stock corporations and limited liability companies.

          Partnerships (Personengesellschaften) are generally not granted full legal capacity, which means they are restricted in their ability to acquire and exercise rights. In addition, they are at their core focused on the natural persons behind the partnership. This factor tends to make it more difficult for actors to move in and out of a company. In other words, considering the overarching objective of the national health platform in Germany, the reasonable conclusion here would be that partnerships are fundamentally unsuitable as a structural form for the ecosystem.

          Corporations (Körperschaften) are permanent associations of persons for the purpose of achieving a function that goes beyond the individual. In contrast to partnerships, they operate independently of any changes with regard to individual members. Most corporations are legal persons, which means they can be bearers of rights and obligations, that is, they can enter into contracts. Corporations can also be organized under both private and public law.

          Public corporations (Körperschaften des öffentlichen Rechts) are associations created by the act of a sovereign state and tasked with carrying out a public service. These corporations are owned by their members, who have a significant influence on policy and decision-making. Membership can be voluntary, but in some cases it can also be compulsory by law.

          Organizational forms under public law are not available to everyone, however. Instead, they serve exclusively to fulfil a public task or statutory mandate. Accordingly, corporations under public law have certain unique powers and privileges. In particular, they can exercise public authority within the scope of their respective statutory mandate.

          The downside of this privileged public position is a relatively low degree of flexibility, at least in practical terms. For example, as government or quasi-government institutions, they are obliged to comply with fundamental rights. Indeed, corporations under public law are frequently rooted in a legal basis. This means that any change in orientation, competency or task may require an adjustment to their legal basis.

          Public law institutions (Anstalten des öffentlichen Rechts) are aggregations of material resources (e.g., buildings, equipment) and personal resources (personnel) brought together for the purpose of managing a public institution. They are legal persons to whom certain tasks have been assigned, whether by law or by statute, and who have also been entrusted with fulfilling a public mission. As a rule, these public institutions and/or their services are placed at the disposal of citizens. Some examples of institutions under public law in Germany are public broadcasting corporations, universities and savings banks. These public law institutions have their own legal personality that allows them to carry out their activities independently.

          Foundations (Stiftungen) can be organized under both private and public law. In general, foundations are designed to enable the management of assets for the benefit of specific purposes. Foundations under public law are usually created by the state via some kind of law or decree, which makes their establishment and subsequent development a rather bureaucratic process. It is also relatively difficult to integrate private-sector actors, which can be financed by a foundation, but only integrated into its decision-making processes to a limited extent. A foundation under public law is financially dependent on public budgets and grants. In practical terms, this means that it is comparatively difficult to secure a foundation’s long-term financing and thus its long-term operation. Indeed, the performance of such a foundation is likely to be directly dependent upon each new government’s budget.

          “For the role of operator, having the status of a legal person under private law provides flexibility and makes it possible for private and state actors to work alongside one another.”

          Prof. Dr. Laura Schulte

          Organizational forms under public law thus offer very little versatility and are therefore not well-suited to serve as operators of a national health platform. They are frequently rooted in legislation, which means that any increase in their tasks or competencies may require a time-consuming amendment to the law. Furthermore, all forms of organization under public law are directly obliged to comply with fundamental rights.

          The participatory rights of third parties, such as service providers in the health care sector, can also be partially derived from a public law institution’s binding obligation to comply with fundamental rights. Furthermore, public institutions are subject to certain requirements when it comes to any competitive action they undertake, and some of these rules may be stricter than those that apply to non-governmental actors (see The state as a provider of information: What is the government allowed to do?). And, finally, it is often difficult to integrate private actors into organizational forms operating under public law.

          It should be noted, however, that state actors – which include federal, state and municipal governments as well as their individual subdivisions – can also take advantage of organizational forms under private law. In practice, this means that if and when government agencies are participants in the ecosystem, it does not automatically follow that the ecosystem must have a legal structure under public law. The potential legal forms for the ecosystem under private law in Germany include an association (Verein), a limited liability company (GmbH) and a stock company (Aktiengesellschaft or AG).

          Overview - Legal structures under private law in Germany

          Association (Verein)

          In Germany, a Verein is considered to be a voluntary, long-term association of several persons who come together in pursuit of a particular purpose. In principle, state actors and private-sector actors can work side-by-side in a Verein.

          In the case of a Verein, it is only possible to limit liability vis-à-vis third parties to a certain extent. In particular, we should take note here of the general personal liability of the members of the executive board – including the entirety of their private assets – vis-à-vis third parties, at least to the extent that the Verein is held responsible for damages to third parties. The question of how the ecosystem would be financed in the form of a Verein raises some additional challenges; above all, it is likely that membership fees would be insufficient to provide the project with a continuous flow of adequate financial means, especially in its initial phase.

          Limited liability company (GmbH)

          A GmbH is a limited liability company that has its own legal personality and acts as a legal entity via its own corporate bodies. In principle, the liability of a GmbH is restricted to the level of company assets. Shareholders in a GmbH can be natural persons or legal persons. Although the shareholders have a share in the GmbH’s assets, they do not assume any personal liability as a result of their participation in the company.

          Limited liability company (non-profit GmbH)

          A non-profit GmbH is a special form of limited liability company. A non-profit GmbH combines the business advantages and framework of a GmbH with the advantages of non-profit tax law, thus making it an attractive legal form for the social sector. However, the earnings generated by the company may be used solely in the service of achieving the company’s non-profit objectives.

          Stock company (Aktiengesellschaft or AG)

          A stock company known as an Aktiengesellschaft (AG) typically unites a large number of shareholders who have invested their capital in the company in return for dividends taken from the income it generates. The profit-driven mandate of an AG is simply not in line with the non-profit objectives of the ecosystem.

          Stock company (non-profit stock company)

          German law also recognizes companies known as gemeinnützige AGs or gAGs, which are stock companies not aimed at making a profit. The focus on non-profit objectives – such as the promotion of science and research, public health, user information and consumer protection – is rewarded in the form of tax breaks in favour of the gAG. The downside of the special tax status of the gAG is the relatively strict set of regulations associated with non-profit tax law. It should be noted, in particular, that a gAG’s non-profit status would be jeopardized if more than half of its capital were used to finance its administration and fundraising, or if the commercial business operations of a gAG were to enter into competition with non-advantaged, for-profit businesses of the same or similar type to a greater extent than is unavoidable when fulfilling the tax-privileged purposes.

          Otherwise, the legal requirements determining the organization of a gAG correspond to the provisions applicable to a regular AG. In particular, the gAG also has an executive board, a supervisory board and an annual general meeting. The executive board is responsible for the gAG’s management, which must be aimed towards the exclusive and direct fulfilment of the legally defined objectives of the gAG.

          Holding company

          It is possible for the ecosystem’s individual services to be operated by different companies (Gesellschaften), each with a different legal form which, however, could be brought together under the common umbrella of a holding company (Holdinggesellschaften). A holding company is a structural form whose main purpose is to hold an interest in one or several legally independent companies on a long-term basis.

          There are two distinct types of holding companies that could function as “umbrella organizations” for the ecosystem under consideration here: an operative holding and a management holding. An operative holding is comparable to a parent company (Mutterkonzern) upon which subsidiaries are dependent in terms of strategy and personnel. In contrast, a management holding has no operational business of its own, but still determines the strategic objectives of its subsidiaries.

          The most significant advantage of this type of holding is flexibility, as each subsidiary is able to develop strategies for its own field of business. As a legal structure, the holding company is not regulated by German law and is therefore not bound to a specific legal form. In fact, holding companies are frequently operated in the legal form of a limited liability company (GmbH) or stock company (AG).

          Conclusion

          In order to effectively pursue its objectives and have the legal capacity to act, the ecosystem must have the ability to bear rights and obligations. This means that any legal structure that does not have legal capacity should be automatically ruled out as an option. Partnerships, for example, do not meet the requirements of a participatory infrastructure for the health care system and should not be considered as a legal entity with ownership of the prospective national digital ecosystem.

          While a structure under public law is technically possible, it would pose challenges for private-sector actors when it comes to participating in the project as a whole. To achieve the broadest possible level of participation and a high degree of flexibility, the most ideal organizational framework would therefore involve a legal structure under private law. This would offer a relatively large degree of flexibility with regard to structural adjustments and the cooperation of both private and state actors on the project.

          Furthermore, considering the diverse range of functions performed by the ecosystem, a holding structure appears to be an ideal choice. Under this structure, a parent company would manage subsidiaries, each of which could undertake different tasks within the ecosystem. This allows for efficient coordination and management of the ecosystem’s various functions.

          (Published on 27.09.2023. The statements in this article refer exclusively to the legal situation in Germany. They represent a guideline and not individual legal advice that goes beyond the Trusted Health Ecosystems project.)

          Author

          While completing her doctoral studies, Laura Schulte gained experience in the field of constitutional law as a research assistant. Her doctoral thesis focused on data protection law, and she conducted further research on this subject at various institutions, including the Queen Mary School of Law in London. From 2020 to 2023, she was employed as an attorney at BRANDI Rechtsanwälte in Bielefeld, specializing in IT and data protection law. Since August 2023, she has held the position of professor of business law at the Hochschule Bielefeld.

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            The state as a provider of information: What is the government allowed to do?

            Prof. Dr. Laura Schulte
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            When developing a structural model for a prospective national health platform, it seems reasonable to assume, at least at first, that some kind of state-run service would be the most ideal provider. We should not forget, however, that the provision of information by the state – which we define as the communication of a range of information, warnings and recommendations – is subject to specific legal standards and guidelines. In the following, we examine the extent to which information can and should be provided by the state, if at all, and under what circumstances it is even possible and/or advisable to operate a national health platform in the form of a state-run information service.

            The challenge

            All government action – especially any action relating to fundamental rights – is based on the assumption that it have some kind of legal justification that can be verified retroactively by a court of law. This assumption itself is anchored in the principle of the rule of law, which is a key element of the Grundgesetz, Germany’s constitution. Among other things, Article 20 (3) of the Grundgesetz stipulates that “the executive [shall be bound by] law and justice.” Every state action that has the potential to impact the fundamental rights of third parties must therefore be examined to determine its legal legitimacy and justification.

            The provision of information by a state authority must be seen as a form of “state action,” given that the action is aimed at informing the general public. The minimum prerequisite can thus be drawn from the principle of the rule of law, which stipulates that the state authority act within the scope of the task assigned to it. In this regard, the provision of information to the public can be legitimized, at least in principle, as an annex to the government’s performance of tasks (Schoch, NVwZ 2011). However, in and of itself, a general allocation of the task of developing and overseeing a government information service is insufficient to secure the legal basis of the prospective platform.

            Background

            One area in which state action clearly requires legitimization is when the government issues official consumer product warnings as part of its efforts to provide consumer-protection information (Voßkuhle and Kaiser, JuS 2018). These warnings are typically targeted at specific products or providers, which can impinge on the business operations of the manufacturers and/or providers involved. In such instances, the affected companies have the right to invoke their constitutionally protected freedom to pursue their profession (Article 12, Grundgesetz) as well as safeguard their personal rights (such as the right to self-determination and self-preservation).

            In dogmatic terms – that is, as far as Germany’s Federal Constitutional Court is concerned – the state’s action in providing information does not constitute an encroachment carried out in the form of a legal act, at least not in the traditional sense of the term. Still, the impact of the provision of such information is very similar to that of an encroachment in the traditional sense. It is therefore reasonable to interpret such state action as being the equivalent to an encroachment (Voßkuhle and Kaiser, JuS 2018).

            According to criteria set forth by German’s Federal Constitutional Court, it will be necessary to determine whether the provision of information by the government has an impact on market competition.

            “When examining the broader collection of information by government agencies, it is essential to assess the extent to which the state provider competes with private-sector entities.”

            Prof. Dr. Laura Schulte

            In this regard, Germany’s Federal Constitutional Court has laid down the following minimum prerequisites which must be met to ensure the legality of state-run information activities: (1) there must be an identifiable state task to be carried out; (2) the rules of order, procedure and responsibility must be adhered to in the fulfillment of the task;  (3) the information must be factually accurate and its content truthful; and (4) as a whole, the act of providing the information must be appropriate and in proportion to the task.

            And, even if government agencies comply with each and every one of these laws, it is still possible for markets to be impacted by their actions. Indeed, a state often has other means at its disposal when seeking to position itself in front of the general public; for example, it can draw on public funds to finance its efforts. For this reason, the public often considers information provided by state agencies to have greater relevance and credibility than information disseminated by third parties. If a government agency is seen as engaging in a private-sector action, the first step is to determine whether there is any justification for this action and whether their action results in any impact on competitors. It is also important to determine whether the information disseminated to the public comes from the public authority itself or from a third party (see also: Ownership: Public or private?)

            Conclusion

            Given the statements made so far, and especially considering the goal of establishing a platform model firmly rooted in the law, the idea of a national health platform operated by the state must be viewed critically. Although the project is by no means focused on the issuance of product warnings and other direct disadvantages suffered by actors, it is nevertheless true that other providers of digital health information and services could be impacted, if only indirectly.

            It is therefore advisable to advocate for a structural approach that does not involve the direct provision of information by a state-run agency. It should also be noted that the partial funding of a national health platform by the government does not automatically imply that responsibility for the platform must also be in government hands. Instead, an open structural model, managed by civil society actors, could serve as an information “hub” and serve as a foundation for additional services.

            To prevent excessive limitations being placed on the activities of private-sector actors, it is advisable to have a platform that is not administered by the state. Efforts should also be made to ensure that companies operating on the market are not excluded or put at a disadvantage.

            (Published on 27.09.2023. The statements in this article refer exclusively to the legal situation in Germany. They represent a guideline and not individual legal advice that goes beyond the Trusted Health Ecosystems project.)

            Bibliography

            Schoch, NVwZ 2011, 193 (196) with reference to OVG Hamburg, NVwZ-RR 2008, 241.

            Voßkuhle and Kaiser, JuS 2018, 343 (344) with reference to BVerfG, NJW 2002, 2621 – Glykolwei.

            Author

            While completing her doctoral studies, Prof. Dr. Schulte gained experience in the field of constitutional law as a research assistant. Her doctoral thesis focused on data protection law, and she conducted further research on this subject at various institutions, including the Queen Mary School of Law in London. From 2020 to 2023, she was employed as an attorney at BRANDI Rechtsanwälte in Bielefeld, specializing in IT and data protection law. Since August 2023, she has held the position of professor of business law at the Hochschule Bielefeld.

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              On the terminology of digital ecosystems and platforms

              Dr. Matthias Naab
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              Dr. Marcus Trapp
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              The terms “platform” and “digital ecosystem” are frequently used in various contexts, but their precise meanings can be unclear. What distinguishes a digital ecosystem and how does it relate to the concept of a platform? The following definitions are intended to shed light on these terms.

              Brands like Amazon, Airbnb or Uber are notable examples of companies that have established extensive digital ecosystems that have a profound impact on the lives of many people. As such, they facilitate the exchange of goods, overnight accommodations and transportation services between providers and consumers. And while companies such as Amazon, Airbnb and Uber originate from the United States and have expanded their operations globally, China has also brought major digital ecosystems such as Alibaba and Tencent to the field.

              Though not as well known, there are also thriving digital ecosystems in Germany. Schüttflix, for example, has transformed the German construction industry by enabling the swift and reliable delivery of bulk materials. MyHammer connects customers with craftsmen, while Urban Sports Club provides sports enthusiasts access to a diverse range of fitness activities.

              As providers, bulk goods suppliers, craftsmen and fitness studios all benefit from gaining access to a large customer base, streamlined processes and other simplifications. Consumers, in turn, enjoy having access to a broader array of options that no single provider could offer alone.

              Digital ecosystems can therefore create a win-win situation and, in some cases, even yield a triple win when we account for the benefits they provide platform operators as well. However, digital ecosystems are also viewed as a potential threat, as companies can establish significant dominance over time and create dependencies that they then utilize for their own business practices. Nevertheless, for many individuals, these digital ecosystems have become integral to their daily lives. It is therefore crucial that we consider how to construct and operate digital ecosystems in a manner that benefits all participants.

              Definition: Digital ecosystem

              “A digital ecosystem is a sociotechnical system that encompasses individuals and companies participating as providers or consumers, as well the IT systems that connect them. All digital ecosystems are characterized by digital brokering, that is, the exchange of goods and services among various parties, all of whom benefit from the fact that the largest possible number of providers and consumers are involved.”

              (adapted from Koch 2022)

              These participants, who are typically independent, expect mutual benefits from their involvement (Koch 2022a, Koch 2022b).

              An ecosystem operator or facilitator provides a service known as asset brokering, which is carried out through a digital platform. This arrangement allows for effortless scalability and generates positive network effects that can be leveraged. Assets play a central role within a digital ecosystem as they are exchanged between providers and consumers. They encompass a wide range of items, including overnight accommodations, bulk materials and digital information.

              The operator of a digital ecosystem often adopts a core business model that is centered around participating in the success of the brokerage process. To achieve this, operators strive to increase the volume of brokered transactions and invest significant effort in ensuring the smooth exchange of assets and the easy onboarding of participants. The term “platform economy” has emerged to describe this kind of brokering activity facilitated through a digital platform.  In this context, the supply side becomes more attractive as consumer engagement increases, leading to a cycle of improved supply and increased consumption. The concepts of “network effects” and “flywheel” capture this dynamic.

              Definition: Digital platform

              The term “platform” has been in use for a long time. However, due to the success of platform companies and the potential offered by the platform economy, the term has enjoyed such widespread currency that it also suffers from overuse, leading to confusion even among experts in the IT industry who often interpret its meaning differently. As a result, business models are at times poorly understood, and companies may attempt to establish a platform without a shared understanding of what a platform truly means for their operations.

              In the context of digital ecosystems, we define a digital platform as a software system that serves as the technical foundation of a digital ecosystem. As such, it is typically developed and operated by an ecosystem operator.

              (adapted from Koch 2022)

              Both providers and consumers directly engage with the platform through APIs or user interfaces, such as a digital marketplace, to facilitate the exchange of assets. The platform’s brokerage process is entirely digital, allowing for scalability and efficiency (Naab 2023).

              It is crucial to distinguish digital platforms for ecosystems from what are known as technology platforms. Technology platforms are utilized to construct and operate software, including services, applications and other technology-based platforms. These platforms consolidate recurring technological and infrastructural aspects of software systems, making them easily accessible through well-defined interfaces. Examples of such platforms include cloud services like Amazon Web Services or Microsoft Azure. Although these platforms do not generate network effects themselves and do not function as the core of digital ecosystems, they are often erroneously conflated in discussions.

              Despite what the term may suggest given its roots in biology, digital ecosystems do not emerge spontaneously or follow an innate evolutionary instinct. Instead, they are intentionally created by organizations that actively address identified shortcomings and generate added value within an industry by taking on a well-designed intermediary role and providing a digital platform that supports such activity.  This is not something that takes place overnight, but which typically unfolds over extended periods of development.

              To ensure a balanced and conflict-free environment, a platform operator must be fully aware of their responsibilities and take concerted action to fulfill them.  This includes accounting for and aligning business, technical and legal considerations right from the beginning. It is important to establish incentives and frameworks that prioritize responsible governance.  Furthermore, a set of values and clear behavioral guidelines should be in place for all participants to follow in order to encourage fair and respectful interaction (Lewrick 2021, Kawohl 2022).

              There are multiple ecosystems within the healthcare system

              Healthcare, like other sectors, offers numerous opportunities for digital ecosystems to emerge. It is important to avoid adopting a view of the entire future healthcare system as one homogenous digital ecosystem, as this often leads to vague discussions in which it’s difficult to attribute accountability to any specific agent. Instead, we should focus on specific digital ecosystems that align with the provided definition and explore how these ecosystems interact within the healthcare sector itself. We can then determine which rules and regulations are needed to govern such ecosystems and develop a strategy to implement them.

              Bibliography

              Choudary S (2016). Platform Revolution: How Networked Markets Are Transforming the Economy ―and How to Make Them Work for You.

              Kawohl J (2022). ECOSYSTEMIZE YOUR BUSINESS: How to succeed in the new economy of collaboration.

              Koch M (2022a). Digitale Ökosysteme in Deutschland – Inspirierende Beispiele zur Stärkung der deutschen Wirtschaft. https://www.iese.fraunhofer.de/content/dam/iese/dokumente/media/studien/studie-digitale-oekosysteme-in-deutschland-fraunhofer-iese.pdf

              Koch M (2022b). A matter of definition: Criteria for digital ecosystems. https://www.sciencedirect.com/science/article/pii/S2666954422000072

              Lewrick M (2021). Business Ecosystem Design.

              Naab M (2023). Der Begriff “Plattform” ist hoffnungslos überstrapaziert! DIE Landkarte für den digitalen Plattform-Dschungel. https://www.informatik-aktuell.de/entwicklung/methoden/die-landkarte-fuer-den-digitalen-plattform-dschungel.html

              Trapp M (2020). Digitale Ökosysteme und Plattformökonomie: Was ist das und was sind die Chancen? https://www.informatik-aktuell.de/management-und-recht/digitalisierung/digitale-oekosysteme-und-plattformoekonomie.html

              Authors

              Dr. Matthias Naab and Dr. Marcus Trapp, co-founders of Full Flamingo, an eco-tech startup, aim to leverage the power of the platform economy for the greatest possible impact on sustainability.  Before 2022, they held senior executive positions at Fraunhofer IESE, where they played a pivotal role in developing and overseeing the field of “Digital Ecosystems and the Platform Economy.”

              Your feedback is important to us

              To contact our project team, please use our form. We look forward to your message and will get back to you as soon as possible.