The power of platform economy in the healthcare system

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In healthcare, that could take the role of capturing diagnostic power and essentially controlling the patient journey and controlling doctor access to the patient journey based on that data.

What are the differences between platform economy and traditional business models?

The platform economy refers to the sum total of social and economic activity that is mediated by digital platforms. Digital platforms are different from traditional business models. Traditional business models are what I call pipelines, which create a product, ship it down, and provide it to the end user. Digital platforms create an infrastructure which allows external parties to come together and create and exchange value with each other.

Now, the reason this is important is because in a traditional pipeline economy, your ability to create value was restricted to your access to resources and to labor internal to the company. In the platform economy, your ability to create value is determined not by the sources internal to you, but by your ability to leverage resources external to you, which means that you now benefit from what is called demand side economies of scale.

How can healthcare benefit from platform economy?

Healthcare is uniquely positioned to benefit from the platform economy. And to understand that, we need to think about the healthcare value chain. There are three distinct positions where platforms can come in and add value. For the physicians and the doctors, platforms can create diagnosis augmentation. They can provide infrastructure that can help doctors make better diagnosis and perform surgery better. Closer to the patient, platforms can serve as a way to act as a custodian of patient data in an aggregated format. And in between the two ends of that spectrum, as healthcare APIs increase, platforms can create a strong integration role in resolving these healthcare APIs across the ecosystem.

What are the risks of platforms entering the healthcare market?

There is every likelihood that platforms entering healthcare could lead to the same data monopolies that we’ve seen in other sectors. And the reason for this is that platforms capture value by extracting and capturing data and creating monopolistic control over data at scale. This is even more important in healthcare because a significant amount of value created in healthcare is created through data-driven diagnosis and data-driven patient care. So platforms are in every way incentivized to capture data as they enter healthcare and to create large data monopolies.

The counter to this is to ensure that on the one hand, we create the right regulatory forces to counterbalance these kinds of risks, but more importantly, ensure that alternatives like creating public infrastructures are set up in a way that innovation is not restricted because of this regulation. So in order to counter digital platforms, we need a combination of both of these aspects.

In the future, who will control patient flows?

I believe it is very conceivable that future patient flows will no longer be controlled by traditional healthcare institutions. As the world gets more connected, we need to realize that healthcare today is very fragmented. Patient data itself is fragmented across different institutions. Naturally, as the world gets more connected, we would see more of concentration of this patient data and more of interoperability. So at this point, we have two choices, whether it’s large multinational companies that will enable that interoperability, or whether it is public digital infrastructures that we create that will enable that interoperability across different systems.

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Sangeet Paul Choudary is author, advisor, and Founder of Platformation Labs and he is a prominent advocate of individual rights in the platform economy. His best-seller “Platform Revolution” is a Forbes “must-read”, his work on platform economy is ranked among the top 10 strategy articles published in the Harvard Business Review. He is ranked a top business thinker by Thinkers50 Radar (2016) and Thinkers50 India (2015). For his contributions to the field of platform economics, Choudary was named a Young Global Leader by the World Economic Forum in 2017.

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What are digital ecosystems?

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These are companies that have dramatically changed whole industries, and even entire areas of life.

What is meant by a digital ecosystem?

While the term “digital ecosystem” may not be immediately familiar to everyone, we’ve all encountered real-world examples of such ecosystems that have significantly transformed various aspects of our daily lives. Think of Uber, Airbnb, and Amazon Marketplace – these are all names we’re acquainted with.

Let’s take Airbnb as an example. On this platform, we have private hosts offering accommodations to fellow private individuals. And right in the middle of this interaction, we find Airbnb, playing a crucial intermediary role. This intermediary role is, in fact, the defining characteristic of digital ecosystems, and it’s a common feature shared by all of them.

This intermediation takes place entirely in the digital realm, and the platform becomes the technical core of our digital ecosystem. To effectively serve the voluntary participants, this digital ecosystem and its platform must be highly scalable. You see, these voluntary participants all expect to gain benefits from being part of this digital ecosystem, and this dynamic sets a self-reinforcing cycle in motion. More and more providers join, attracting more and more consumers. This, in essence, is what gives rise to the frequently mentioned network effects that underpin all business models in the platform economy.

What’s new about digital ecosystems?

Digital ecosystems thrive not by introducing entirely novel concepts but by elevating existing ones to new heights. This approach holds significant appeal for consumers as it grants them access to a broader array of offerings than ever before. For providers, it’s equally enticing, offering access to a vast consumer base without the burden of bearing market development costs themselves. Naturally, for the operator of the digital ecosystem, it also proves highly profitable.

Yet, in the public sector, the presence of successful digital ecosystems remains notably scarce. Especially within government agencies, there’s a dearth of prosperous examples. It’s imperative that we harness the potential of this successful paradigm for public sector entities and leverage the capabilities of the platform economy accordingly.

And what are the risks?

Certainly, where significant benefits abound, risks often lurk in the shadows. Typically, a digital ecosystem is launched in one country, and its operators work diligently to expand it further within those borders. However, due to their inherent scalability, the potential for rapid international expansion looms large. Consequently, there exists a certain peril – namely, the prospect of international giants entering the German market with ease, rapidly gaining dominance, and then dictating the ecosystem’s rules within. And if the ecosystem is really big, and becomes very established, and there aren’t many alternatives, then of course that creates the risk for other participants that they too will no longer have any real alternative.

How can ecosystems be regulated?

The risk of abuse of power is relatively difficult to counter. After all, companies typically build digital ecosystems within the framework of applicable laws, progressively achieving remarkable success. Nevertheless, the issue of power concentration persists, prompting efforts, particularly at the European level, to establish a regulatory framework that curbs excessive centralization of power.

The other risk is more at the level of market dominance, which can be addressed by trying to encourage the emergence of more digital ecosystems in Germany, and thus creating a natural counterweight to the international players. One additional aspect to note is that especially if the state also acts to provide support, it can have an influence on both the regulatory conditions and the values that are embodied in a digital ecosystem of this kind.

Are all digital ecosystems focused on making profits?

These entities do not necessarily have to prioritize profit above all else. We’re all familiar with examples like Wikipedia, which enjoys widespread usage, or Better Place, a donation platform that sustains itself through contributions. Another avenue to explore is seeking suitable sponsors, or even having the public sector assume a sponsorship role. In this manner, a digital ecosystem can be conceived and operated.

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

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What is platform power?

Dr. Michael Seemann

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Platform power

The graph grab
The politics of platforms
The business model
Enshittification
The ambivalence of platforms
Bibliography
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Platform power
The graph grab
The politics of platforms
The business model
Enshittification
The ambivalence of platforms
Bibliography
Author

Platforms. We all use them every day. Instagram, eBay, Uber, Wolt, Airbnb … Platforms are useful because they organize communication, coordination and transactions, and thus make all kinds of tasks easier. But if we’re honest with ourselves, we also often feel uncomfortable with our dependence upon them. In the following article, I explain various aspects of platform power and its implications.

Platforms have power. Few would disagree with this truism. But there is often dispute about exactly what kind of power they have. For example, there is the issue of economic power. Platform companies often have vast amounts of money and resources that enable them to implement their ideas. In addition, they have market power. Platform companies are often described and analyzed as monopolies, or at least as actors that dominate their markets. And finally, platforms have data power. They collect mountains of data about us and our behavior, and about society as a whole. In addition, they can increasingly be said to have political power. Their lobbying corps are among Brussels’ and Washington’s largest, and they can often influence political discourse through their algorithms.

All of these analyses are correct. But it seems to me that these areas of power are themselves only the effects of an entirely different power. My thesis is that platforms have their own, very specific power, and that all these other forms of power derive from it

Platform power

I am referring here to “platform power” (Seemann 2021): a power held and wielded only by platforms, and which can be explained only by their very special structure.

Platform power consists of two parts:

Network power, which draws individuals, institutions and other participants into the platform and binds them to it.
Control, which allows platform operators to influence everything that happens on the platform.

Network power is actually just another name for “network effects.” This term from the field of economics describes the circumstance in which actors always prefer the network that itself contains the greatest number of other actors. We all have seen how this works: A social network with no one else in it is not very appealing. To have value to me, a network must allow me to communicate with others. The value of a network is therefore directly related to its size.

However, this effect can also be described as a form of power (Grewal 2008). My decision to join one network or the other is not completely free, as it is strongly influenced by these network effects. At the same time, it’s hard to leave a network in which I’ve already built a lot of relationships. This effect is also called “lock-in,” because in a certain sense it prevents departures. Network effects thus draw people into a network and keep them there. For this reason, it also makes sense to speak of “network power.”

But network power long predates digital platforms’ arrival on the scene. Most of us learned English as our first foreign language, for example. This is partly because it is so useful to be able to speak English, given that English is the language spoken by the greatest number of other people in the world. The network power of the English language, one might say, is greater than that of French.

Network power exists everywhere in our lives. Gestures, languages, customs – all have network power because they rely on there being a sufficient number of other people able to recognize and interpret them. Platforms too have network power. But while no one is able on their own to control, change or exclude people from languages, gestures or customs, Instagram and Uber can determine who is allowed to access their networks and what people can do there.

This is where control, the second factor of platform power, comes into play. Platforms are technical infrastructures that give their operators many opportunities to exercise control. Simply by designing the platform’s features, operators can determine which things are possible on them and which are not. They also have the ability to control what interactions happen on the platform via the search, recommendation or matching algorithms. And they can even decide to exclude certain people, or reduce their opportunities for interaction. Put these two things together – network power and the ability to exercise control – and a new form of power emerges: platform power.

The graph grab

Every platform faces an initial challenge: To be attractive to users, the platform must acquire network power. To do so, it must attract users. This is a chicken-and-egg problem that is difficult to solve. In the past, platforms have solved the dilemma by incorporating existing networks within themselves. Google, for example, sits on top of the world wide web, WhatsApp imports its users’ contacts by uploading their address books, Uber initially poached cab drivers, and Facebook went from campus to campus in its early days persuading students at elite universities to join its platform.

The trick of integrating existing networks into your platform in order to make them the basis of your own network’s growth is what I call “graph grabbing” (Graphnahme). A graph grab of this kind conducted by profit-oriented platforms could pose a serious threat in the healthcare sector. I have developed a plausible scenario for this elsewhere (Seemann 2022).

The politics of platforms

It is no longer possible to understand today’s politics without taking platform politics seriously. Google’s past involvement in China, Facebook’s influence on the U.S. elections, Elon Musk’s purchase of Twitter: Platforms are political, even if they have long wanted to give a different impression. Even the incorporation of another set of networked relationships is a political act. Imagine if a private platform could gain similar control over the healthcare system, for example.

The business model

However, platform power is not only a source of political order-making; it is also the foundation of all platform business models. In one way or another, every platform business model uses network power and control as leverage to make certain user groups pay – whether by limiting access to features or by limiting access to other users. This is evident when Uber or Airbnb collect commissions, or when Amazon takes fees from merchants, for example. But even the advertising business model only represents the toll that advertisers pay to the commercial platforms in order to be allowed to reach the user base.

Enshittification

For-profit platforms face a contradiction here. On the one hand, a platform always wants to grow, because growth is the way to achieve platform power and thus usefulness. To do this, it must be as open as possible, and provide everyone access to everything. On the other hand, a platform usually also wants to earn money. To fulfill this goal, it must close itself off and limit access, because otherwise no one will pay the tolls. As a result of these conflicting dynamics, every platform goes through multiple phases.

In the early phase – that is, shortly after the graph grab – a platform is focused on growth. In this phase, platforms try to be as useful as possible to everyone in order to acquire platform power. The platform finds its business model only once a significant number of people have joined and begun using it. The operator then determines the bottleneck points where it wants to exact tolls, and starts to close them little by little. As growth levels off, these access points are increasingly closed off, and tolls are collected in an increasing number of places. In the next phase, the platform is then concerned only with extracting the greatest amount of profit possible from the increasingly dependent community. Little by little, user options narrow, overall usefulness diminishes and use of the platform becomes increasingly expensive. Science-fiction author Cory Doctorow and net activist Rebecca Giblin call this process “enshittification” (Giblin & Doctorow 2022).

The ambivalence of platforms: Usefulness is power

It is incredibly difficult to get people to establish a common standard. In sociology, this is referred to as the “problem of collective action” (Olson 1965). Once a common communication standard has been established, all communication participants benefit from it. That is the great merit of platforms. Therefore, we can’t forget: Platforms are useful for the same reason they are powerful.

Platforms are a concept for organizing human interactions in which network power can be combined with control. Platform power is the foundation both of platforms’ increasing political influence and their business models. Since most platform operators are capitalistic companies, they look for ways to skim off the added value they generate. To do so, they must inevitably limit access to interactions, and reduce the platform’s usefulness.

Platforms are useful, and are dangerous precisely for that reason. Platforms should not be rejected as a matter of principle, but users should be very careful about which platforms they depend on. Especially when it comes to sensitive social settings such as healthcare.

Bibliography

Giblin R, Doctorow C (2022). Chokepoint Capitalism: How Big Tech and Big Content Captured Creative Labor Markets and How We’ll Win Them Back. Boston.

Grewal D S (2008). Network Power. The Social Dynamics of Globalization. New Haven.

Olson M (1965). The Logic of Collective Action. Public Goods and the Theory of Groups. Cambridge.

Schmitt C (1950). Der Nomos der Erde im Völkerrecht des Jus Publicum Europaeum. Berlin.

Seemann M (2014). Das Neue Spiel. Strategien für die Welt nach dem digitalen Kontrollverlust. Freiburg.

Seemann M (2021). Die Macht der Plattformen. Politik in Zeiten der Internetgiganten. Berlin.

Seemann M (2022). Die Graphnahme der Gesundheit. Ein Planspiel zur möglichen Plattformisierung des deutschen Gesundheitssystems. Baas J (Hrsg.). Gesundheit im Zeitalter der Plattformökonomie. Ziele. Herausforderungen. Handlungsoptionen. Berlin. 50–58.

Author

Michael Seemann studied applied cultural science and received his Ph.D. in media science in 2021. In 2010, he launched a blog focusing on the loss of control over data on the internet, and in 2014 published a book on this topic under the title “Das Neue Spiel” (The New Game). His second book, “Die Macht der Plattformen ” (The Power of Platforms) was published in 2021. In 2016, he served as an official expert for the Bundestag on the topic of platform regulation. He delivers regular presentations on topics including internet culture, platforms, artificial intelligence and the crisis of institutions in an era marked by the digital loss of control.

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The transformative nature of digital ecosystems

Dr. Matthias Naab

Dr. Marcus Trapp

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Digital ecosystems...

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Digital ecosystems...

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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.”

What is platform power?

Platforms. We all use them every day. Instagram, eBay, Uber, Wolt, Airbnb … Platforms are useful because they organize communication, coordination and transactions, and thus make all kinds of tasks easier. But if we’re honest with ourselves, we also often feel uncomfortable with our dependence upon them.

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On the terminology of digital ecosystems and platforms

Dr. Matthias Naab

Dr. Marcus Trapp

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Digital ecosystem

Digital platform
Ecosystems in healthcare
Bibilography
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Digital ecosystem
Digital platform
Ecosystems in healthcare
Bibilography
Authors

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

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.”

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