Difficult Business Models of Digital Business Platforms for Health Data: A Framework for Evaluation of the Ecosystem Viability

Cross-organizational platforms with a purpose to enable the exchange of data about their patients face not only technical challenges but also challenges for the viability of the business model of their ecosystem. Regional healthcare information systems (RHIS) have been evaluated from many aspects, like utility, process improvement, benefits to users and patients and cost savings. However these evaluations do not explain the problems in the viability of their ecosystems. This paper develops an ecosystem evaluation framework (EEF) based on platform theories and theory of constraints (TOC). It demonstrates how EEF is used in evaluation of a RHIS to explain its problems in viability. EEF is composed of a model and a method. The model defines the ecosystem: The platform, the producers and consumers, other stakeholders, the friction between the producers and consumers, the transactions reducing that friction, and the goals of the ecosystem and the goals of its stakeholders. The method applies following criteria: Does the platform serve its purpose in reducing the friction between producers and consumers, does the platform benefit every stakeholder in the ecosystem enabling them achieve more of their own goals, does the platform solve the chicken-andegg problem, reach the critical mass, create network effects and does the improvement of the platform benefit every stakeholder. Using EEF in evaluation of RHIS reveals the inherent difficulties for digital business platforms, specifically when the ecosystem consists of both public and private organizations with mismatching goals. In the future EEF helps to address these problems early on.