Open Digital Platforms in Health Care: Implementation and Scaling Strategies

We investigate strategies to implement and scale digital platforms in highly-regulated settings such as health care. Despite considerable research efforts, these scaling dynamics are still not well understood. Based on a qualitative, comparative study (U.S. and Germany) of six digital health care platforms, we suggest two feedback cycles that contribute to explaining the arising difficulties: First, we observe that openness on code and content layers fuels platform growth as suppliers, healthcare providers, insurances, and patients are more likely to use and contribute to the platform. In opposition, risks such as a lack of or uncertainty about regulations prompt the provider to close the platform to uphold control which in turn reduces the benefits for potential suppliers. We further discuss scaling strategies when multiple user groups are involved.