JMIR Publications

ABSTRACT

Background:

Digital health promises numerous value-creating outcomes. These include improved health, reduced costs, and the creation of lucrative markets, which in turn provide high quality employment, productivity growth, and a climate that attracts investment. For this value creation and capture to occur, the activities of a diverse set of stakeholders within a digital health ecosystem need coordination. However, the antecedents the coordination needed for an effective digital health ecosystem are not well understood.

Objective:

The purpose of this study is to investigate the systemic conditions of the digital health ecosystem in Alberta, Canada as critical antecedents to ecosystem coordination.

Methods:

We employed a qualitative case study of the systemic conditions within the digital health ecosystem in Alberta, Canada using semi-structured interviews with 36 stakeholders representing innovators-entrepreneurs, health system leaders, support partners, and funders. Data were coded for key themes and synthesized around five propositions.

Results:

The findings indicate varying levels of support for each proposition, including accessing real problems, data, training, and space for evaluations. However, the most foundational gap appears to be in ecosystem navigation. In particular, the absence of intermediaries to provide guidance on available support services and dependencies among the various ecosystem actors and programs.

Conclusions:

Navigating the systemic conditions of the digital health ecosystem is extremely challenging for entrepreneurs without prior healthcare experience, and this remains an issue even for those with such experience. Policy interventions aimed at increasing collaboration among ecosystem support providers, along with tools and incentives to ensure coordination, are essential as the ecosystem grows.