Trust is a crucial factor in multi-actor data-sharing initiatives, particularly in sensitive domains like healthcare, where patient privacy, regulatory requirements, and organizational collaboration intersect. However, achieving trust-by-design, creating trust through intentional design choices, is challenging. To address this challenge, this paper investigates how trust frameworks in healthcare data-sharing are designed and how they evolve over time. Central to this inquiry is the conceptualization of “trust anchors”– designable components that provide a foundation for creating trust. Drawing on Technological Innovative Systems theory, this research qualitatively examines two healthcare trust frameworks, each at different lifecycle stages. The case studies reveal how trust anchors contribute to both the development and active management of trust frameworks. The contribution includes a lifecycle approach for trust frameworks and a matrix for categorizing trust anchors, providing guidance for organizations aiming to implement and maintain multi-actor data-sharing frameworks. We find that enforceable trust anchors are more important in the mature phase of a trust frameworks, while in the growing phase, less designable and enforceable trust factors assume a greater role.

Companies and public agencies who are looking to improve their services can benefit from more data sharing. However, due to regulations and security concerns, data sharing between individuals, businesses and public agencies is complicated. There are many variables to consider in a multi-actor environment where actors with various roles and incentives look for legal and technical certainty. Public and private organizations increasingly acknowledge the need for multi-organizational agreements on data sharing standards. This results in the rise of trust frameworks to guide efforts towards trustworthy data sharing in an interorganizational setting. However, academic literature on trust frameworks is scarce, and we lack a systematic understanding of the factors that constitute trust in a multi-actor data sharing environment. The objective of this paper is to provide a systematic understanding of the antecedents of trust playing a role in trust frameworks. A two-stage approach is followed, starting with a systematic review of antecedents, followed by an empirical inquiry as verification. Our findings indicate a wide range of antecedents - including technological and organizational antecedents - can be considered.

Amidst increasing online data sharing among organisations, there is a growing need for interoperability and trust in the digital space. When there is no infrastructure provider for sharing information (e.g. by Big Tech players and/or government-owned infrastructures), public and private actors must figure out how to reach agreements about the technical specifications and data infrastructure components to facilitate inter-organizational collaboration. This paper zooms in on the empirical phenomenon of trust frameworks emerging in practice. The main research question is twofold: (1) what are the goals actors strive for with trust frameworks and (2) which components are developed for achieving these goals? Drawing on previous literature and a case study approach, interoperability, certainty, efficiency, and security emerge as goals of trust frameworks. As for the second question, we draft an exhaustive diagram of components from both the literature and our case study. This explorative research lays the foundation for future research into trust frameworks as a major change in traditional approaches to cross-sector data exchange.