The Dutch first-line healthcare domain faces challenges arising from an ageing population and resource limitations, accentuating the need for an effective IT domain. Inadequate interoperability and data portability between information systems used by healthcare organisations in daily processes hinder patient treatment and innovation. This study explores a platform-based information system as a solution to enhance innovation and interoperability. Previous research focused on the IS supplier perspectives, but this research aimed to examine patients and healthcare professionals' needs considering the development of a platform-based information system.

The study is conducted within a socio-technical context, guided by the Design Science Research Methodology (DSRM). This study centers around five sub-research questions distributed across design cycles within DSRM. The preliminary research (including a focus group, semi-structured interviews and expert talks) revealed inefficiencies in communication regarding care around the medication process. The statements gathered during this research phase were validated on a bigger scale by conducting a survey. The statements resulted in a number of requirements, which were formalised and categorised using a System Requirement Structure (SRS) design. The SRS resulted in five main areas: supporting healthcare professional participation, regulating access, enabling clear and concise content, supporting agreements, and supporting patient participation. The low-level requirements of each of these areas were used to construct the platform modules and platform architecture, using a layered approach (showing the business, information and technology layer). The platform architecture was developed through iterative evaluations with domain experts, enhancing quality and detail. The evaluations also resulted in a new perspective on the platform-based information system, rather seeing it as a platform-based ecosystem solution.

The practical contribution of this research lies in two areas. Firstly, the designed platform addresses the need to improve communication within the healthcare domain, offering a communication service that can significantly enhance efficiency and collaboration among healthcare providers and patients. The insights and requirements from various perspectives can also be applied to enhance communication practices in other healthcare lines and countries. Secondly, the platform-based ecosystem design provides valuable insights into the roles, responsibilities, and interactions among different stakeholders, serving as a blueprint for developing similar ecosystems in other domains. The design also aligns with the Communication Platform as a Service (CPaaS) concept, offering the potential for further exploration in other industries.

Additionally, the research contributes to the scientific literature by addressing the research agenda on digital platforms by providing a comprehensive overview of how platform-based ecosystems can be conceptualised and designed in the healthcare sector. The findings can guide further research on feasibility, financial implications, and governance in platform-based ecosystems. The study’s value also extends to other domains, such as education and government, where ISs play a crucial role. Moreover, this study found that the interoperability layers can be applied and adapted within the healthcare context and potentially in other IS ecosystems, providing strong guidance and support for designing platforms and services. The research design demonstrates the relevance and applicability of interoperability layers, and with further experimentation, these layers may have broader applicability across different domains. Overall, the study’s positioning in Design Science Research (DSR) places it as an improvement for communication and an exaptation for the platform-based ecosystem, with potential for reuse and further research in various domains and contexts. The academic contribution also entails identifying knowledge gaps that must be explored in the future: the next steps.

Several areas need further research to enhance the development of the platform-based ecosystem and communication service. Firstly, understanding the patient’s perspective through focus groups or interviews can provide valuable insights into communication preferences and platforms. Secondly, detailed research on communication variety in healthcare and specifying platform content and user details will ensure successful implementation. Thirdly, following the Architecture Development Method (ADM) cycle can optimise the business, information, and technology architecture, cost-sharing decisions and stakeholder governance. Additionally, exploring governance frameworks like the Institutional Analysis and Development (IAD) framework will facilitate feasible implementation. Lastly, developing new design principles and guidelines for digital platform (ecosystem) design will better support the platform-based ecosystem’s growth and refinement. ... Read more

In Dutch primary care, there is a dilemma that needs to be solved: caregivers using different digital platform in information system (DPIS) have difficulties in transferring necessary medical information. Although DPIS, as an emerging technology, assists in the decision making, coordination and control that occurs in the organizational environment. Its lack of openness leads to difficulties in exchanging information data. Therefore, this study focuses on the architectural requirements that can facilitate the openness of DPIS for primary care in the Netherlands. A design science approach was used to answer this question. The study first clarifies the current situation using document analysis and literature review, then defines the factors influencing openness and the requirements of stakeholders regarding openness and identifies architectural requirements. Finally, a conceptual artifact was developed and the requirements were validated in discussion with domain experts. The results of the study suggest that a clear distinction should be made between open to share or open to use when defining the openness of an architecture, and in addition, we should focus on the development of standardized data exchange regulations. ... Read more

Information systems (IS) in Dutch first-line healthcare are organized complex and inefficiently. This limits innovation and interoperability of IS in this domain. Innovation is considered useful to make first-line healthcare more efficient. Digital platform literature shows a how a digital platform provides a more flexible approach to IS and greater rate of innovation. There is little ex-ante design knowledge on how to develop a digital platform. Also, transforming IS in healthcare is complex and often fails. Moreover, openness of a platform can enhance innovation but also introduces risks such as loss of control. This research focused on examining what architectural configurations can facilitate a desired level of platform openness for the Dutch primary healthcare domain. A design science research approach was used to answer this question. Design choices for architectural openness were distilled from literature. A concept artefact on design choices was developed and evaluated with domain experts. The study shows that openness is desired from the perspective of IS suppliers but that openness can never come at the cost of loss of quality or security. Respondents are reluctant to open up critical functionality embedded in the platform. Future researchers are suggested to study the design of boundary resources to manage control over complements and the relationship with complementors. ... Read more