The emergence of a national collaborative digital ecosystem. A study of one-citizen-one-health-record in Norway

Abstract

Developing national e-health solutions has proved to be quite challenging in most countries. However, the coming of digital ecosystems have changed our understanding of how to deal with this type of large-scale socio-technical complexity. Platform ecosystems is not only a technical structure, but a new organisational form, which builds on a particular governance-architecture configuration. How can these insights contribute to improve the national e-health structures? How can we transform a fragmented e-health infrastructure into a national collaborative ecosystem? Our framework is the idea of a collaborative digital ecosystem, characterised by collaborative architecture and collaborative governance. Our empirical evidence is the gradual emergence of the e-health ecosystem of Norway, which we studied over a decade, from 2011 to 2022. We offer two contributions. First, we discuss how to orchestrate a collaborative architecture-governance configuration, focusing on complementary roles, the need for a self-reinforcing process, and the balance of control and autonomy. Second, we point to the role of attractors, i.e., architectural and governance elements that work as gravitational forces, in shaping of the ecosystem.