The Emergence and Dynamics of Electronic Health Records – A Longitudinal Case Analysis of Multi-Sided Platforms from an Interoperability Perspective

Emerging health record platforms are interesting examples of the ongoing process of digitalization and the great opportunities they provide for innovation and additional services. Incumbent players are under increasing pressure from new entrants to offer their customers a user experience they have become familiar with through platforms such as Apple and Google. The emergence of the digital German health record is shown as a case-study, harnessing a longitudinal database and adopting a process-sensitive perspective. Important events are structured into individual episodes and phases and discussed in-depth. The study shows how platform owners of health records respond to changes in the highly regulated healthcare system and its digitalization in Germany. Contrasting with extant knowledge about interoperability as a relevant precondition for platforms, our study shows the important role played by interoperability as a design parameter for emerging platforms, which results in seven interoperability challenges for respective stakeholders