What is next for the digitalisation of Swedish Healthcare? An exploratory study of the digital healthcare ecosystem and the business model innovation of e-Health providers

Abstract: With an ageing and growing population, health- and social systems globally are facing challenges in ensuring that their national infrastructure can handle this demographic shift. Within the upcoming 10-year period, the group of people above the age of 80 years is forecasted to increase by 50 per cent in Sweden. Shifting demographics will further strain a healthcare system already facing structural issues. A challenge alluded to when discussing the coordination of the Swedish public healthcare system is the political and bureaucratic complexities that its' structure implies. Where bureaucratic inertia and lagging change management have incentivized a marketisation of the primary care system, through the entry of mHealth providers. Through shifting market dynamics the provision of accessible digital healthcare has become a priority. Clearly illustrated by the declaration of 'Vision eHealth 2025' which aims to align the digitalisation efforts strategically. With the prospects of digitalisation, the guiding motive within this qualitative and exploratory study has been to explore the challenges that prevail within the Swedish digital healthcare ecosystem, how the business model innovation among eHealth providers has been affected, and to evaluate the future trajectory for the digitalisation of healthcare. Through interviews with industry experts within primary care, the results emerged that public and private stakeholders are facing challenges in realizing an aligned ecosystem due to 1) decentralised coordination of the healthcare system, 2) the political discourse surrounding marketisation and 3) a lack of interoperability between regions' digital infrastructure. Through business model innovation mHealth providers have been able to reposition their role in the ecosystem - either by adopting a complementor approach to facilitate joint value creation or conversely by extending their value proposition to a digiphysical provision model. Finally, Vision eHealth 2025 delineates an ambitious future outlook for the digitalisation of healthcare. In this study, stakeholders involved in the digitalisation process contrast the highly set ambitions with their respective organizational realities, and deliberate on what's next for the digitalisation of Swedish healthcare.