On the basis of this research, how can digital entrepreneurship efforts in healthcare markets be channelled to best economic and societal effect? Our findings demonstrate that digital health technology will not find traction if it does not take account of the healthcare ecosystem’s actor constellations and practices, organization, regulations, and infrastructures. The most enlightened digital technology entrepreneurs we have met during our research were aware of this, and their entrepreneurial efforts were accordingly directed toward all of these constituent elements. While the digital and healthcare industries are still far from happily married, the most astute entrepreneurs we met engage in a convergence strategy where they kept as many points of reference within the ecosystem steady all while ‘digitally enhancing’ them. Digital entrepreneurship in complex ecosystems such as healthcare is thus a question of reflexive innovation which is not afraid of attacking that space’s holy cows. We propose four critical success factors for ecosystem shaping through digital health entrepreneurship.
1. Entrepreneurs should never underestimate the effort and resources that shaping the healthcare ecosystem takes.
Complex ecosystems present multiple points of friction, inertia and resistance to digital entrepreneurs. Successful ecosystem shaping can only happen on the basis of such deep acquaintance with the system to be disrupted, and with ample attention to the engagement process.
2. In the healthcare ecosystem, ‘user-centricity’ takes on multiple dimensions
The most successful ventures we interviewed all gave simultaneous attention to the habits and routines of different target audiences: hospitals or employers, consumers or patients, and payers. Astute digital health entrepreneurs gave equal weight to these different yet interlinked audiences from the outset. This multi-pronged approach allowed them to identify and address real and existing problems that caused enough actors enough pain to overcome practice inertia. Perhaps even more important than designing for separate customers at once was the fact that these firms also aligned their value propositions with multiple stakeholders’ measures of value.
3. In digital health, no venture is an island
Any business ecosystem involves interrelationships and partnering, as value creation cannot be done by one party alone. In complex ecosystems these partnering requirements are exacerbated: not only do these ecosystems require knowledge of and access to multiple different entry points, but because of the diversity of stakeholders and cultures, they also require complex entrepreneurial skills sets. Accordingly, two characteristics were common across our pool of successful digital health entrepreneurs: One, they built their venture’s skills pool from the outset with a view to reflect ecosystem complexity, drawing from a relatively broad range of professions. And two, they engaged in partnerships with diverse experienced players to complement and add to this internal skillset. Thus, a venture’s social and cultural resources should be a mirror reflection of the ecosystem’s.
4. Digital entrepreneurship in complex ecosystems is a marathon, not a sprint
A concerted ecosystem strategy requires that firms break down the ‘overwhelming’ problems facing digital entrepreneurs, in the words of a respondent, into smaller chunks where progress can be seen and measured. This strategy not only de-risks commitment for future investors or customers, it also helps entrepreneurs to ‘reality-check’ their strategy continuously against an often rapidly evolving context. One of the obstacles many of our entrepreneurs encountered was that such a marathon approach did not sit well with the typical three to five year venture capital investment time horizons. Next wave entrepreneurs may therefore be better advised directing their funding efforts toward what is generally referred to as ‘patient capital’ such as social impact funds, Government schemes or institutional investors who understand the timelines involved in ecosystem transformation.
