Design tensions in a two-sided marketplace for reusable digital therapeutics software components: a qualitative interview study
Journal
MedRxiv
Type
working paper
Date Issued
2026-07-20
Author(s)
Abstract
Objectives
To identify stakeholder-perceived design tensions in a two-sided marketplace for reusable digital therapeutics (DTx) software components and to use these tensions to propose alternative marketplace concepts.
Methods
We conducted 24 semi-structured interviews with digital health researchers and professionals. Data were analysed using hybrid deductive-inductive codebook thematic analysis. The Magic Triangle provided the initial deductive structure. One researcher coded all transcripts; a second independently applied the developing codebook to five transcripts to refine definitions and consistency. Seventeen parent themes were synthesized into 12 design tensions, which informed three author-generated marketplace concepts.
Results
Participants described trade-offs concerning target users and host, component scope and customization, quality labels, verification, geographic scope, pricing, interoperability, platform launch, risks and market niche. The resulting concepts emphasized a regional startup ecosystem, a research-oriented hybrid marketplace or a global marketplace with stricter entry requirements.
Discussion
The concepts combine the tensions in different ways and highlight competing priorities in governance, openness, assurance, scalability and early platform growth.
Conclusion
Stakeholders identified recurring design choices for a DTx software-component market-place. The concepts provide hypotheses for prototyping and evaluation; the study did not test technical feasibility, market demand, regulatory acceptability or effects on development cost or time.
KEY MESSAGES
WHAT IS ALREADY KNOWN ON THIS TOPIC
DTx development can require substantial software, evidence-generation and regulatory resources. Reuse of software components could reduce duplicated work, but exchange of reusable components in DTx is not well characterized.
WHAT THIS STUDY ADDS
Interviews with 24 digital health experts identified 12 design tensions and informed three author-generated marketplace concepts for different contexts.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
The findings can guide prototype specifications and policy questions concerning quality labels, software integration, maintenance and responsibility. Effects on cost, development time, adoption and patient access require empirical evaluation.
To identify stakeholder-perceived design tensions in a two-sided marketplace for reusable digital therapeutics (DTx) software components and to use these tensions to propose alternative marketplace concepts.
Methods
We conducted 24 semi-structured interviews with digital health researchers and professionals. Data were analysed using hybrid deductive-inductive codebook thematic analysis. The Magic Triangle provided the initial deductive structure. One researcher coded all transcripts; a second independently applied the developing codebook to five transcripts to refine definitions and consistency. Seventeen parent themes were synthesized into 12 design tensions, which informed three author-generated marketplace concepts.
Results
Participants described trade-offs concerning target users and host, component scope and customization, quality labels, verification, geographic scope, pricing, interoperability, platform launch, risks and market niche. The resulting concepts emphasized a regional startup ecosystem, a research-oriented hybrid marketplace or a global marketplace with stricter entry requirements.
Discussion
The concepts combine the tensions in different ways and highlight competing priorities in governance, openness, assurance, scalability and early platform growth.
Conclusion
Stakeholders identified recurring design choices for a DTx software-component market-place. The concepts provide hypotheses for prototyping and evaluation; the study did not test technical feasibility, market demand, regulatory acceptability or effects on development cost or time.
KEY MESSAGES
WHAT IS ALREADY KNOWN ON THIS TOPIC
DTx development can require substantial software, evidence-generation and regulatory resources. Reuse of software components could reduce duplicated work, but exchange of reusable components in DTx is not well characterized.
WHAT THIS STUDY ADDS
Interviews with 24 digital health experts identified 12 design tensions and informed three author-generated marketplace concepts for different contexts.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
The findings can guide prototype specifications and policy questions concerning quality labels, software integration, maintenance and responsibility. Effects on cost, development time, adoption and patient access require empirical evaluation.
HSG Classification
contribution to practical use / society
Refereed
No
Publisher
openRxiv
Subject(s)
Division(s)