Entering non-platformized sectors: The Co-evolution of legitimacy debates and platform business models in digital health care

Digital platforms have deeply transformed a wide variety of sectors. However, new platform business models often face critical legitimacy challenges. Consequently, new entrants must continuously design and redesign their business model components, particularly when entering non-platformized sectors that are highly regulated. We draw on a longitudinal case study of the emergence of digital healthcare platforms in Sweden between 2013 and 2020. The analysis unravels a dynamic process of redesigning platform business models and their constituent components in response to legitimacy debates, suggesting that permission to operate can be fragile and subject to continuous negotiation. Our findings contribute to current insights into platforms, business models, and digital innovation in complex institutional contexts. Furthermore, our work carries implications for managers and policy makers in the digital health area.