As in many western countries, Denmark's demographic changes and the organizational and financial changes of the Danish healthcare are challenging the levels of provided healthcare and point towards the establishment of telemedicine as means of patient support, diagnosis, and treatment. However, telemedical solutions, despite the benefits they provide, are faced with a number of challenges that inhibit their adoption, development, and implementation.
In this project, we examine the approach of a software ecosystem as means of addressing these issues. A software ecosystem can be roughly explained as the software development and distribution by a set of actors dependent on each other and the ecosystem. We commence on the hypothesis that the establishment of a software ecosystem on the telemedicine services of Denmark would address these issues and investigate how a software ecosystem can foster the development, implementation, and use of telemedicine services.


We initially expand the theory of software ecosystems by contributing to the definition and understanding of software ecosystems, providing means of analyzing existing and designing new ecosystems, and defining and measuring the qualities of software ecosystems. We use these contributions to design a software ecosystem in the telemedicine services of Denmark with (i) a common platform that supports and promotes development from different actors, (ii) high software interaction, (iii) strong social network of actors, (iv) robust business structures, supporting actor involvement in the ecosystem, and (v) proper orchestration and governance of the ecosystem to promote and support the changes and the health of the ecosystem.

Our work contributes to Net4Care, a platform to serve as the common platform in the software ecosystem under establishment. In addition, it contributes by providing input and guidelines on the role and activity of 4S organization, an organization to serve as an orchestrator in the ecosystem with the aim of managing the platform, supporting actor and software interactions, and promoting the ecosystem health. This thesis documents the groundwork towards addressing the challenges faced by telemedical technologies today and establishing telemedicine as a means of patient diagnosis and treatment. Furthermore, it serves as an empirical example of designing a software ecosystem.