Recipe for ecosystem success – how companies in the Swiss health care sector can work together to achieve more

Less than 15% of business ecosystems worldwide are successful in the long term. Nevertheless, I believe it is still worthwhile for the Swiss health system and would like to outline the four critical factors for success that need to be considered.

Julia Biller

27. December 2023

Healthcare ecosystem
If implemented successfully, the ecosystem recipe has great potential for the Swiss health care sector. (Photo: NS)

Business ecosystems are made up of different companies that work together to provide a service that each company could not provide on its own. The focus is on what customers need. This is how Amazon can provide a seemingly unlimited range of products, which is due to the large number of sellers on its e-commerce platform. The basis for these interactions within the business ecosystem is often a digital platform – for example Uber, Airbnb and the Compassana health care ecosystem. If implemented successfully, the ecosystem recipe has great potential for the Swiss health care sector. 

The vision: integrated health care, easy access and new services 

The advantages of a health care ecosystem such as Compassana can be illustrated using the fictitious example of Andreas L., 57. He was diagnosed with type 2 diabetes two months ago. His GP prescribed him medication, advice from a nutritionist and physiotherapy to encourage him to exercise more. He is finding the transition difficult: He lacks an overview of his treatment plan and spends a lot of time coordinating appointments and managing his medication. Andreas L. can simply consult an app for the many minor issues associated with his health care needs. He can view the treatment plan agreed with his GP as well as his medical data and documents. He can share this information with the various health professionals involved in his treatment. He uses the app to make his appointments. He is sent the prescription for his medication digitally and has it filled at the partner pharmacy around the corner. If he ever has any queries, he can call a health care professional at any time – and be assured that his counterpart has all the necessary information about his medical situation. Finally, he also sees in the app that his supplementary insurance covers an innovative digital service that can support him with his blood glucose readings, which he is happy to use. 

As this example shows, cooperation between various partners (GPs, pharmacies, telemedicine, insurance companies and digital health providers) can significantly enhance the patient journey. However, it is only possible if the partners join forces in an ecosystem – after all, none of them would have been able to meet Andreas L.'s needs on their own.  

From vision to reality 

In spite of the significant added value that is anticipated, the road from vision to reality is a rocky one. In every industry, for every successful ecosystem model that succeeds like Amazon, there are at least eight others that fail to get off the ground or become established in the medium term. Based on my experience, the strategic considerations within an ecosystem differ significantly from those for individual companies: There are four key success criteria to consider: 

Factor for success 1: there are only winners in the ecosystem
Ecosystems can only be successful if all ecosystem partners benefit from their participation in the ecosystem. This is why the added value for each individual partner needs to be clearly identified and reviewed on a regular basis. Tariff structures in the Swiss health care system sometimes hamper the pursuit of shared goals across care sectors. A successful ecosystem needs to have a clear shared vision. The incentive systems within the ecosystem must be structured in such a way that they create added value for all partners. 

Factor for success 2: scale fast
Once the vision and added value are clear for all partners, the ecosystem needs to be expanded quickly. According to a study carried out by MIT Sloan Management Review 80% of successful ecosystems garner a market share of at least 50% in their first five years. Ecosystems that failed to grow rapidly and significantly in their first five years were rarely successful in the long term. Network effects need to be taken into account when scaling up. At Compassana, for instance, this means that there needs to be a balance between patients and health professionals on the platform. In addition, the flow of patients is highly regional, which in turn means that the regional network density has to be taken into account: If you are a patient in Thurgau, you get little added value from a doctor in Geneva. 

Factor for success 3: the right KPIs
I am often asked about the number of people using the Compassana app. I don't think this is the right question to ask – because the success or failure of an ecosystem should be measured by the number of transactions enabled by the ecosystem. Successful transactions (as in the case of Uber, connecting available drivers with passengers) create added value for users. While users can be acquired in the short term, successful transactions offering added value cannot. The following should be applied whenever progress in ecosystem development is reviewed: focus on the right KPIs. 

Factor for success 4: a decisive ecosystem mindset 
As an article published in the Harvard Business Review explains, over the past forty years the majority of strategies have been built on a "moat-based" logic. Companies endeavoured to build an insurmountable moat around their own companies by means of their own positioning or the development of valuable resources, with the aim of differentiating themselves from their competitors. Ecosystem strategies are based on a new logic: the aim is to maximise transactions and share resources. At Compassana, for instance, partners invest in standards and functionalities that other ecosystem participants can also use. For this to work, the teams have to have an ecosystem mindset. 


Ecosystems have the potential to drive integrated health care and innovation. When an ecosystem is being established, its added value for all participants must be clear, it needs to be scaled quickly and focus on the right KPI, plus the ecosystem mindset has to be put into practice. Only then do you have a real chance of being among the 15% that succeed.