Abstract

This study studies how mission-driven strategies are framed and operationalised in the governance of digital health ecosystems within Italy’s private healthcare sector. Healthcare organizations frequently express socially oriented missions that highlight access, personalization, and empowerment; however, a significant gap persists between these normative commitments and the design of digital platforms. This research employs a qualitative, multiple-case study approach involving five healthcare entities to outline three distinct pathways of mission- platform alignment: symbolic, structural, and emergent. Effective mission integration was indicated by governance artifacts such as partner onboarding processes, data-sharing protocols, and patient engagement dashboards, which influenced coordination and legitimacy within ecosystems. In contrast, the symbolic use of mission language led to fragmented governance and diminished institutional coherence. Conceptually, this study merges ecosystem governance theory with Foucault’s ideas of governmentality and biopower, repositioning platform governance as a matter of ethical regulation rather than merely technical coordination. This paper advances the field of value-based digital transformation by presenting "mission–platform alignment" as a framework for assessing innovation legitimacy, stakeholder trust, and inclusive ecosystem design. Healthcare leaders, platform designers, and regulators are provided with practical implications to ensure that digital health ecosystems enhance institutional objectives rather than undermine them.

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