281 General discussion 9 roadmap ensures a better fit among humans (meeting their needs), organizations (aligning with their digital strategy), and technology (being technically feasible and compatible with existing infrastructure). It emphasizes a value-driven approach and considers the needs of all stakeholders (36). Currently, development teams often define the value proposition and business model post-development, rather than integrating them into the development process. However, having the potential payers involved from the start can help co-create value to the eHealth technology and inform the business model (27), which is necessary for adoption and sustained funding (37). Therefore, we recommend that researchers adopt frameworks like the CeHRes roadmap to systematically identify all relevant stakeholders, understand their needs, explore value propositions, and actively incorporate business modelling in the development and implementation process. While defining a business case or launching a business is generally not considered a primary focus for academics, start-up incubator programs can provide university spin-offs with the necessary resources, support, and guidance to establish themselves a business and gain traction in the market, moving beyond project funding. Although beyond the scope of this dissertation, paediatric nurse Nicole Donkel and myself decided to spin-off the Hospital Hero app (chapter 4) and participate in an incubator program for startup companies after its development. This program offered us valuable insights for defining our business case and advancing the implementation and scale-up of the Hospital Hero app. Lastly, both public and private funding bodies play significant roles in catalysing the development and implementation of eHealth solutions. However, few public and private funding parties provide specific funding for activities such as market or business validation. Funding opportunities that do encourage for example stakeholder identification and analysis are still outcome driven, requiring a finished product as output, making value identification a secondary objective. The complex system of payments or reimbursements, typically coming from third parties like the government or private insurance companies, further complicates funding issues (35). Moreover, there are differences in perception of value, financial incentives and the intricate interplay between economics of insurers and healthcare providers to consider (38).
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