Design tensions in a two-sided marketplace for reusable digital therapeutics software components: a qualitative interview study

Objectives To identify stakeholder-perceived design tensions in a two-sided marketplace for reusable digital therapeutics (DTx) software components and to use these tensions to propose alternative marketplace concepts. Methods We conducted 24 semi-structured interviews with digital health researchers and professionals. Data were analysed using hybrid deductive-inductive codebook thematic analysis. The Magic Triangle provided the initial deductive structure. One researcher coded all transcripts; a second independently applied the developing codebook to five transcripts to refine definitions and consistency. Seventeen parent themes were synthesized into 12 design tensions, which informed three author-generated marketplace concepts. Results Participants described trade-offs concerning target users and host, component scope and customization, quality labels, verification, geographic scope, pricing, interoperability, platform launch, risks and market niche. The resulting concepts emphasized a regional startup ecosystem, a research-oriented hybrid marketplace or a global marketplace with stricter entry requirements. Discussion The concepts combine the tensions in different ways and highlight competing priorities in governance, openness, assurance, scalability and early platform growth. Conclusion Stakeholders identified recurring design choices for a DTx software-component marketplace. The concepts provide hypotheses for prototyping and evaluation; the study did not test technical feasibility, market demand, regulatory acceptability or effects on development cost or time.