[Motivations, Challenges And Values Of Developers In Diga And Health App Start-Ups: A Qualitative Interview Study In...

In Germany, a wide range of health apps is now available, supported by the Digital Healthcare Act (DVG), which has been in effect since 2020. These digital applications raise hopes for more equitable access to healthcare, particularly for people in rural areas. While previous studies have primarily focused on users and healthcare professionals, there is little empirical research on the perspectives of stakeholders involved in app development. This paper is based on a qualitative interview study with 16 actors from the field of health app and DiGA development. The data were analysed using reflexive thematic analysis. Three main, partially overlapping motivations for engaging in this field were identified: personal experiences as a patient, a professional background in healthcare, or economic interest. Regardless of their motivation, the interviewees agreed that health is a special good that carries certain moral obligations. At the same time, they cited legal ambiguity and bureaucratic obstacles as main challenges. The findings show that digital health innovations operate within a tension between economic growth and the social mandate of healthcare. We argue that understanding the motivations, challenges experienced, and values guiding stakeholders in health app development is particularly relevant, as their actions and values shape the technologies that are increasingly becoming part of the healthcare system.