Apps and knowledge contributing to creating value for ehealth solutions

Mobile applications for multiple sclerosis (MS) hold growing potential for self-management and remote monitoring. However, research on how they generate value for patients and other stakeholders remains limited. Existing studies emphasize usability or adoption, while overlooking their role within broader healthcare ecosystems. This study investigates how MS-related apps generate value across stakeholders and explores adoption patterns among Spanish patients through an ecosystem-based perspective. A systematic review of MS-related apps available in Spain, a national survey of patients, and semi-structured interviews with clinicians and developers were conducted. This triangulated design enables a multi-actor analysis of app functionalities, adoption levels, and perceived value within the digital health ecosystem. Findings reveal that most apps offer basic functionalities, such as symptom tracking and medication reminders, but are underutilized by patients. Adoption is concentrated on a few platforms, while several apps show limited engagement. Barriers include usability challenges, a lack of integration with healthcare providers, and language limitations. Notably, patients expressed strong interest in features such as cognitive training and IoT-based monitoring, yet actual usage remains low. Interviews with stakeholders highlight structural misalignments and governance issues that hinder clinical adoption and coordinated value creation. This study underscores the need for coordinated, stakeholder-informed development strategies that bridge the gap between patient needs, app functionalities, and clinical workflows. While limited to Spanish-speaking users and self-reported data, the findings of this study offer strategic insights for ecosystem-wide adoption and engagement.