Table 2.

Major players’ roles and influences in a blockchain-based health care ecosystem.

Major player type	Major players	Roles	Influences on the ecosystem
Keystone	IBM	Platform provider in the ecosystem Aim to create opportunities for niche players and support the operation of the whole system	Enable the establishment of a healthy environment, which leads to an organization’s survival and prosperity Convene followers to achieve diversity
Physical dominator	Health Care Service Corporation or other health care service providers	Integrators in the ecosystem Integrators directly own and manage a large proportion of a network by using vertical or horizontal measures	Provide most products and services to meet customers’ needs Exploit their positions to take over the network and extract the created value
Niche player	Aetna of CVS, Anthem, or PNC Bank	Value creators and innovators in the ecosystem Focus all potential endeavors on enhancing their narrow domain of expertise	Leverage complementary resources from others to create differentiated value Competition and cooperation of niche players support the coevolution of the ecosystem