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# Oura’s Aggregation Play, Patient Empowerment, The EU Angle
- URL: https://marginsofcare.com/ouras-aggregation-play-patient-empowerment-the-eu-angle/
- Published: 2026-11-12T21:00:49.000Z
- Updated: 2026-11-12T21:00:49.000Z
- Author: Eva Worst

In his famous 2015 article, Ben Thompson coined the term [Aggregation Theory](https://stratechery.com/2015/aggregation-theory/) and explained how the internet broke the previous distribution-based consumer business model, which depended on owning the supplier relationship:

> The fundamental disruption of the Internet has been to turn this dynamic on its head. First, the Internet has made distribution (of digital goods) free, neutralizing the advantage that pre-Internet distributors leveraged to integrate with suppliers. Secondly, the Internet has made transaction costs zero, making it viable for a distributor to integrate forward with end users/consumers at scale.

![](https://storage.ghost.io/c/31/96/3196e6e7-a692-4a81-823d-4b6678f19732/content/images/2026/11/image.png)

He then went on to give examples of different aggregators and how they did it:

Apple owned the customer, thanks to their superior hardware; Amazon matched user data with e-book publishers, maximising sales; Uber matched independent drivers with customers and maximised ride volume; Airbnb matched vacant rooms with tourists and maximised property usage.

In 2017 he also defined [three different aggregation levels](https://stratechery.com/2017/defining-aggregators/), with Level 2 aggregators typically formed in highly regulated markets (such as healthcare):

> Level 2 Aggregators: Supply Transaction Costs

> Level 2 Aggregators do not own their supply; however, they do incur transaction costs in bringing suppliers onto their platform. That limits the growth rate of Level 2 aggregators absent the incursion of significant supplier acquisition costs.

> Uber is a Level 2 Aggregator (and Airbnb in some jurisdictions due to local regulations). Uber owns the user relationship and bears no marginal costs in terms of COGS, distribution costs, or transaction costs. Moreover, Uber does not own cars; those are supplied by drivers who sign up for the platform directly. At that point, though Uber needs to undertake steps like background checks, vehicle verification, etc. that incur transaction costs both in terms of money as well as time. This limits supply growth which ultimately limits demand growth.

> Level 2 aggregators typically operate in industries with significant regulatory concerns that apply to the quality and safety of suppliers.

Finally, he ended his original article with the following warning (emphasis mine):

> **The Uber and Airbnb examples are especially important: vacant rooms and taxis have not been digitized, but they have been disrupted.** I suspect that nearly every industry will belatedly discover it has a critical function that can be digitized and commodified, precipitating this shift. The profound changes caused by the Internet are only just beginning; aggregation theory is the means.

It seems like 11 years later the internet, or rather AI, finally caught up with the healthcare industry, and Oura is set to seize the opportunity, combining multiple strategies. 

Like Apple, they own the customer; like Amazon, they use user data and like Uber they match patients with clinicians and maximise treatment volume; like Airbnb they could match vacant intervention facilities and operation rooms with patients (or personnel) and maximise utilisation.

For the longest time in human history, it was doctors visiting patients at their home as needed. This was however not scalable - you could only visit so many patients each day and you also couldn’t carry all your equipment. So doctors started forming clinics and hospitals, and it were the patients that had to now visit the doctor. The internet then empowered the patients with information, but it didn’t reverse the dynamic. What does, however, is the combination of rich monitoring data, personalised guidance and access to just-in-time treatment. This introduces an earlier entry to the clinic, one which was not possible before generative AI, and one that ultimately empowers the patient and gives her choice.

Worldwide there are 6 million people who currently own an Oura Ring and while there are no specific numbers for Europe, we can assume it’s around 1 million (or at least it will be soon). Oura is [not a medical device in Europe](https://marginsofcare.com/oura-goes-clinical-measuring-health-outcomes-actionable-intelligence/), which means it cannot diagnose or monitor conditions, but it can track your body metrics, [alert you when something changes](https://marginsofcare.com/oura-to-acquire-counsel-health-asynchronous-care-ouras-demand-generation-power/), provide you with additional information and connect you with a doctor. It’s online booking on steroids: instead of the patient manually searching to book a visit with a doctor whenever they find the motivation and a fitting time slot, it’s the patient metrics that trigger the automated matching process.

This should be a warning sign for [companies](https://marginsofcare.com/nvidia-invests-in-doctolib-open-source-and-value-migration/) that serve "the manual patient entry”. Oura shows that bodily metrics [are actionable](https://marginsofcare.com/oura-to-acquire-counsel-health-asynchronous-care-ouras-demand-generation-power/) and that creates a new, defensible path for healthcare provision.