In health and care, an open digital ecosystem can make it easier to build applications that support safe, high quality compassionate care. It allows applications and services from multiple vendors to work together for an individual user whatever their role (e.g. clinician, patient, carer, social worker, commissioner, manager, care worker, etc.) such that there is a many-to-many substitutability between applications and services. In other words, an application requiring a service can use any available service provider via common APIs.

An open ecosystem is vendor and technology neutral and eliminates lock-in, facilitates innovation and forces vendors to compete on quality, value, and service. (Apperta Foundation, 2018 p.15)