For health and social care to benefit from digital technologies there needs to be a vibrant ecosystem with innovations that are problem-led and rapid to implement, while using the best evidence-based technology. The evolution of the ecosystem is far from this ideal and risks being shaped by dysfunction. 

The design, development, implementation and use of digital technologies in health and care can be considered to be an ecosystem made up of provider organisations, staff, patients, carers, innovators, regulators, researchers, charities and suppliers. It’s a complex ecosystem with many interacting parts, each one with different incentives and aspirations that can make them pull in slightly different directions. If the ecosystem is healthy, it should create a number of benefits for all parts of the system.