Roundtable: Driving digital health success, from buy-in to impact

Stratford Group recently hosted a roundtable discussion, bringing together six healthcare experts to explore the most pressing challenges in digital health. The discussion was organized around three key topics: gaining approval and buy-in, effectively measuring benefits, and scaling successful initiatives. As our experts shared their experiences a unifying theme emerged: digital transformation makes a meaningful impact when leaders align people, processes, and technology.

“There’s that phrase, “Change happens at the speed of trust”, and I think at the end of the day, all of this depends on trust. And that comes with thoughtful change management.”
– Viren Naik
Medical Council of Canada

Moderated by Shelagh Maloney of Stratford Management Consulting, the roundtable participants provided valuable perspectives about driving digital transformation in complex healthcare environments.

Participants included Susan Anderson, chief information officer and leader of the Health Information Unit for the Department of Health and Government in Nunavut; Rana Chreyh, vice president and practice leader for Digital at Stratford; Simon Hagens, vice president, Performance at Canada Health Infoway; Dr. Sarah Muttitt, chief information officer, Hospital for Sick Children and University Health Network, Toronto; Dr. Viren Naik, CEO, Medical Council of Canada; and Nicole Vandenborre, director of Operations, CAN Health-Atlantic.

Securing approval, buy-in, and implementing successfully: Beginning with a discussion about gaining approval and buy-in for digital health initiatives, it was stressed that these projects often represent large-scale business transformations, not simply IT implementations, and require long-term commitment from across the organization. To secure executive sponsorship, it’s crucial to clearly define the problem and outline specific, measurable objectives. A well-defined goal is essential to rally the organization behind the initiative, help overcome resistance and drive change.

“We’re not implementing technology for technology’s sake. We are solving a big problem for the organization; that’s how it gets behind a technical implementation.”
– Dr. Sarah Muttitt
Hospital for Sick Children and University Health Network

Securing buy-in, however, extends beyond executives. Frontline staff must be onboard, as the ones who typically interact with the technology daily. “Co-creating” was mentioned often as a means to encourage buy-in and ensure the technology implementations are addressing the needs of the people they serve – including patients and families.
The goal is not to create a digital strategy, but to build a digitally enabled system that supports the achievement of corporate objectives.

While everyone works toward a go-live date, this date is only the beginning. Continued investment and assessment during subsequent days, months and years are required to ensure the system delivers on its promises. By involving sponsors and users from the outset, setting clear goals, and being adaptive, organizations can effectively implement and scale digital health initiatives. Clarity and collaboration are also key, especially in an already resource-constrained system.

“…with a very thoughtful front-end startup, some significant success can be accrued.”
– Susan Anderson
Department of Health and Government, Nunavut

Measuring and communicating benefits: Achieving benefits is dependent on defining the problem and expected outcomes upfront and a benefits model should connect project outputs to measurable results. This creates a roadmap for tracking short-term successes and linking them to long-term impacts. Efforts to realize and communicate success fall short when goals and benefits are not clear.

“…a project does not lead to benefits. The project delivers an output and it’s only through the correct design that you realize your outcomes.”
– Rana Chreyh
Stratford Management Consulting

User involvement impacts benefits realization. By engaging clinicians, administrators, and patients in both design and governance, organizations ensure that technology addresses specific problems. This avoids common pitfalls like technology failing to integrate into daily workflows. Strong leadership is also critical in driving projects to success. Leaders must establish a clear vision, make decisions effectively, and communicate progress and value to all, continually.

Successfully scaling and spreading projects: To move projects beyond pilot mode and achieve widespread adoption, organizations need a strategic approach that aligns objectives and priorities. Securing buy-in is a critical first step, but the process does not stop there. Co-creating solutions with patients, families, and vendors ensures that systems are not only functional but meaningful. As projects scale, ongoing investment in training, optimization, and user proficiency is essential for unlocking the technology’s full potential and delivering lasting value.

“To scale, we need to get to a place where we have ecosystem understanding internally so that we understand where we play externally.”
– Nicole Vandenborre
CAN Health Network

Scaling innovations nationally may introduce technological and cultural complexities. Occasionally circumstances arise where the organization that is responsible to drive the project is not receiving the benefits of that initiative. This mismatch can lead to initiatives with great value to other parts of the health system not being implemented.

Successful examples, like the rapid adoption of virtual care during the COVID-19 pandemic, demonstrate that with the right infrastructure, clear value proposition, and sufficient investment, scaling can be achieved. However, addressing resistance to change and misaligned incentives is critical to ensuring broad implementation of these innovations. Leveraging key drivers such as a compelling business case, adequate funding, and a supportive regulatory environment can help overcome barriers.

Achieving lasting success requires designing systems for scale from the beginning. Often, systems are implemented without considering how they will connect, which leads to fragmentation and costly integration efforts. A forward-thinking approach and collaboration across all parties and all geographies ensures that digital health innovations can be scaled effectively and sustainably. Roundtable participants have had success with transformative change by aligning objectives, sharing lessons learned, and coordinating efforts.

Overcoming cultural resistance was mentioned throughout the discussion. All agreed that the ingrained mindset of “this is the way we’ve always done it” creates substantial barriers to change.

Healthcare professionals may be hesitant to change their established workflows or don’t have the capacity to learn new methods. Demonstrating tangible, real-time outcomes builds momentum for adoption. For example, when clinicians see positive results, they are eager to adopt. Shorter evaluation periods and clear, immediate results can significantly reduce reluctance, ensuring that technology is embraced by frontline workers.

In Canada, the fragmented, provincially mandated healthcare system adds complexity to national efforts. While many acknowledge the need for change, entrenched practices and varying priorities and needs can make it difficult to break from outdated systems and approaches.

To address these hurdles, small, strategic shifts rather than sweeping legislative changes may offer the best chance for success. By focusing on collaborative, incremental improvements and encouraging people to solve problems for themselves and for the broader system, organizations can start to shift cultural norms, share the workload, and avoid duplication.

Easing the entry points for others to participate in these changes – by standardizing specific language in RFPs for healthcare operators, for example – is one way to gradually push the system forward, fostering a culture that embraces innovation while balancing the need for stability and familiarity.

“With these three levers – some rules, some ‘moral suasion’ and some funding, then most things are achievable”.
– Simon Hagens
Canada Health Infoway

Final insights: As the discussion concluded, the critical role of strong leadership in driving successful technology implementation was emphasized. In this context, it’s important to note that leadership was defined by mindset, and not by title.

While technology serves as a powerful enabler, it is leadership that ensures initiatives are endorsed, scaled, and sustained. Without strong leadership guiding people, culture, and collaboration even the most promising innovations risk stalling. Fostering a culture of continuous learning and innovation will be essential to scaling digital health initiatives and moving beyond the argument “we’ve always done it this way”.

The contributors:

Shelagh Maloney is Senior Business Advisor at Stratford Group and an experienced healthcare executive. She is Vice Chair of Vision Loss Rehab Canada, holds a B.Sc. from the University of Waterloo, and is a Certified Professional in Health Information & Management Systems. Shelagh received the Women Leaders in Digital Health Award in 2017 and became a Digital Health Canada Fellow in 2022.

Susan Anderson is an e-Health strategist with over 30 years of experience in healthcare informatics. She leads the Health Information Unit at Nunavut’s Ministry of Health as the CIO. Susan is passionate about understanding Inuit culture and is a dedicated volunteer, serving as a Director for CHIMA’s national Board and Chair of its governance committee.

Rana Chreyh is Practice Leader, Digital at Stratford Group. With over 25 years of experience, she specializes in strategy development, IT integration, and large-scale solution delivery. Her expertise spans technology, healthcare, and medical devices. Rana holds an Ivy League Executive MBA and is known for bridging business and IT strategy seamlessly.

Simon Hagens is Vice President, Performance at Canada Health Infoway, overseeing Analytics, Research, and Performance Reporting. He previously served as Board Chair at Four Villages CHC, guiding a successful merger of community health providers. Simon holds a B.Sc. from the University of Guelph and an MBA from McGill University.

Dr. Sarah Muttitt is the joint VP & CIO for SickKids and UHN. With over 30 years of healthcare experience, she has led eHealth initiatives worldwide, including as CIO for Singapore’s Ministry of Health. Sarah holds an MD from the University of Alberta and an MBA. She has held leadership roles at Alberta Health Services and Canada Health Infoway.

Dr. Viren Naik is the CEO of the Medical Council of Canada and a Professor of Anesthesiology at the University of Ottawa. He is internationally recognized for his leadership in medical education, with over 25 years of experience. Dr. Naik holds a Master of Education and an Executive MBA and has led key medical training initiatives across Canada.

Nicole Vandenborre is a healthcare IT consultant with over 20 years of experience in portfolio management. She has led major initiatives across multiple jurisdictions, uniting diverse stakeholders for successful outcomes. Currently, Nicole is Director of Operations for the Atlantic region at CAN Health Network, having worked with organizations like Canada Health Infoway and Horizon Health.