A holistic approach to executing large-scale healthcare transformations

Large-scale healthcare transformations are complex endeavours. Success depends not just on technology but on aligning people and processes for long-term impact. Without this alignment, even the most sophisticated digital solutions can fail to deliver their intended impact.

Transformation projects fail at an alarming rate, often due to poor planning, resistance to change, and underestimating the complexity of implementation.

A structured approach – balancing people, process, and technology – is key to ensuring leadership engagement, optimized workflows, and sustainable adoption.

To gain insights into best practices for managing large-scale healthcare transformations, we spoke with two Stratford Group experts: AJ Harris, an IT and digital transformation expert specializing in system implementations and interoperability, and Kathryn Yeung, a change management specialist focused on leadership alignment and workforce readiness.

Together, they offer a holistic approach to executing healthcare transformations that endure.

Laying the groundwork
Before launching a major transformation, organizations must define the why – whether it’s regulatory compliance, patient care improvements, or operational efficiency.

The transformation must align with strategic objectives and have clear, measurable goals to guide decision-making and ensure long-term impact. Without this alignment and strong leadership buy-in, projects can stall or fail.

Key factors for success:

* Readiness: Are leaders and teams prepared for change?
* Stakeholder alignment: Have all impacted groups been identified and engaged?
* Governance: Who makes decisions, and how will risks be managed?
* Change management: How will communication and training be handled?
* External validation: Have outside experts been engaged to challenge assumptions?

One of the most common mistakes is failing to secure strong leadership sponsorship. External advisors can help identify blind spots and ensure decisions are grounded in best practices.

“If senior leadership is not fully bought in, the project is set up for failure. There is no scenario where a large-scale transformation isn’t painful. The only way through it is with strong leadership and a clear ‘why’ behind the change,” said Stratford Group’s AJ Harris.

The role of people
While technology enables transformation, people drive it. Many organizations underestimate how much effort must go into process optimization and change management – not just the technology itself. In reality, the hardest part is ensuring that the people and processes are prepared to use the technology effectively.

Change management is often cited as the most challenging aspect of large-scale projects, especially in industries like healthcare, where workflows are deeply ingrained, and even small changes can disrupt operations.

Without clear leadership commitment and organization-wide alignment, transformation efforts can quickly stall.

The key is not just top-down approval but trickle-down adoption – leaders must actively champion the change, managers need to reinforce it, and frontline teams must feel supported in adapting to new ways of working. Effective change management is not just about communication; it’s about ensuring that teams have the training, resources, and structured support needed to integrate new systems into daily operations.

“The biggest challenge isn’t the technology – it’s getting the organization to use it effectively. Turning on a system is easy; aligning it with business processes and ensuring adoption is the real effort,” Harris noted.

How to overcome resistance to change
Resistance to change is natural. However, resistance is rarely about outright opposition; more often, it stems from uncertainty, lack of clarity, or fear of the unknown. Successfully navigating this requires early engagement, ongoing support, and clear feedback loops to address concerns before they escalate.

Key strategies:

• Active leadership engagement – executives must champion change with visible support and consistent messaging.
• Targeted support for impacted teams – identifying those most affected ensures tailored interventions.
• Empowered managers – mid-level leaders must be equipped to guide teams through change.
• Frequent, transparent communication – uncertainty fuels resistance; clear messaging mitigates it.
• Strong feedback mechanisms – employees need structured ways to raise concerns and influence decisions.
• Measurable adoption tracking – usage metrics and employee feedback highlight where additional support is needed.

At the core of overcoming resistance is recognizing that change is not just a technical shift – it’s a human one.

“Resistance to change isn’t just reluctance – it’s often uncertainty. People instinctively try to maintain familiar ways of working, even when change is necessary. That’s why it’s critical to assess resistance early and create feedback mechanisms that allow teams to voice concerns and adapt in real time. Change isn’t just about systems – it’s about ensuring people feel prepared, supported, and confident in what comes next,” observed Kathryn Yeung.

The process perspective
A well-defined process is critical to keeping large-scale transformations on track, within budget, and aligned with strategic goals. In healthcare, regulatory requirements, complex integrations, and data security concerns make structured methodologies essential. Yet, many organizations underestimate the importance of process clarity and data readiness – key factors that often determine success or failure.

“Most organizations don’t fully understand how their business processes function until they’re forced to map them out. Every transformation project involves peeling back layers of legacy workflows that have evolved over time, often in inefficient ways,” noted Harris.

Key Process Considerations:

• Select the right approach – Agile, Lean, or Six Sigma methodologies help maintain flexibility and drive continuous improvement.
• Define workflows and accountability – every phase should have clear responsibilities and measurable outcomes.
• Prioritize data governance – poor data quality or lack of integration can derail even the most well-planned projects.
• Engage stakeholders early – identifying impacted roles before implementation helps prevent bottlenecks.
• Take an iterative approach – regularly assess process readiness and refine strategies as needed.

Data governance is particularly critical in healthcare, where privacy regulations and interoperability standards add complexity. Addressing data quality, compliance, and integration requirements early prevents costly setbacks.

“Organizations often select a technology solution without fully considering the state of their data. Data governance should be a prerequisite for any digital transformation initiative, especially in healthcare, where privacy regulations are strict and non-compliance carries significant risks,” said Harris.

By structuring transformation efforts around clear processes, risk management, and data governance, healthcare organizations can minimize disruption and ensure long-term success.

While technology is often the catalyst for transformation, it is rarely the hardest part.

Selecting the right tools and vendors is essential to long-term scalability, interoperability, and ease of adoption. However, many organizations fall into the trap of customizing solutions to fit outdated workflows, creating long-term maintenance burdens.

Best practices for technology selection:

• Prioritize interoperability – ensure seamless integration with electronic health records (EHRs), patient portals, and other critical infrastructure.
• Evaluate vendors carefully – look beyond sales demos to assess long-term support, customization flexibility, and upgrade paths.
• Consider end-user experience – even the best technology will fail if clinicians and staff find it difficult to use.
• Assess security and compliance – in healthcare, adherence to privacy regulations (e.g., HIPAA, PHIPA) is non-negotiable.

Sustaining change
Deploying a new system is just the beginning. Without structured support, training, and governance, organizations risk backsliding, adoption fatigue, or inefficiencies that undermine long-term success.

“Too often, projects end at deployment. The reality is a transformation isn’t successful until the organization fully integrates the new system into its everyday operations. That requires continued leadership involvement and reinforcement,” commented Yeung.

Keys to sustainable transformation:

• Develop internal change champions – empower employees to sustain momentum after external consultants leave.
• Establish feedback loops – address post-implementation challenges by continuously refining workflows.
• Embed sustainability planning early – don’t treat steady-state operations as an afterthought.
• Ensure training is hands-on and role-specific – build true proficiency, not just awareness.
• Foster a culture of continuous improvement – iterative changes make adaptation easier.
• Leverage data insights – monitor adoption, track progress, and adjust strategies as needed.

By addressing sustainability from the outset, and recognizing that success depends on training, structured support, and long-term engagement, organizations can ensure their transformation efforts deliver lasting value.