Backbone of supported clinics: Infrastructure and services that work

Over the past several articles, we have introduced our vision for a digitally optimized clinic and the foundational pillars to help realize the benefits of digital transformation:

• Empowered: building skills, confidence, and shared accountability needed to adopt and sustain change.
• Connected: ensuring information follows patients and clinicians across settings, for continuity of care.
• Streamlined: redesigning workflows, roles, and processes to reduce administrative burden, not digitize existing inefficiencies.

Yet these elements cannot succeed in isolation. Lasting change requires a strong foundation of support behind the scenes. In this final instalment of our series, we examine the Supported pillar and the infrastructure, services, and governance that allow digital solutions to thrive over the long term.

What it means to be a supported clinic: A digitally optimized clinic requires more than a collection of individual tools. It depends on a strong foundation of reliable connectivity and modern hardware, well-maintained systems, robust privacy and cybersecurity safeguards, and responsive support when problems arise. These capabilities should operate seamlessly in the background, allowing clinicians and clinic staff to focus on patient care and managing the practice, rather than troubleshooting technology, or responding to cybersecurity incidents.

Unfortunately, maintaining this foundation remains a challenge for many practices.

Findings from the 2024 National Survey of Canadian Physicians, led by Canada Health Infoway and the Canadian Medical Association, highlight several barriers that limit the value clinicians can realize from digital health technologies. Based on responses from 1,145 physicians across Canada, respondents cited unreliable infrastructure, insufficient time and training, inadequate technical support, and limited ongoing vendor support as key challenges.

These challenges have real consequences for clinician wellbeing. The 2024 Survey on Tech-Related Burnout by OntarioMD (OMD) similarly found that access to high-quality IT support was associated with lower levels of tech-related burnout. This highlights the critical role that reliable support services play in enabling positive digital experiences for clinicians and clinic staff.

These findings align not only with published research, but with OMD’s 20 years of hands-on experience supporting clinicians and community-based practices in adopting digital health technologies. Throughout this work, we have consistently observed that most community-based clinics lack the capacity, resources, and specialized expertise required to manage technology infrastructure, vendor relationships, cybersecurity, and digital governance. As a result, these responsibilities often fall to clinicians or clinic staff who are already balancing competing priorities and the demands of patient care.

When this happens, technology management becomes an additional operational burden rather than a catalyst for quality improvement, creating challenges that are unsustainable over time.

Importantly, there is no single support model that will work for every clinic. Some organizations may benefit from centrally coordinated services, while others may be better served through local or hybrid approaches.

Regardless of how support is delivered, the common requirement is reliable access to technical expertise, governance, cybersecurity, and operational assistance. Shared or centrally coordinated managed services are one approach to meeting these needs.

When designed around clinical needs, clear accountability, and appropriate service standards, they can provide access to specialized support while reducing the burden on individual clinics. Group purchasing of technology and IT services may also reduce procurement burden and improve value through greater purchasing power and economies of scale.

Characteristics of a supported clinic: OMD’s digitally optimized practice vision describes a supported clinic as one with robust support systems that create a secure, efficient and technologically advanced environment for both staff and patients. Key features include:

• Modern digital infrastructure: Reliable networks (Wi-Fi), current hardware, integrated digital platforms, and scalable technologies that support clinical operations today while enabling emerging capabilities such as AI-assisted documentation, intelligent document management, workflow automation, and future innovations.
• Comprehensive technology management: EMRs, networks, hardware, software and cybersecurity are actively monitored, maintained and supported so clinicians and clinic staff are not acting as their own IT department.
• Privacy-by-design, security and governance: Strong governance, privacy safeguards, cybersecurity control, and incident response processes protect patient information, support regulatory requirements, and maintain trust. As cyber threats targeting healthcare organizations continue to increase, preparedness, monitoring, education, and response planning are becoming essential components of modern practice operations.

Collectively, these supports establish a stable digital foundation that lowers risk, reduces administrative burden and enables sustainable adoption of innovation. Equally important is change management. New technologies, workflows, and services only create value when teams understand how they fit into daily practice and have the support to adapt over time. Technical support and organizational readiness must evolve together.

Managed services and shared platforms: reducing the burden of adoption: In practice, a supported clinic is not expected to manage every aspect of technology on its own. Managed services, shared platforms and coordinated procurement models can help reduce the effort required to select, implement, maintain and secure digital solutions.

Examples of support may include:

• Managed digital health research and evaluation services that assess emerging technologies and publish findings and recommendations, enabling clinics to make evidence-informed adoption decisions.
• Coordinated procurement and licensing that reduces administrative burden, improves value, and helps align products with clinical and system priorities.
• Managed technology and cybersecurity services that provide infrastructure support, backup and recovery, security monitoring, and ongoing maintenance in an environment of increasing cyber risk and limited in-clinic expertise.
• Curated digital health marketplaces and assessment frameworks that help clinics identify trusted solutions aligned with their needs, workflows, and level of digital maturity, and allow for continuous feedback to vendors for future improvements.

For clinics, these supports shift the focus away from sourcing and managing technology toward making informed decisions about how digital tools can improve care delivery.

A well-managed, digitally optimized clinic also leads to financial sustainability. Coordinated services and digital enablement can help reduce operational costs, streamline administrative processes, and improve practice efficiency, creating capacity for ongoing modernization and innovation. For vendors and health system partners, they create clearer expectations around integration, service standards, support and value.

Supported as the enabler of continuous improvement: The Supported pillar is not static; it enables continuous improvement. OMD’s optimized practice maturity model, readiness assessment tool and digital playbooks give clinics a structured way to understand where they are today and what supports they need next – technically and organizationally – to move forward. This means treating infrastructure and services as evolving capabilities rather than one-time purchases.

For vendors, policymakers, buyers and digital leaders, this reframes support as strategic infrastructure rather than operational overhead. It is the foundation that enables Empowered teams, Connected information, and Streamlined workflows to function effectively and evolve over time.

Bringing the four-pillar vision together: Taken together, Empowered, Connected, Streamlined, Supported define characteristics of a modern, digitally optimized primary care environment. The four-pillar vision is not a collection of narrow workflow fixes; it deliberately addresses the whole clinic through a people–process–technology lens.

Empowered focuses on building a digitally capable workforce and patient community. Connected enables information exchange where care happens. Streamlined re-architects high-friction workflows with automation and thoughtful design. Supported provides the infrastructure, services, governance and technical expertise needed to make safe and sustainable improvements.

While each pillar is described separately, they are designed to function together. A clinic cannot be truly streamlined without connected information, connected systems cannot achieve their potential without empowered users, and none of these efforts can be sustained without the infrastructure and services that support them. The greatest value emerges when all four pillars mature together.

Viewed this way, the four-pillar vision offers a practical roadmap for clinics, vendors, policymakers, and health system leaders. Rather than focusing on individual technologies, it encourages stakeholders to examine how people, processes, information, and infrastructure work together to support care delivery and continuous improvement.

Most importantly, success will not be measured by the number of technologies deployed, but by whether clinicians experience less burden, teams work more effectively, and patients receive safer, more coordinated and more accessible care.

For Canadian Healthcare Technology’s readership, the opportunity is clear: design and invest in technologies, services and policies that align with this four-pillar vision.

Done well, it is a bridge-building strategy – connecting patients to clinicians, clinics to clinics and clinics to tools – so that effort at the macro (system) and micro (clinic and team) levels remains focused on what matters most: practical value for clinicians and better outcomes for patients.