Making it stick: The magic of leadership in digital health transformation

When it comes to digital health, the challenge is not merely to innovate but to ensure that innovations are sustainable and operationalised within healthcare systems. Leadership has a central role to play when it comes to making digital health changes stick. As we pour billions into digital health – one of the largest line items in federal and state budgets – the question remains: How do we convert these exciting investments into tangible health outcomes?

In an essay entitled ‘Hazards of Prophecy: The Failure of Imagination’, the great science fiction writer, Arthur C. Clarke, once posited “three laws”. His third law is most famous, yet there is merit in sharing the other two in the digital health context.

The first of these was that, when a scientist tells you that something is possible, the scientist is almost certainly right. (On the other hand, Clarke added, when the scientist tells you that something is impossible, the scientist is very probably wrong.) We might simplify this to mean that we should listen to those who know what they’re talking about. Those in the trenches understand the problems they face better than anyone else.

In the case of digital health, that means the healthcare workforce. The doctors, nurses, allied health professionals, admin, tech staff, leaders, managers and every person in the trenches working hard to bring a positive experience and outcome to patients. This insight is crucial for leaders who aim to transform digital health innovations into practical solutions. By deeply and genuinely engaging with the workforce, leaders can identify the real issues and design solutions that address these challenges effectively.

Clarke’s second law – that the only way of discovering the limits of the possible is to venture a little way past them into the impossible – is also relevant to leaders in this space. Leaders should be encouraged to venture into the impossible. This is not to say that they should do so without meticulous planning and preparation, or that leaders should rush about embracing digital health solutions without first defining what problems they’re trying to solve. 

Therefore, a systematic approach to problem-solving is required here. This involves asking critical questions and benchmarking against global standards to ensure that the solutions are not only innovative but also effective. The magic lies in inspiring teams to explore the art of the possible, while grounding their efforts in solid planning and preparation.

Clarke’s third and most famous rule – that any sufficiently advanced technology is indistinguishable from magic – captures the essence of digital health’s potential and underscores the importance of narrative when it comes to inspiring change. While technology can dazzle, it must be accompanied by narrative substance. Leaders must craft compelling stories that resonate with their teams, ensuring that the narrative aligns with the organisation’s goals and inspires action. This storytelling is central to effective communication and change management, helping to embed digital health innovations into everyday practice.

Steve Jobs was famously a master storyteller, whose ability to inspire through narrative transformed technology into an integral part of everyday life. Leaders in digital health must similarly craft narratives that inspire and engage, ensuring that the stories they tell align with their organisation’s mission and values. By starting with the “why,” as Simon Sinek suggests, before getting to the what and how, leaders can build a narrative that resonates deeply and drives meaningful change.

But storytelling is only one of the ways that leaders can make digital health changes sustainable. They have to listen, too. Leaders should continually engage with their teams with an aim to build relationships, listen to feedback, and adapt their strategies accordingly. Such human-centred design processes are crucial. Leaders should be ready to make tough choices – and to be accountable for them – while allocate resources effectively. By operationalising existing structures, rather than creating new committees, leaders can streamline decision-making and drive change more efficiently.

Finally, Nicholas Taleb’s concept of antifragility seems directly relevant to digital health systems. Rather than being fragile, health systems should embrace tension and crisis, and learn, thus becoming stronger in the process. The COVID-19 pandemic exemplified this, as healthcare systems adapted and evolved in response to unprecedented challenges. Leaders should embrace this mindset, fostering a culture of learning and adaptation that supports continuous improvement.

These are only a few ideas that leaders might benefit from as they seek to make digital health innovations sustainable. By listening to those in the trenches, venturing into the impossible, and crafting compelling narratives, leaders can transform investment into better health outcomes. 

The journey requires a balance of art and science, inspiring teams while grounding efforts in practical strategies. As we continue to navigate the complexities of digital health, these lessons will be crucial in shaping the future of healthcare delivery and optimising the exciting investment in digital health and in improving outcomes for our community.

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This piece is an edited version of a speech delivered by Dr Paul Eleftheriou at the Digital Health Festival on 14 May 2025.