Digital health is often described as the future of healthcare, yet despite significant investment and innovation, widespread scale remains elusive in many parts of the sector. Too often, the narrative around scaling digital health products is overly focused on the readiness and responsibilities of tech providers.
But let’s be honest. No digital solution - regardless of how ‘groundbreaking’ it is - can scale unless the entire healthcare ecosystem evolves alongside it.
The conversation needs to shift. Scaling digital health isn't just about getting a tool into a health system. It's about transforming how that system operates. And transformation takes more than just technology, you’re implementing change.
One of the biggest misconceptions in digital health is that securing a buyer is the ultimate milestone. We celebrate contract signings and pilot launches as if they guarantee long-term success (because your tech is great right?). They don’t.
A buyer is just one part of the equation, the thin end of the wedge. Implementation, adoption, integration, and impact are where the real work begins. Time and time again, companies secure buyers only to find that the product never gains meaningful traction with users, or gets stuck at pilot stage. Why? Because health systems are complex organisms. They don’t change just because someone signs an agreement.
Deborah Onuegbu recently wrote a fantastic article about the “buyer-user gap” for Digital Health Africa (that inspired me to share my thoughts!), focusing on the challenge that those paying for digital health initiatives are several steps removed from the end user. It’s a real and recurring problem, but that gap is just one of many. Solve that one, and another appears: clinician workflow alignment, patient engagement, data interoperability, phone networks (yes really), regulatory ambiguity, geo politics. The list goes on.
This whack-a-mole effect highlights the central issue: we treat problems in isolation, but success in digital health depends on system-wide alignment. When only one piece of the puzzle moves, the others resist.
For digital health to truly scale, every player in the healthcare ecosystem must evolve. That includes:
Insurers and payers are pivotal too. We’ve done extensive work helping insurers shift their thinking from “How much does this cost?” to “How much can this save?”, especially in chronic disease management, where early interventions and sustained engagement can reduce the burden of complex, high-cost care later on. But here’s the catch: even if patients aren’t paying for a solution directly, if they don’t use it, the insurer and payer won’t see any value. No usage means no outcomes; no outcomes means no ROI. It’s a closed, symbiotic loop which breaks without engagement.
One example of where we’ve seen this mindset shift in action is through two of our partners in Africa: Dr. Elton Fredrick Afari and Elton Black, both working in health insurance. They not only share a name, but a shared understanding that scaling digital health means reshaping how every person in the chain thinks and behaves. They're not just deploying solutions, instead they're working to align clinicians, patients, and internal teams around adoption. They’ve recognised that even when a service is offered “free of charge” to members, success can’t be assumed. Adoption doesn’t follow availability. It follows trust, relevance, and continuous reinforcement, and it’s that kind of mindset that unlocks real system-level change. Then, longer term it becomes the norm, and that’s the utopian future for digital health solutions.
Change takes time, understanding, learning and most of all… incredible patience. But patience is not something many digital health companies are at liberty to exhibit. Stay super lean and buy time to move your solution from novel to norm.
The time has come to stop framing scaling as a tech problem. It’s a human problem. An organisational problem. A systems problem.
If we want digital health to live up to its potential, we need to ask more of every player in the system - and support them in changing. Because real scale happens when everyone sees themselves as part of the solution.
Let’s stop asking when digital health will scale, and start asking how we can evolve together to make that possible.
Digital health is often described as the future of healthcare, yet despite significant investment and innovation, widespread scale remains elusive in many parts of the sector. Too often, the narrative around scaling digital health products is overly focused on the readiness and responsibilities of tech providers.
But let’s be honest. No digital solution - regardless of how ‘groundbreaking’ it is - can scale unless the entire healthcare ecosystem evolves alongside it.
The conversation needs to shift. Scaling digital health isn't just about getting a tool into a health system. It's about transforming how that system operates. And transformation takes more than just technology, you’re implementing change.
One of the biggest misconceptions in digital health is that securing a buyer is the ultimate milestone. We celebrate contract signings and pilot launches as if they guarantee long-term success (because your tech is great right?). They don’t.
A buyer is just one part of the equation, the thin end of the wedge. Implementation, adoption, integration, and impact are where the real work begins. Time and time again, companies secure buyers only to find that the product never gains meaningful traction with users, or gets stuck at pilot stage. Why? Because health systems are complex organisms. They don’t change just because someone signs an agreement.
Deborah Onuegbu recently wrote a fantastic article about the “buyer-user gap” for Digital Health Africa (that inspired me to share my thoughts!), focusing on the challenge that those paying for digital health initiatives are several steps removed from the end user. It’s a real and recurring problem, but that gap is just one of many. Solve that one, and another appears: clinician workflow alignment, patient engagement, data interoperability, phone networks (yes really), regulatory ambiguity, geo politics. The list goes on.
This whack-a-mole effect highlights the central issue: we treat problems in isolation, but success in digital health depends on system-wide alignment. When only one piece of the puzzle moves, the others resist.
For digital health to truly scale, every player in the healthcare ecosystem must evolve. That includes:
Insurers and payers are pivotal too. We’ve done extensive work helping insurers shift their thinking from “How much does this cost?” to “How much can this save?”, especially in chronic disease management, where early interventions and sustained engagement can reduce the burden of complex, high-cost care later on. But here’s the catch: even if patients aren’t paying for a solution directly, if they don’t use it, the insurer and payer won’t see any value. No usage means no outcomes; no outcomes means no ROI. It’s a closed, symbiotic loop which breaks without engagement.
One example of where we’ve seen this mindset shift in action is through two of our partners in Africa: Dr. Elton Fredrick Afari and Elton Black, both working in health insurance. They not only share a name, but a shared understanding that scaling digital health means reshaping how every person in the chain thinks and behaves. They're not just deploying solutions, instead they're working to align clinicians, patients, and internal teams around adoption. They’ve recognised that even when a service is offered “free of charge” to members, success can’t be assumed. Adoption doesn’t follow availability. It follows trust, relevance, and continuous reinforcement, and it’s that kind of mindset that unlocks real system-level change. Then, longer term it becomes the norm, and that’s the utopian future for digital health solutions.
Change takes time, understanding, learning and most of all… incredible patience. But patience is not something many digital health companies are at liberty to exhibit. Stay super lean and buy time to move your solution from novel to norm.
The time has come to stop framing scaling as a tech problem. It’s a human problem. An organisational problem. A systems problem.
If we want digital health to live up to its potential, we need to ask more of every player in the system - and support them in changing. Because real scale happens when everyone sees themselves as part of the solution.
Let’s stop asking when digital health will scale, and start asking how we can evolve together to make that possible.
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