Pilots do not fail, handoffs do
Most digital health pilots work. What breaks is the transition from a motivated pilot team to an ordinary week in a busy clinic.
Pilot programs are run by volunteers, champions, and people who want the idea to succeed. Scale is run by everyone else. That difference explains most of the innovation graveyard in healthcare.
A pilot proves that something can work under favorable conditions. The harder question is whether it still works when the champion moves roles, the workflow changes, and nobody is watching the dashboard.
I have started asking teams to design the handoff before they design the pilot. Who owns this in month twelve? What training exists? Which metric will someone actually be accountable for?
Innovation in healthcare is rarely limited by ideas. It is limited by the operational discipline to carry a good one across the gap between demonstration and daily practice.
