Health systems now generate and store more information than at any point in their history. Records are digital, monitoring is continuous and analytical capacity is expanding.

Yet greater information has not automatically produced greater coherence.

In many institutions, digital capability has grown faster than the logic that gives it meaning. Data flows multiply and tools accumulate, while decision-making remains fragmented and coordination effort-intensive.

This section examines a different layer of transformation: not how work is organised, but how information supports that work.

It explores how sequencing, visibility and governance shape digital performance; why integration can increase complexity rather than reduce it; and what conditions allow information to reinforce reliability instead of amplifying variability.

As digital systems mature, artificial intelligence will increasingly influence prediction and optimisation. But algorithms depend on clarity of ownership, escalation and constraint. Where that clarity exists, intelligence compounds. Where it does not, complexity accelerates.

Digital transformation is therefore defined not by technical deployment alone, but by whether information enables deliberate coordination across settings, teams and time.


Surgeon at work on operating in hospital

The last analog system in a digital world

Establishes the macro thesis: healthcare digitised information but not coordination.

Designing the digital operating spine of care

Defines the structural architecture required for digital and AI to generate system-level coherence.

Sequencing digital transformation in Germany’s hospital reform

Applies the framework to a live reform environment, focusing on absorptive capacity, federal governance and sequencing constraints.