Four steps to a successful transformation


woman leaning out of ipad to point at medical chart illustration

Health systems are in the midst of a period of rapid and widespread innovation. New technologies, new care methodologies, and new experiences have all come together to make the healthcare world of today very different from even a few years ago.

But the rapid pace of change and innovation has also created new challenges for patients, providers, and health systems alike. Health systems are just that—systems—and each new individual transformation and innovation creates ripple effects that must be managed and carefully planned for. If not, health systems run the risk of innovating themselves into disarray.

True transformation requires more than just progress and one-off innovation. It requires a vision of where you’re going, a commitment to how you’re going to get there, and commitment to ensuring that those changes are lasting and well-managed.

The pace of innovation

Clinical workflows, patient experiences, workforce systems, and revenue models have all undergone dramatic shifts in recent years, leading to a fundamental re-imagining of every part of the healthcare experience. Much of this rapid innovation and adoption was done in response to sudden, big picture changes in the healthcare landscape, and for good reason—telehealth and virtual visits became essential tools for surviving the revenue disruption of the COVID epidemic, while also dramatically shifting consumer demand.

But rapid shifts like this also come at a cost. For patients, it has meant increasingly finding themselves in strange territory, having to adapt to a rapidly changing healthcare landscape that may include services and systems that their past experiences haven’t equipped them to navigate and which may not be fully incorporated into a larger patient experience. For providers, it has meant constant disruption of their workload and responsibilities, and being asked to balance learning new tools with more conventional workforce challenges like burn out.

Rapid change can deliver huge dividends, opening doors and providing tactical flexibility. But it also comes with unexpected costs and complications that can leave health systems staggering to support them for the long term. That’s why it’s so essential to not just pursue innovation in fits and starts, but as a persistent, long-term transformation strategy that addresses the future as well as the here-and-now. 

Laying the foundation for real transformation

Transformation requires vision—a vision of where your health system needs to be and what capabilities will be required to make that vision a reality. But just having vision isn’t enough. You also need a complete transformation process:

  1. Vision — Where do you want to take your health system?
  2. Operating model — How will your new vision actually function? How will it interact with other parts of your health system? What do you need to do to achieve it?
  3. Governance — Who will be responsible for the new systems and processes your vision will put in place? Who is responsible for the vision itself, for its execution, accountability, and long-term management?
  4. Empowerment — Do your stakeholders and innovators have the leeway they need to actually execute on your vision and roadmap?


When we talk about vision, we mean more than just an idea. For a vision to be able to successfully drive a transformation initiative, health systems need to understand the full ramifications of the vision they wish to achieve. That means looking at the capabilities that will be required, the improvements that will be necessary, and the barriers that will need to be navigated to make that vision a reality. It also means creating buy-in and presenting a well-defined vision of success that executive leadership can stack hands around.

Operating Model

One of the critical facets of a successful transformation initiative is the ability to connect your short-term decision making and plans at the weekly and monthly level to your long-term goals at the quarterly, annual, and multi-year scale. Which of your health system’s current projects are essential to your long-term strategic vision? Are they performing adequately to achieve it? If not, you may need to consider methods to augment or accelerate them. Conversely, if a project isn’t critical for that vision, it may need to be deprioritized. These are essential decisions that will impact your ability to achieve your vision, and navigating them successfully requires a fleshed out and operationalized vision of transformation.

Understanding the operating model of your transformation process also means knowing the connections between different parts of the system. Will standing up a new capability require additional training for nursing staff? Will virtual visits generate additional paperwork? Anticipating the impact of transformation throughout the system is essential for its ability to function—as well as understanding and measuring the positive impact. 


Another essential element of successful transformation is instituting the necessary long-term governance to achieve and maintain your transformation processes. This may mean establishing a dedicated transformation office that can directly facilitate positive disruption. It also means establishing measurable, accountable metrics so you can track progress and adjust your process to optimize success.

Establishing effective governance will also require establishing the necessary buy-in across the organization to make transformation into a top-level priority, while ensuring that all stakeholders have been activated and engaged, both at the executive level and especially among those actually delivering and administering care.

This need for governance also doesn’t go away when the initial transformation is complete: transformation is both a short- and a long-term goal. Just as your current projects need to be successfully stewarded to completion, they will need to be overseen long-term while the transformation agenda moves on to subsequent initiatives.


The last key to ensure long-term transformation success and the ability to realize your vision is empowering the people in your organization to execute on that vision of change. During COVID, health systems gave their workers considerable leeway to rapidly iterate and innovate to ensure that they could weather the exigencies of the COVID-19 crisis—a fact borne out by the rapid pace of innovation in the first year of the pandemic. But with the peaks of COVID-19 behind us, many health systems have rolled back that authority and put additional constraints on transformation projects.

Transformation is inherently an iterative, challenging process. The teams putting transformation into practice need to be able to move fast and make independent decisions, while still being accountable for progress and meaningful change. Putting a structure into place that will spread this power across the organization, rather than centralizing it entirely within an innovation office or elsewhere, is a critical component of transformation.

Preparing for an age of transformation

The rapid pace of change in healthcare isn’t going away. If anything, it’s likely to accelerate as more and more capabilities that were once seen as leading-edge innovations transition into “must-haves” that health systems will need to adopt in order to stay competitive. That will make it even more essential for health systems to have a mature, repeatable transformation process in place.

The longer health systems go without having a clear transformation process—one that is durable, accountable, measurable, repeatable, and actionable—the more work it will be to adopt one and the more they will run the risk of wasted resources on incomplete transformation projects and potentially miss out on meaningful impact to their revenue, customer satisfaction, and business models.

Adopting a big-picture vision for transformation can be daunting. It requires the alignment of major stakeholders, a forward-thinking mindset about the state and progress of the industry, and—because transformation is a process that is really never finished—an eye towards whether yesterday’s vision of the future is still the right one for today. But it’s a challenge that health systems can’t afford to put off.

To learn more about how AVIA can help you envision the right long-term transformation goals and strategy for your health system, contact us today.