This is digital health’s hard part. Realizing digital health benefits requires digital health leaders to construct effective models and methodologies to manage change and understand that sustainable changes takes time. Numerous change management models are available. Whichever model is used, key themes are:

• change needs time, but for digital health, a prompt, significant rise in net benefits is needed after implementation to ensure sustainability;
• building health workers’ and managers’ capacity to succeed with change must begin and be substantially complete before implementation
• success needs two parallel strands:
  • hard components, such as realistic timescales, skills and capacity, commitment and health workers time and effort needed;
  • soft skills, such as culture, leadership, motivation; and
• most successful transformation is usually at organizations’ peripheries and led be general managers, and health workers in health care organizations, and deals with specific local problems and challenges.

Digital health leaders in all parts of health systems must engage health workers to identify and agree:

• which health workers’ activities are critical to health care transformation goals;
• how can digital health be used to change these activities; and
• how long will it take for the transformation be become sustainable?

Seven leadership and change management methodologies are summarized briefly in the DHIF manual Appendix 3. <LINK> They are:

• ADKAR®;
• Kotter’s 8-Step Model;
• Kurt Lewin’s Unfreeze-Change-Freeze Model;
• McKinsey 7-S Model;
• Tipping point leadership;
• Lean Six Sigma; and
• The Captain Class.