Digital health technology promises to revolutionize healthcare, offering personalized care, lower barriers to access, and better health outcomes. Yet, despite the immense potential, a staggering nine out of ten digital health pilots fail to scale. The disconnect between ambition and reality leaves many leaders wondering: why is innovation in healthcare so difficult?

To explore this challenge, KMS Technology spoke with Dr. Julien Willard, a former intelligence officer, economist, and head of tech strategy at Accenture and IBM. With a diverse background spanning clinical medicine, health economics, and C-suite consulting, Dr. Willard offers a unique perspective on how healthcare organizations can successfully implement technology like AI to make a meaningful impact.

We’ll explore why so many pilots fall short, and what strategies can turn a promising idea into a market-winning product.

Listen to the episode here, or keep reading to gain further, deeper insights.

Healthcare Is Human, Political, and Irrational

Dr. Willard’s experience as a clinician and diplomat taught him a crucial lesson that many tech-focused innovators overlook.

“Most innovation discussions forget that every health system is designed to avoid loss, not maximize gain,” he states. “Healthcare is not only human, but also political and deeply irrational.”

Succeeding in healthcare means navigating a complex ecosystem of human behavior, political interests, and deeply entrenched systems. 

Under this lens, he discovered that “the loudest voices often aren’t the economic buyers, and the patient community is not particularly involved in the shaping of digital health solutions.” 

For many organizations, this disconnect becomes the root cause of failed pilots: the struggle to connect technological capabilities to real value.

What Digital Health Actually Is

Digital health has become an umbrella term that can mean anything from telehealth to wellness apps. But Dr. Willard emphasizes a more precise definition: 

Digital health technologies offer the ability to deliver personalized care, lower barriers to access, and positively impact health outcomes. These tẹchnologies are often regulated as medical devices. They are designed to work independently, or alongside pharmaceuticals, clinical trials, clinician-delivered therapies, and traditional medical devices.

“I believe this is a category of medical products that will fundamentally shift how healthcare is delivered globally. Because digital health technologies empower not only national, but also local healthcare systems.”

Dr. Willard points to new FDA pathways that allow software to augment the effects of drugs, such as improving medication adherence. While it may sound incremental, this shift represents a foundational change. Improved patient adherence greatly enhances clinical trial data, prevents drop-outs and rework, and ultimately brings life-saving treatments to market faster. When clinical trials are operating against tight patent timelines, speed-to-market can make a million-dollar difference in regards to ROI. 

Innovations Decide Business’s Survival

Healthcare and life sciences are notoriously conservative, and for good reason: regulatory, ethical, and safety barriers are high. But the competitive reality remains.

“If you’re not innovating, you’re going to be behind the entire sector quickly.”

Patients don’t care what technologies power their devices. They care about convenience, comfort, and outcomes. Dr. Willard pointed to the success of a glucose-monitoring company, noting that its rapid growth was driven not by its sensors, but because it delivered a better user experience with predictive analytics and device integration.

As more clinical trials operate off of Bring Your Own Device (BYOD) models, the need for solid technology foundations, built to automate and scale, become more critical. Not just for consumer adoption, but for the efficacy and efficiency of clinical research and healthcare outcomes.

The Disconnect: Why Most Digital Health Pilots Are Doomed to Fail

Many organizations launch digital health pilots with good intentions, often driven by board-level pressure to innovate, especially with technologies like generative AI. However, these initiatives frequently crumble before they have a chance to deliver real value. Dr. Willard identifies several recurring patterns that lead to failure.

1. Pilots as Optics

Too often, pilots are launched for show. They serve as a box-checking exercise to appease leadership, without any real commitment to scaling the solution.

“Pilots are often used as optics,” Dr. Willard explains. “We’re doing this so our CEO sees that we’re doing this… but we actually have no intention to scale this technology within the enterprise. I have seen this so many times.”

These initiatives are siloed and lack a strategic vision for breakthrough innovation. And this approach is short-sighted. Organizations who lack a good faith effort to pilot meaningful solutions will be left behind as competitors gain their footing. Big breakthroughs are already happening, and healthcare leaders need to build their technology foundations now.

“A lot of generative AI pilots in healthcare are too focused on the operations aspect.” Dr. Willard draws a clear distinction to clarify his point, “There are a few small biotech companies that do AI drug discovery. So this is where I think about innovation – a true breakthrough driven by generative AI as a technology; versus transcribing doctors’ notes.”

2. Missing Buy-In from Payers and Patients

A brilliant idea is worthless if no one will pay for it or use it. Many pilots are developed in a vacuum, without considering the “policy full stack” – the entire journey from regulatory approval to patient access. Unfortunately, key questions about reimbursement, product value, and pricing are often treated as an afterthought.

According to Dr. Willard, the policy full stack includes:

Regulatory Authorization Ensuring the digital health technology meets regulatory requirements and receives approval to enter the market.
Product Value Assessment Determining the clinical, economic, and patient impact of the technology; and defining how much it should be reimbursed.
Pricing & Reimbursement Defining the payment model, reimbursement pathway, and how payers will fund the technology.
Patient Access Infrastructure Ensuring patients can realistically access and use the technology, including distribution, affordability, and adoption pathways.

 

Without early input from payers, the path to monetization is unclear. Likewise, if the solution doesn’t address a genuine pain point for patients or clinicians, adoption will falter.

In other words, pilots must be aligned, early and often, with a core business value. Identifying these critical use cases is a recurring challenge, and why so many pilots fail to launch.

3. Lack of Budget, Ownership, and Integration

Even successful pilots face a dead end without a clear path forward. Dr. Willard highlights common organizational roadblocks:

  • No Budget to Scale: Teams run pilots knowing there are no funds allocated for a full-scale rollout. 
  • No Clear Owner: The person who ran the pilot often has a demanding day job and cannot take ownership of the scaled solution. 
  • No Space for Integration: Pilots are added to existing dysfunctional processes, or are isolated from real-world workflows. Teams have to rethink the processes and workflows to make sure the technology actually works.

Dr. Willard is clear: “These pilots in many clients are too often MVPs (minimum viable products) in name only. Usually they’re not viable, not integrated and not budgeted.”

A Playbook to Move From Pilot to Profitability

How can organizations beat the odds? Dr. Willard outlines a clear, focused approach for investors and enterprise leaders aiming to drive meaningful innovation in digital health.

How Larger HealthTech Organizations Can Navigate Innovation

Large organizations have the resources to innovate, but often spread themselves too thin. Dr. Willard’s advice is simple:

“You have to be focused.”

He points to Eli Lilly’s CEO, who attributes decades of success to relentless focus rather than chasing every opportunity. “What made us successful is focus. We never pivoted from what we are good at,” Dr. Willard shares. “We’re always focused on what we’re great at, and we kept hitting this target over and over again.”

For healthtech companies, that means resisting the urge to build everything in-house and embracing strategic partnerships instead. “There is a concept of an ambidextrous organization, where you have a fully fledged organization that runs the pilots, but it’s sort of a separate entity, but still reporting to the same manager as the rest of the department.”

Dr. Willard also provides a practical framework for pilot selection and focus: “We can’t pursue all 100 use cases. So let’s figure out what are the use cases that will lead to breakthrough innovation and are in line with the core of our business. This is where I would put my money.”

What Makes a Digital Health Solution Viable 

Digital health tools continue to expand across R&D and clinical operations, but not all solutions are built to withstand the rigor, complexity, and regulatory landscape of healthcare. Drawing from Dr. Willard’s experience, there are three key elements to determine whether a digital health solution has staying power in the clinical ecosystem.

1. A Viable Use Case

A digital health solution is viable only when it solves a problem that clinicians and patients experience, rather than a theoretical challenge defined by product teams.

Dr. Willard explains: “A lot of the digital health solutions that have been in the market did not succeed. Although they were really good experiments for the people who started those pilots, they were not addressing problems that either clinicians or patients were really facing.”

In the clinical context, viability starts with:

  • A clearly defined clinical or operational burden
  • Evidence that the solution improves clinical efficiency, patient safety, or data quality
  • Feedback from patients and clinical staff who actually use the tool

Digital health is moving beyond pilots and experimentation, and healthcare leaders increasingly need a clear, strategic lens to evaluate which solutions can meaningfully advance clinical outcomes, operational performance, and patient experience. 

2. Modern, Scalable Technology

While buzzwords like AI attract attention, healthcare leaders must differentiate between technology that creates meaningful value and technology that exists primarily for market positioning.

Dr. Willard observes, “A lot of firms are complaining that every single pitch they hear has artificial intelligence in it. And once you actually start looking under the hood, oftentimes, there is no artificial intelligence there. It’s just named that way.”

For investors, they want technology that is real, scalable, and built to last. But this isn’t just a problem facing healthtech start-ups. The same urgency to adopt AI has infiltrated established healthcare organizations, who are facing tremendous technical debt.

A digital health solution cannot be viable if it cannot be maintained, audited, extended, or integrated. Leaders must evaluate not just what technology does today, but whether it can evolve alongside the regulatory and infrastructural shifts that define healthcare.

3. The Right Team

An idea is only as good as the team executing it. Dr. Willard emphasizes that digital health viability is ultimately an execution challenge, one that depends on teams that can bridge clinical insight, regulatory strategy, and product development.

“Revenue and innovation are not enemies. But mediocrity and misalignment are.” Dr. Willard continues, “You need to have a leader who is a business operator, not afraid of making bold decisions that will last.”

Even investors are increasingly conducting behavioral assessments to ensure a company has the right blend of vision and operational excellence. They want to ensure that they are betting not only on the right technology and idea, but also on the right people who can execute effectively.

Healthcare is a uniquely political and emotionally charged system, and teams must be able to operate within that complexity.

Treat Your Digital Pilots Like a VC Portfolio

Dr. Willard closes with one of the most pragmatic philosophies for digital innovation:

“You need to prepare for the fact that many of your pilots will dramatically fail, but each should teach you something valuable.”

Instead of expecting perfection, leaders should:

  • Spread risk across multiple pilots
  • Focus on the few that matter most
  • Learn rapidly
  • Resource the winners
  • Sunset the rest without fear

Revenue and innovation are not enemies. But mediocrity and misalignment are. 

In fact, innovation is essential for long-term revenue generation

The Future of Health is Digital and Focused

The path to digital health innovation is filled with challenges, but the opportunity is too great to ignore. Success requires moving beyond technology for its sake and embracing a strategic, human-centric, and intensely focused approach.

As Dr. Willard concludes, leaders must ask themselves a critical question before launching any new initiative: “Would we still build this if a competitor did it first?” If the answer is yes, then you may have found an idea worth pursuing with the focus and commitment required to win.

To sum up, the future of healthcare will be digital. However, only organizations that innovate with precision, intention, and focus will lead that future.

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