Beyond innovation: Why healthcare transformation stalls — and what’s missing

Across Europe, we've never had more alignment on the need to transform healthcare. Policy agendas are shifting. Innovation pipelines are full. And there's growing consensus that the future of care must be more digital, distributed, and sustainable.

Yet change remains frustratingly slow. Why?

Because most of our systems aren't built to absorb innovation. They are designed to preserve what exists - not enable what's next.

In my view, the challenge today isn't a lack of bold ideas - it's the absence of the structural conditions needed to turn them into system-wide outcomes.

The ambition-execution gap

Whether I speak with hospital leaders or health authorities, one thing is clear: the case for change is no longer in dispute. But the machinery to deliver that change is often missing.

Even when the will is strong, systems are held back by fragmentation, rigid care structure, and limited delivery capacity.

Innovation thrives in pilots - but rarely reaches scale.

We see promising models-like virtual wards, digitally enabled chronic care, AI-supported diagnostics, and care navigation services-but most remain local, unsupported by aligned incentives or delivery infrastructure

The result is all too familiar: strong ambition, limited spread. Ideas circulate. Demonstrations multiply. But without the systems to carry them, change stays stuck at the edge

What's missing? A new architecture for change

Other sectors have faced similar moments. In telecoms, the shift from analogue networks to digital platforms required interoperable standards, regulatory reform, and large-scale infrastructure investment. In energy, transformation demanded grid modernisation, storage capacity, and cross-border coordination to enable renewable integration.

These sectors didn't transform through isolated projects. They built shared systems that made change scalable and repeatable.

Healthcare now faces that same inflection point. We need to shift:

• From episodic delivery to continuous, connected care
• From local excellence to system integration
• From isolated pilots to replicable platforms

This doesn't mean copying playbooks from other sectors in full.

It means applying an "industrial lens" to how we build capacity, share learning, and scale what works.

Why it matters now

The pressure on our systems is intensifying. Ageing populations, workforce fatigue, and budget constraints are converging with higher patient expectations.

At the same time, there's real momentum. EU initiatives such as EHDS, EU4Health, and IHI are pointing in the right direction. And the appetite for transformation is growing - both politically and operationally.

The question is: can we turn that appetite into system readiness?

My experience suggests we can - but only if we stop treating transformation as a one-off effort and start building shared infrastructure: digital backbones, outcome-based funding models, operational delivery teams, and above all: collaboration.

Let's move from intent to structure

Transformation won't happen through good intentions alone. It takes systems designed to evolve - with care models that are not just innovative, but ready to be adopted and sustained.

As we move toward the launch of the new Sector Committee on Healthcare System Transformation at MedTech Europe, my hope is that it becomes a platform for alignment - a space to connect perspectives, shape shared frameworks, and begin translating ambition into collective action.

A reference point for shared learning and system-wide engagement.