A digital health innovation may demonstrate strong clinical or operational results during a pilot and still fail to scale because it is dependent on donor funding, a particular technology vendor, externally funded technical staff, non-standard data structures, temporary infrastructure or project-specific workflows. Similarly, an innovation that operates effectively in one facility may encounter substantial barriers when introduced across multiple states, regions, health networks or national systems. This persistent gap between proof of concept and institutional adoption is what the health innovation community increasingly recognizes as “pilotitis.”
The ABCHealth CEO Roundtable was convened to examine this critical transition and identify practical pathways from pilot to scale. The discussions highlighted the importance of designing for scale from inception, with governments, regulators, health workers, communities and other stakeholders engaged early in the innovation process. Participants also emphasized the need for interoperable data systems, enabling policy and regulatory frameworks, workforce capacity, institutional ownership and implementation models that reflect local health-system realities.
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