My View - The future of digital health leadership

VIEW - Becky George, Fellow of HiNZ

In every conversation about the future of digital health, one question keeps resurfacing: do we have the right perspectives at our leadership tables to meet the challenges ahead? It is a deceptively simple question, yet the answer reveals a structural weakness that continues to shape how we design, govern and deliver health services in Aotearoa New Zealand. 

Our system is complex, dynamic and deeply interdependent. It relies on people who bring different skills, worldviews and lived experiences. And yet, as my research into allied health systems leaders confirmed, our leadership structures still default to narrow, medico-centric models.  

Research shows that when we typically recruit from our wonderful colleagues in nursing and medicine, we are leaving out many potential leaders who bring a lens for community, consumer and systems thinking. This is not a small oversight; it is a systemic constraint that inhibits innovation, equity and digital transformation. 

The cost of homogeneity 

When leadership teams share similar professional backgrounds, they inevitably bring similar assumptions about what health is, how it should be delivered, and which problems matter most. This is not about capability; it is about perspective. A system designed primarily through a biomedical lens will naturally prioritise facility-based care, clinical throughput and traditional hierarchies. But the future we are moving toward: consumer-focused, community-based, digitally enabled, demands something different. 

My research identified many instances of allied health systems leaders aligned with this paradigm. Their perspectives, grounded in philosophy, professional practice and systems leadership, reflected consumer-focused outcomes, integrated service delivery and digitally enabled access. If that is true, and it is, then our leadership paradigm must evolve accordingly. We cannot build a digitally mature, equitable health system using the same leadership blueprint that shaped the past. 

Bias is not just unfair, it is inefficient 

One of the most striking findings from the research was the evidence of systemic bias in leadership development. Participants described being overlooked, underinvested in, or funnelled into roles that did not reflect or fully utilise their capabilities. The findings reflected such marginalisation is not just discriminatory, it is a waste of potential. 

That waste has consequences. When diverse professions, such as the scientific, technical and allied health, are excluded from leadership pathways, the system loses access to people who understand community need, interprofessional practice, and the realities of service delivery across the continuum of care. It also loses leaders who are fluent in integrated care and systems thinking for digital innovation and development, capabilities that are no longer optional. 

Three levers for change 

The research identified three practical areas where action is both possible and urgent: 

1. Validation 

We must normalise difference as a strength. Being different is a good thing; thinking differently and presenting alternate perspectives are positive benefits. Leadership identity needs to be nurtured early, visibly and intentionally across all professions. 

2. Development 

Leadership development cannot remain accidental, dependent on chance encounters, informal sponsorship or unspoken expectations. Equitable access to training, funding and structured pathways is essential if we want a leadership pipeline that reflects the breadth of our workforce. 

3. Endorsement 

Our governance frameworks must shift from credential-based gatekeeping to informed skills-based selection. Recruiting for capability rather than professional background is not radical; it is rational. It is also necessary if we want leadership teams that can navigate complexity rather than replicate legacy thinking. 

A Call to Courage 

None of this change will happen by accident. It requires courage from individuals willing to step into spaces not built for them, and from organisations willing to redesign those spaces entirely. It requires leaders who are future-focused, relational, digitally fluent and grounded in the realities of diverse communities. 

Most importantly, it requires each of us to examine our own influence. Leadership is a practice… we need to broaden the diversity of perspectives at the table, invite new voices, and embrace leaders who bring diverse thinking. 

The future of digital health will not be shaped by a single profession, discipline or worldview. It will be shaped by the collective intelligence of a system that finally recognises the value of its own diversity. 

And that future starts with us, today, choosing to lead differently. 

Acknowledgement and thanks go to Dr Karen Webster and Dr Nicola Kayes for their role in enabling this research. 

If you want to contact eHealthNews.nz regarding this View, please email the editor Rebecca McBeth.

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