For most private enterprises, a business strategy must be in place, outlining how to accomplish the objectives. Crafting a strategy might be difficult, but even more so to deploy and execute. For many public organizations, a strategy is often less distinct because of the challenges to balance the interests from so many stakeholders.

The everyday mainstream dialogue on healthcare digitalization is dominated by many recurrent topics from the ¨what¨ domain – the mission and overall goals defined as infrastructure, EMR, cloud solutions, GDPR, cyber security, etcetera. Less efforts are being spent on talking about the ¨why¨ issues – the ultimate vision and incentives for improving healthcare by way of digitalization. Even less efforts are being spent on the “who” issue – the value network that will co-create and capture value. Last and least comes the ¨how¨ issues – the introduction of new techniques and digital tools by way of applied improvement science and in a systematic way to ensure that healthcare gets most “bang for the buck” and that a change is always an improvement.  

Healthcare of today is complex and requires leadership, resources, and skills beyond the capacity of any single leader. One key success factor is to view the collective goals in healthcare as moral imperatives in a purpose-driven system. This implies that the strategy and purpose are well understood and communicated and that there is an understanding of the purpose of the purpose.

Most of the conventional perspectives on the governance and management of healthcare fits into the four main perspectives of a Balanced Scorecard (BSC). With a BSC in place, there is a fundament for the agile and flexible leadership needed in the world of VUCA to execute balanced governance and management – to continuously handle the dynamics in each perspective and the interplay between them.

The most important interplay between the BSC perspectives in healthcare of today is the one including the quality of care and finance perspectives. Improvement in quality of care most often leads to improvement in finances, while the reverse approach is most often wrong. These two perspectives are the main components in the value equation (but with the other two perspectives embedded), depicting the Return on Digital Investment (RODI).

Healthcare leaders of today and tomorrow need to master both the balanced management and governance and applied improvement science beyond the everyday “mainstream change management thinking”. Digitalization is an integrated part in all healthcare leadership of today, and should therefore not be a separate BSC perspective, but integrated in the four conventional perspectives. An unmet need of today that needs to be met tomorrow.