Fail fast to scale fast: Tips for success with digital health pilots

Nothing in the digital health environment stands still for very long these days, especially now that there seems to be a major new breakthrough in artificial intelligence every couple of weeks. Organizations are eager – bordering on desperate – to leverage these next-gen technologies in the battle against growing financial, clinical, and regulatory pressures, and are increasingly pouring money into pilot programs to optimize their processes.  

Pilots themselves are far from a new concept. Most organizations run at least a few of them every year. But it’s become more important than ever to make sure that the time and money spent on experimenting with change are worth it, either by returning cold, hard results – or at least by informing future efforts through failure.   

In either case, the key is to move fast and learn fast, even if that means abandoning a promising idea when it’s clear that it isn’t going to work, according to a panel of digital health experts convened at ViVE 2025 in Nashville this past February. 

During the lively session, the group of digital health and virtual care leaders shared their top tips for success with digital pilots, many of which centered on being decisive and disciplined when assessing the value and viability of their projects. 

Staying focused but remaining flexible

“Architecting a good pilot is really about defining your problem and what you’re trying to solve for,” said Sherene Schlegel, COO and CNO of Virtual Care and Digital Health at Providence in Seattle. “Make sure you have the discipline and structure to measure and remeasure; reevaluate and remeasure again. It’s a continuous journey and you need to stay focused on what you’re trying to achieve without being completely rigidly tied to how you thought you were going to achieve it in the beginning.”  

The right combination of structure and flexibility is crucial for being adaptable without losing sight of the end goals, agreed Emily Warr, Administrator for the Center for Telehealth at the Medical University of South Carolina. 

“You need to be able to flex and change the metrics, if perhaps you’re seeing the results you anticipated, but you have to be disciplined about not adjusting everything so much that you try to become all things to all people,” she advised. “If you start having a bit of mission creep based on feedback from one stakeholder, then all of a sudden, you’re just creating a custom solution that will solve their unit’s problem but can’t scale to other units because you lost sight of what you were trying to make an impact on.” 

A well-designed pilot will establish a “North Star” goal that guides the entire project from start to finish, Warr continued. 

“For example, we decided that the goal of our virtual nursing program was going to be helping bedside nurses get back to the joy in their work by giving them more opportunities to take care of patients directly. With that in mind, we started tackling all the activities that take them away from that goal and giving those tasks to virtual staff instead,” she said. “Throughout the process, despite differences in opinions on how to accomplish the mission, and different perspectives and priorities from the various executives involved, we all stayed aligned on what our North Star was and why it was so important for the work that we were doing.” 

Embracing flexibility while retaining a core goal is equally important for Al Smith, SVP and CIO at Lifepoint Health, based in Tennessee.  

“It’s very easy to fall into the trap of the perfect being the enemy of the good,” he noted. “Sometimes when you’ve got hard metrics on the line, such as financial savings or performance percentages that you really want to hit, you get locked into specific numbers instead of evaluating the results more holistically. There are times when making progress toward a goal is a victory, or getting close to the ideal number is a big win. Think about impact in broader terms, as well as specific ones, to really understand whether you’re moving in the right direction, or you need to pivot.” 

Demonstrating strong leadership through empathy and active listening

Pilots need a pilot: someone who can take charge of guiding the ship in the right direction – and take responsibility if things start to go sidewise. But this leader (of group of leaders) needs to be more than a strong hand.  They also need to encourage sustained engagement and enthusiasm throughout the entire project, especially when big changes are afoot. 

“Listening to your people is crucial for bringing those folks along with you on the journey,” said Schlegel. “You have to stay open to what they’re experiencing, and be able to address their concerns at every step of the way. Be very intentional about change management, so that there’s clarity and a chance to anticipate and get used to upcoming changes. Executive sponsorship really helps with this, because it demonstrates that your entire team is aligned around the same mission and the same goals.” 

Building a strong, multidisciplinary team is essential for making sure there’s representation from all the right stakeholders at strategically important points in the pilot, stated Rachelle Longo, AVP of Telehealth at Oschner Health in Louisiana.  

“Know which stakeholders are really the right people to pull in at different points in the project,” she recommended. “We created a digital nursing innovation committee that’s led by our Chief Digital Officer, our system CNO, our CIO, and some other members of different teams. We’ll bring potential projects to this group, which has a really informed perspective from across the organization, and have them weigh in on whether we should move forward with a specific project and where the bottlenecks might be. Getting that insight from strategic points across the org chart is incredibly important.” 

And when it comes to the IT department, added Smith, make sure they know how the technical knowhow should complement and enhance the subject matter experts involved in the implementation. 

“At the end of the day, these aren’t just IT initiatives, and they can’t be led by IT alone,” he stressed. “They have to be led by the teams they’re going to affect the most, whether that’s operations, nursing, physicians, etc. While IT needs to make sure everything is being designed and implemented in a way that makes sense, we also need to learn to take a little bit of a backseat and let the end users have a lot of creative control in the direction and execution.”  

Learning when to call it quits in pursuit of the greater good

Even the best laid plans can sometimes go awry, especially when working with early-stage technologies such as generative AI. The most important advice from the panel boiled down to monitoring metrics carefully and being clear about when to move in a different direction if the trends aren’t aligning with the goals.  

“Fail fast,” summed up Schlegel. “That’s part of the rapid process improvement cycle. You can’t be afraid of failure if you want to keep learning. It’s a pilot for a reason – the whole point is to learn and experiment. Embrace the fact that you’re going to iterate, pivot, and readjust probably multiple times throughout your project, because that’s what the journey to success looks like.” 

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at [email protected].