Aligning Organization and Health System Digitalization Efforts

Aligning digitalization efforts at multiple levels in health systems is challenging. This case study traces digital development in six academic health centres (AHC) in the province of Ontario (Canada) to understand factors that influence internal digital capacities and their contribution to system-level policy objectives. Data were collected through document review and interviews with AHC leaders in 2019 and repeated in 2021 to explore the influence of the Covid-19 pandemic and system reforms. Results point to digitalization efforts in AHCs that unfolded over three decades with minimal intersection or coordination with provincial efforts, and improved prospects for alignment with the recent policy focus on patient-centred integrated care and the positive pandemic influence on the perceived value of digitalization.