If you have spent more than five years on a hospital floor, you already know the feeling. The medication is sitting in the cabinet. The order is signed. The patient is in front of you. And somewhere between those three points there is a digital wall that should not be there — a checkbox, an alert, a workflow gate that someone built without knowing what your morning actually looks like.
You work around it. Quietly. Cleverly. Often. And every time you do, a small piece of you whispers the same question: who designed this, and why didn’t anyone ask me first?
That whisper is not a complaint. It is the early signal of something far bigger — the moment when a clinician stops being a user of the system and starts becoming an architect of it. This post is about how to make that transition real.
The Override That Saved Lives
Years ago, when I was working at Cerner, I had a clinical problem on my desk that on paper looked like a setting in a database. The patient record system had a switch — either require pharmacy review of medications before nursing could administer them, or don’t. In most parts of the hospital, that prospective review was a brilliant safety net. In the Emergency Department and PACU, it was a clinical hazard. The seconds between a physician saying “give it” and the drug actually reaching the patient were stretching far beyond what the situation could afford.
I didn’t write a memo. I didn’t escalate it through three committees. I pulled in an expert on Cerner’s pharmacy workflow and an expert on Cerner’s programming language, sat down with both of them, and we wrote a solution that triggered an override only when a clinician was standing in PACU. Everywhere else, the safety net stayed intact. In the two locations where time was a clinical risk, the system finally worked the way care actually needed to flow.
That fix is still in production. It is treating patients I will never meet, in hospitals I will never visit, with a piece of clinical judgement I happened to encode into the system on a Tuesday afternoon. That is what designing the system you wished you had actually looks like — and it is exactly the kind of work waiting for clinicians who are ready to step into digital health.
Why 2026 Is the Year This Stops Being Optional
Healthcare has reached the part of the digital transformation curve where the easy wins have already happened. Most hospitals have an electronic patient record. Most have a portal. Most have ambient AI scribing somewhere in pilot. The question is no longer “do we have the technology?” The question is “is the technology actually doing what clinicians need it to do?”
The answer, in too many places, is still no. The World Economic Forum’s 2026 review of digital health concluded that the dominant barrier to impact is no longer invention — it is implementation. The NHS 10-Year Plan implementation is hitting its stride, with the Federated Data Platform now live across more than half of acute trusts, and ambient voice technology rolling out at scale. In the United States, ONC’s 2026 interoperability rules are forcing systems to share data in ways that will expose every poorly designed workflow they have hidden behind a firewall. In Ireland, the HSE’s national EHR programme is finally moving from procurement to implementation.
Every one of those programmes will succeed or fail on the same variable: whether clinicians are at the table when the system is being built. Not as advisors. Not as user testers brought in late to validate something already finished. As architects.
The Identity Shift From User to Designer
Most burned-out clinicians I coach come to me in the middle of a quiet identity shift they haven’t yet named. They have stopped seeing themselves only as the person on the receiving end of broken systems. They have started seeing themselves as someone who could fix them — if only the path were clearer.
I recognise that shift because I lived it. The move from “this workflow is awful” to “I am the person who could redesign this workflow” is not a job title change. It is a shift in how you read the room when you walk into work. You stop counting the things that are wrong and start cataloguing the things that could be different. You stop being a passenger and start being a builder.
That shift is the foundation of Pillar 4 work — Impact and Purpose. Patient outcomes. Healthcare innovation. System change. Meaningful work. Legacy building. None of those words mean anything until a clinician looks at a broken process and thinks, “I am the person who is going to design what comes next.”
What Legacy Actually Looks Like in Digital Health
People hear the word legacy and think of monuments — buildings with their name on them, awards on a shelf, citations in a paper. The legacy I see in digital health is quieter and far more durable than that.
It looks like the override I wrote at Cerner, still firing in PACUs across the country. It looks like a clinical decision support rule that has prevented thousands of unsafe prescriptions a clinician will never know about. It looks like a discharge workflow redesigned by a nurse who got tired of patients waiting six hours for a bed clean, and who now has that fix running in 90 hospitals. It looks like the documentation pattern an AI scribe was trained on — a pattern that came out of one clinician’s frustration with note bloat, encoded into a model that now drafts notes for a million encounters a month.
Legacy in digital health is the ripple, not the splash. And the people best positioned to create those ripples are clinicians who have lived inside the systems long enough to know exactly which ripple matters.
Steps You Can Take Now
Pick one workflow you currently work around. Not a wish list — one specific, named workaround you do every shift. Document it: what the system asks you to do, what you actually do, and what the consequence is for the patient. That document is your first piece of digital health intellectual property.
Map the system that owns that workflow. Is it the EPR? The pharmacy module? The orders engine? Knowing the technology is half the credibility you need to walk into a digital health conversation.
Find the clinical informatics or digital transformation lead in your organisation and ask for a thirty-minute conversation. Bring your one workflow document. Most of these leaders are starving for clinicians who arrive with a specific problem rather than a general grievance.
Look at adjacent roles — Clinical Informaticist, Implementation Lead, Digital Clinical Safety Officer, Optimisation Analyst. In the NHS, search for trust-level roles posted under digital and informatics. In the US, search Epic and Oracle Health customer organisations. In Ireland, watch the HSE’s digital programme recruitment pages.
Build one meaningful connection in the digital health space this month. Not a hundred LinkedIn requests — one real conversation with someone who has made the transition. Ask them what surprised them. Listen carefully.
Ready to Make Your IMPACT?
If you are a doctor, nurse, or allied health professional in the US, UK, or Ireland — and you are tired of working around the systems instead of designing them — the path into digital health is shorter than it looks from where you are standing right now.
Coaching is the accelerator. Not because I have all the answers, but because I have lived this transition, and I know which workflow is worth your first redesign and which conversation is worth your first meeting. I have helped clinicians move from bedside to boardroom, from frustrated user to system architect, from working around the problem to fixing it for everyone who comes after them.
That is what the Transformation pillar of the IMPACT framework is for. Innovate. Momentum. Problem-Solving. Adaptability. Courage. Transformation. The work is not easy. The work is worth it. And the legacy is real.
If you are ready to design the system you always wished you had, I offer a free initial consultation for clinicians seriously considering this transition. Reach out directly, or visit my coaching page to book a call. The next ripple in healthcare is waiting for a clinician who is ready to throw the first stone.
References
1. World Economic Forum. (2026, January). Why digital solutions and AI in healthcare fail to scale. https://www.weforum.org/stories/2026/01/digital-solutions-and-ai-in-healthcare/
2. NHS England. (2026). Federated Data Platform: Annual progress update. https://www.england.nhs.uk/digitaltechnology/digital-tools-for-staff-and-services/federated-data-platform/
3. Office of the National Coordinator for Health IT. (2026). HTI-3: Interoperability and Information Sharing Final Rule overview. https://www.healthit.gov/topic/interoperability
4. HSE Ireland. (2026). National Electronic Health Record Programme update. https://www.ehealthireland.ie/national-programmes/electronic-health-record/
5. npj Digital Medicine. (2026). Large-scale system-level digitalisation initiatives in the National Health Service in England: insights from three national evaluations. https://www.nature.com/articles/s41746-026-02495-8
6. Imperial College London. (2026). Delivering the NHS 10-Year Plan: The Role of Digital Transformation. https://www.imperial.ac.uk/news/articles/convergence-science/2026/delivering-the-nhs-10-year-plan-the-role-of-digital-transformation/
7. Becker’s Hospital Review. (2026). Why clinical informatics roles are the fastest-growing leadership track in US health systems. https://www.beckershospitalreview.com/healthcare-information-technology/
8. Validic. (2026). 2026 Digital Health Trends: 5 Shifts Shaping Connected Care. https://validic.com/blog/2026-digital-health-trends–5-shifts-shaping-connected-care/
