Examining digital transformation failures to improve health outcomes in Scotland, suggesting a new AI-driven approach.
Scottish healthcare faces a critical juncture as AI technologies promise transformation, while past digital initiatives have delivered disappointing results. This article examines lessons from digital transformation failures and proposes a fundamentally different approach: reimagining Scotland's health service as a ‘Health and Wellness Service’ enabled by AI-driven organisational transformation rather than mere technology adoption. Drawing on international comparisons (South Korea, Estonia, Denmark) and analysis of current Scottish policy frameworks (Operational Improvement Plan; Service Renewal Framework; Population Health Framework), the article argues that Scotland's devolved powers and manageable scale create an opportunity for world-leading implementation – if political will and implementation discipline can be sustained. The article provides an implementation roadmap while honestly acknowledging AI's limitations, fiscal constraints, and organisational challenges. Success requires early wins that rebuild healthcare workforce trust, national coordination through an AI Centre of Excellence, and ruthless focus on measurable outcomes rather than technological novelty. Scotland's deteriorating health outcomes demand urgent action; AI-enabled transformation offers potential, but only if we avoid repeating past mistakes of prioritising technology over organisational change.
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Martin Crilly (2026) studied this question.
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