In-house team or agency for hospital digital: choosing the split
The argument is never really about headcount. It is about which work is continuous and which is episodic, and who stays accountable for the outcome once the contracts are signed.

The argument is never really about headcount. It is about which work is continuous and which is episodic, and who stays accountable for the outcome once the contracts are signed.

Before choosing between building and buying, answer what the app replaces, whether patients will open it twice, and who owns it in year three. The choice follows.

A CRM changes what happens to a patient today. A data platform changes what you can see. Most hospital groups have the first problem and buy the second.

Agency sprawl across hospital units is rarely anyone’s fault. Here is how to design the roster deliberately, around decision rights, shared assets and one review route for patient content.

How to assess a hospital head of digital beyond the polished deck: the four capabilities to test, the work sample that reveals judgement, and the red flags worth taking seriously.

Where systems thinking, measurement and process help a hospital group’s growth function, where a hospital stops behaving like a system, and what an engineer must learn about judgement.

How to structure the quarterly board paper from digital and growth, which metrics survive, what to leave out, how to show risk, and why it is not a marketing report.

The hybrid roles a hospital group’s growth function cannot survive without, how to grow product and data talent inside a hospital, and how to make yourself replaceable.

What a board seat on a hospital group’s digital subsidiary actually asks of an operator: oversight not execution, related-party and data scrutiny, and the questions worth repeating.

A candid account of the habits a digital head has to give up to own growth in a hospital group: campaigns, channels, vanity metrics, building, and defending your own function.
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