“Technology Alone Is Not Enough”
An interview with Prof. Dr. Akira-Sebastian Poncette on implementation science, digital innovation, and the future of learning hospitals
Interview by Dr. Sven Jungmann
Discussing the why and the how of implementation science with one of the leading experts in the field.
Digital solutions for healthcare are abundant – from AI-driven documentation and telemonitoring to robotics. And yet, why do so few of these technologies make it into everyday clinical practice? Why do so many innovations stall in pilot projects or remain confined to labs? To explore this, our founder Sven spoke with Prof. Dr. Akira-Sebastian Poncette. An anesthesiologist, medical informatician, and Professor of Clinical Implementation Science at Charité Berlin, Poncette has been a pioneer in Germany’s “Hacking Health” movement. Today, his research systematically addresses not only how to build digital technologies, but how to ensure they are sustainably implemented.
Jungmann: You hold a chair in implementation science for digital health. Why is such a discipline needed?
Poncette: There’s no shortage of technologies. The real problem is that they often don’t reach the patients who need them. Time and again, we see tools that work beautifully in a lab but fall apart once deployed in a hospital. The reasons almost always come down to poor implementation and an unprepared context. Take a digital ECG device: it may function flawlessly in technical tests. But if the ward lacks stable Wi-Fi, it’s useless. It’s never just about whether the device works — it’s about whether the environment is ready to support it.
Jungmann: What does this mean concretely for hospitals?
Poncette: Success requires three things:
Effective technology – the tool must work reliably.
Effective implementation – a structured process to integrate it.
A prepared context – from IT infrastructure to team culture.
If one of these pillars is missing, the whole project collapses.
Jungmann: Many hospital leaders hope digitalization will save costs. Is that realistic?
Poncette: In the long run, yes. But the implementation phase is costly. It’s not enough to simply purchase devices. Staff need to be freed up, workshops organized, infrastructure adapted. If those costs aren’t accounted for, failure is almost inevitable. And expertise is critical. You need someone who has successfully led implementations before. If you assign it to a junior staff member without experience, the odds of success are slim.
Jungmann: You often refer to frameworks like CFIR and ERIC. What role do they play?
Poncette: These are evidence-based tools designed to structure implementation.
CFIR (Consolidated Framework for Implementation Research) helps identify barriers and enablers – spanning technology, organizational structures, individual users, workflows, and external conditions.
ERIC (Expert Recommendations for Implementing Change) lists over 70 concrete strategies to address those barriers, ranging from stakeholder workshops to designating digital “champions.”
Using frameworks like these helps hospitals avoid trial-and-error and base their approach on structured evidence.
Jungmann: Many hospital managers hesitate to launch big, resource-heavy projects. Are there smaller steps that still work?
Poncette: Absolutely. I recommend at least three short workshops:
Before implementation – clarify goals, surface problems.
During implementation – identify and prioritize barriers.
After implementation – evaluate outcomes and adjust.
These don’t need to be full-day events. Two focused hours can already make a difference. What matters is bringing everyone to the table: physicians, nurses, IT, and ideally also patient representatives.
Jungmann: What’s the key to getting teams on board?
Poncette: Participation. Projects dictated top-down almost always fail. Success comes when you identify digital champions within the team — motivated, tech-savvy clinicians or nurses who support the project and persuade peers. But they can’t do this on the side. They need dedicated time, maybe two days per week, to actively contribute. That investment boosts motivation, prevents burnout, and creates lasting success.
Jungmann: How do you measure whether an implementation was successful?
Poncette: Traditionally, we look at patient-reported outcomes, like quality of life. In implementation science, we broaden the scope:
Time: How long does it take to write a discharge summary before and after implementation?
Errors: How many medication errors are prevented?
Staff satisfaction: Do clinicians stay longer because bureaucracy is reduced?
There’s no universal set of metrics. The key is to define outcomes in advance, together with the users.
Jungmann: You talk about hybrid studies. What does that mean?
Poncette: Traditionally, we first test whether a technology is effective, then later think about implementation. Hybrid studies do both at once: they examine whether a technology works and how it integrates into real workflows. This saves time, produces more realistic insights, and prevents us from discovering years later that a promising tool fails in practice.
Jungmann: You co-founded Hacking Health Germany in 2013. How has the landscape changed since then?
Poncette: Back then, the “know-do-gap” was glaring. We had the knowledge and the technology, but we weren’t applying it. Today, we have a scientific discipline dedicated to closing that gap: implementation science. In the U.S., it’s far more developed, with dedicated journals and professorships. In Germany, we’re catching up, but resources and structured training opportunities remain limited.
Jungmann: What is your vision of the “hospital of the future”?
Poncette: There won’t be a single blueprint. The future lies in learning hospitals — organizations that continuously test, implement, evaluate, and, if necessary, discard technologies. That requires flexible structures, shorter contract cycles, structured playbooks, and knowledge sharing. Otherwise, every hospital wastes resources reinventing the wheel.
Jungmann: You sound rather critical.
Poncette: Yes, because in Germany we implement a lot but rarely learn from it. Every hospital runs its own isolated project. There’s little exchange, no shared playbooks. Collectively, we waste enormous resources. If we pooled insights and shared best practices, we could save both time and money.
Jungmann: What practical steps can hospital leaders take?
Poncette: Three things:
Prioritize innovation visibly. If leadership isn’t clearly behind a project, it won’t succeed.
Mandate teams. Give staff a clear mandate to improve processes or test tools.
Foster a culture of innovation. Move away from “We’ve always done it this way” toward systematic experimentation and learning.
In the U.S., there are even dedicated roles — so-called Implementation Support Practitioners. I believe Germany will need similar roles soon.
Conclusion
Implementation science may sound academic, but it’s deeply practical. It determines whether digital tools in hospitals succeed or fail. For hospital leaders, the message is clear: success doesn’t depend on choosing the “right” software, but on creating the right structures, strategies, and contexts for adoption. As Poncette summarizes: “Technology alone is not enough.”
If you wish to watch the full video (in German), you can click below.
