Everywhere in the world, healthcare leaders talk about AI, virtual hospitals, and predictive analytics. The presentations are impressive, but the reality on the ground is far less glamorous. A patient still waits in a crowded corridor with a paper folder. A doctor still writes notes no one else can read. A claim still takes weeks to reconcile. The future of healthcare will not be digital simply because advanced technology exists. It will only be digital if we fix the basics.  

The first basic is identity. You cannot deliver safe, continuous, data-driven care if you are never fully sure who is sitting in front of you. In many systems, one person can appear under several spellings, multiple ID numbers, or different records across insurers, hospitals, and labs. That breaks continuity of care and weakens trust in any digital system. A stable, universal way to identify patients is as fundamental as electricity in a hospital. 

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The second basic is data quality. We often speak about “big data” in health, yet most organisations still struggle with “correct data”. Incomplete forms, inconsistent coding, free text fields, and disconnected spreadsheets make it hard to trust the information. AI models and decision-support tools are only as good as the data they work with. If we want a digital future, we must invest in simple disciplines: standardised fields, shared terminologies, and a culture where accurate data capture is regarded as clinical excellence, not administrative punishment. 

The third basic is workflow. Technology fails when it is bolted onto dysfunctional processes. In many facilities, the patient journey is a maze: registration in one place, payment in another, records elsewhere, results in a separate building. When a digital tool arrives that does not match this reality, it becomes “extra work”. Real transformation happens when we redesign the journey itself. Digital tools should simplify what clinicians and administrators do every day, not add another layer of clicks on top of chaos. 

Payments and incentives are another crucial basic. If providers are paid in ways that reward volume over value, or if claims remain opaque and slow, digital systems will always be seen as a cost rather than an enabler. Transparent, timely payment flows create the confidence needed for adoption. When a clinician sees that documenting care properly leads to fewer disputes and faster reimbursement, digital tools stop feeling like surveillance and start feeling like protection. 

Infrastructure might sound obvious, but it is often underestimated. Unstable connectivity, unreliable power, and limited device access can quickly turn even the best digital solution into a source of frustration. In some settings, the most transformative act is not deploying AI, but ensuring that every clinic has a stable connection, a secure way to back up records, and basic support when devices fail. A digital future rests on very physical foundations. 

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Trust cuts across all of this. Patients need confidence that their data will be used to help them. Clinicians need to trust that systems will not fail mid-consultation. Policymakers need to trust that the data they receive reflects reality. Trust is built through strong governance, clear privacy rules, and honest communication when issues arise. It grows when frontline workers are included in design, not presented with instructions after decisions are already made. 

From my work in African health systems, I have seen that the most interesting innovations often emerge where the constraints are sharpest. Yet even the most creative solutions struggle if identity, data, workflows, payments, infrastructure and trust are not aligned. This is not just an African story. High-income countries also face fragmented records, siloed systems, and misaligned incentives. The contexts differ, but the basics are strikingly similar. 

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So, what should leaders do now? First, resist chasing every new technology trend without a clear link to foundational gaps. Second, set an agenda around a few non-negotiables: robust identity, minimum data standards, core workflows, clear payment rules, and strong governance. Third, measure progress on these basics with as much pride as we announce new pilots. A quiet improvement in data completeness can be more powerful than a loud announcement about another app. 

The digital future of healthcare is still within reach. It will not arrive all at once, and it will not be delivered by technology alone. It will be built step by step, as we strengthen the rails beneath the systems we dream about. When we take the basics seriously, everything else becomes more possible, more trustworthy, and more human.