The Strategy of Health

Creating an effective digital health strategy with Ajay Singh, MBA, Chief Commercial & Strategy Officer at Quality Reviews

By: The American Journal of Healthcare Strategy Team | Dec 12, 2024

Introduction: Why Digital Health Strategy Matters More Than Ever

In today’s healthcare environment, digital health strategy is no longer a “nice to have”—it’s the cornerstone of organizational survival and growth. Executive leaders face unprecedented challenges: evolving patient expectations, financial constraints, regulatory shifts, and a flood of new technologies. But the stakes aren’t just operational—they’re existential. As Ajay Singh, MBA, Chief Commercial & Strategy Officer at Quality Reviews, puts it: “Everything you knew about digital health and patient engagement changed in March of 2020… we came to a new world where everyone was back to ground zero.”

This week’s episode of The Strategy of Health podcast features a candid, deep-dive conversation with Ajay Singh, whose career spans the clinical, advisory, and digital health startup worlds. He’s helped guide more than 30 health systems and 22 million patients through the evolving digital health landscape, and his pragmatic insights are essential reading for healthcare executives navigating the intersection of technology, strategy, and care delivery.

From Biochemistry to Boardroom: Ajay Singh’s Unconventional Journey to Healthcare Strategy

How did Ajay Singh transition from science to healthcare leadership, and why does his path matter to today’s leaders?

Ajay Singh’s story isn’t the straight-line journey most would expect from a chief commercial officer at a major digital health firm. “I went to college… with zero idea what I wanted to do,” he admits. “I kind of took the advice of my parents that college is where you go figure it out.” After earning a biochemistry degree from Case Western Reserve University, Singh confronted a pivotal decision: medical school or something broader.

What changed his mind? A senior-year public health course. “Dr. Scott Frank was saying things like access, health equity, social determinants of health—before it was cool to say it,” Singh recalls. That class, coupled with the implementation of the Affordable Care Act, made Singh realize he could “affect massive change at a granular level” outside traditional clinical medicine.

His early career in hospital operations and consulting at The Advisory Board Company deepened his perspective. “There was a gap in tying extremely bright clinical people to truly efficient operating people,” Singh notes, “two wheels on the same track but running at different speeds or directions.” His work evolved into digital health, driven by a belief that “there’s way too much opportunity on the industry, administrative, and operational side” to be ignored.

Key Takeaways:

  • Healthcare leaders can—and often should—come from nontraditional backgrounds.

  • Early exposure to system-level problems helps cultivate a strategic mindset.

  • Interdisciplinary experience (clinical, advisory, tech) is increasingly valuable in healthcare leadership.

The Digital Health Revolution: Patient Engagement at Scale

What makes digital health strategy crucial for engaging patients—and what’s different about today’s landscape?

Digital health isn’t just about slick apps or AI-powered chatbots. At its core, it’s about engagement—bridging the distance between providers and patients throughout the care journey. Quality Reviews, where Singh serves as Chief Commercial & Strategy Officer, exemplifies this philosophy. “We offer a platform that allows providers, payers, and value-based care organizations to deploy automated, customized, and personalized workflows… outbound to patients, caregivers, family members, to allow them to stay engaged across the care journey,” he explains.

With 22 million patients already using the platform and more than 30 health systems on board, Quality Reviews is more than a vendor—it’s an industry barometer. Singh sees 2024 as a turning point: “The strategy of today for a healthcare organization is get back to basics. 2020-2023 brought a litany of new problems. 2024, we’re finally normalizing… but the problems are the same. It’s not a new set.”

Critical Points:

  • Digital health is now fundamental to meeting patient engagement and operational goals.

  • “Back to basics” doesn’t mean old thinking; it means refocusing on real, persistent challenges.

  • Scale matters: platforms serving tens of millions of patients set new standards for the industry.

Bridging the Divide: Aligning Clinical and Operational Priorities

How do you align clinicians and administrators when their priorities (and languages) often clash?

One of Singh’s central themes is the “gap in tying extremely bright clinical people to truly efficient operating people.” This is a leadership challenge that technology alone cannot fix. “It’s like talking two different languages… two wheels on the same track but running at different speeds or directions,” he says.

How do you solve this? Singh’s answer is both philosophical and tactical:

  1. Meet clinicians where they are. “Even the act of calling a physician to your office to talk to them is already setting up failure. You have to actually meet them,” Singh advises.

  2. Build multidisciplinary, not just multidepartmental, teams. “You have to find people that represent leadership as well as the front line. If you’re going to bring IT, don’t just bring your VP. Bring the applications person, the senior data analyst. Bring top to front line for all departments.”

  3. Let passion surface. “If a physician is asking questions, pushing back, seems disgruntled—you have the best physician champion right there. The physician that doesn’t want to talk, that’s the problem.”

Ajay Singh’s Top Recommendations:

  • Avoid top-down mandates without engagement.

  • Include both leadership and practicing clinicians in digital strategy committees.

  • Allow a “venting” period—“Give yourself a solid month”—to surface genuine issues before forming solutions.

From Vision to Execution: Building a Real Digital Health Strategy

What concrete steps should leaders follow to develop and implement a successful digital health strategy?

Ajay Singh lays out a step-by-step playbook, distilled from years advising health systems and launching digital health tools. Here’s the core framework he recommends:

  1. Tie strategy to patient engagement first.
    “Your digital health strategy has to be tied to patient engagement—that’s the first goal.”

  2. Identify key patient populations.
    Focus on the top groups you serve or where revenue/outcomes matter most.

  3. Map the patient journey.
    Typically, Singh suggests breaking it into five stages:

    • Discoverability

    • Booking care

    • Diagnosis

    • In-care insights

    • Follow-up at home
      “If you’re looking at oncology, it may be different, but start with five.”

  4. Find the gaps.
    For each stage and population, ask: Where do we have gaps? Are they due to lack of people or inefficiencies despite resources?

  5. Decide on the type of scaling needed.

    • Are you trying to automate, augment, accelerate, optimize, or deflect?

  6. Select solutions accordingly.
    “Lean toward products that can solve multiple challenges at a time, but recognize that no one vendor will be the only solution.”

  7. Reduce disconnection, not just among patients but workforce, too.
    “The theme of disconnected—where do patients feel disconnected? Where does the workforce feel disconnected? Will this solution solve those challenges?”

Sample Workflow for Digital Health Strategy:

  • Step 1: Are we pursuing broad transformation or quick wins?

  • Step 2: Root all decisions in patient engagement.

  • Step 3: Define populations, map journeys, spot gaps.

  • Step 4: Categorize gaps: people vs. process vs. tech.

  • Step 5: Decide: Automate? Augment? Optimize? Deflect?

  • Step 6: Evaluate tools: platform vs. point solution.

  • Step 7: Test for patient and workforce connection before implementation.

Singh’s warning: “You are not going to live in a world where you have one vendor. Sorry to tell every IT or finance person—that’s not going to be the solution you have.”

Governing for Success: Redesigning Digital Health Committees

Why do so many governance committees fail, and how should they be structured instead?

Healthcare’s love-hate relationship with governance committees is well known. Singh’s take? “So many governance committees have failed because we’re still stuck to 2010’s DNA of what a governance team should be… 15 years later, we’ve got to change that mentality.”

What Works in 2024:

  • Multidisciplinary leadership:
    Every digital health governance team must have *at least two leads: a clinical leader and a digital/IT leader—*with equal authority and mutual respect.

  • Inclusion from the front lines:
    “Not just someone with an MD, but people who are actually nurses, practicing technicians, and operational staff.”

  • Defined mission:
    “Are we thinking about larger strategy to affect the entire health system or just quick wins?”

  • Financial realism:
    Strategies must be matched to real budgets, not wishful thinking.

Sample Committee Composition:

  • Chief Digital Officer (or equivalent)

  • Practicing clinician (not just medical degree holders)

  • Senior IT/data analyst

  • Frontline nurse or technician

  • Administrative representative (e.g., revenue cycle, access)

  • C-suite sponsor (e.g., COO, CFO, CMO)

Overcoming Resistance: How to Engage Physicians and Nurses in Digital Health Initiatives

What’s the secret to winning buy-in from skeptical clinicians and staff?

Ajay Singh doesn’t sugarcoat the challenge: “Engaging clinicians—whether physicians or nurses—is always a challenge, but it’s a good challenge.” His methods are rooted in respect and realism:

  • Meet in their environment. Don’t drag busy clinicians into conference rooms—go to them.

  • Listen for passion. The most vocal critics often become the most effective champions.

  • Allow a storming phase. Give everyone time to express frustrations before asking for solutions.

  • Data matters—but don’t oversell. “Data is only as good as what you put into it. Show it, but respect where they’re coming from.”

Most importantly, Singh believes in surfacing shared goals: “At the end of the day, coming together to talk about a common goal is the biggest problem to begin with.”

Steps to Engage Frontline Staff:

  1. Physically meet clinicians and staff where they work.

  2. Identify and empower passionate voices (even dissenters).

  3. Build in a formal “venting” period.

  4. Anchor strategy in solving real, frontline “up at night” issues.

  5. Use governance structures that elevate clinical and operational leaders equally.

Measuring Success: What Makes Digital Health Solutions Stick?

How do you ensure technology adoption drives real results—not just a flashy demo?

Singh cautions against focusing only on ROI: “If you’re a technology company that has any value, you should be generating ROI. But that’s not enough anymore… it’s how are you able to configure, customize, and make your tool flexible to fit into the client’s world.”

He shares an example: Quality Reviews recently launched an inpatient rounding tool at a multi-hospital health system. “The question has come up: what is the best response time for someone at the hospital to respond to this request? Every hospital is going to be different. Every unit is going to be different during day vs. night. We’ve put that on ourselves to change workflows for all those use cases.”

Key Success Metrics for Digital Health Solutions:

  • Configurability to diverse workflows and units

  • Integration into existing EHR and operational systems

  • Reduction in “alert fatigue” and unnecessary logins

  • Measurable impact on patient engagement and satisfaction

  • Evidence of workforce (not just leadership) buy-in

Actionable Takeaway: Get Real, Get Engaged, Get Results

What’s the bottom line for healthcare leaders developing a digital health strategy today?

Ajay Singh’s journey and experience deliver a clear, actionable message: Digital health strategy is about more than technology. It’s about aligning people, processes, and tools around real patient and workforce needs. “We’ve come to this part where a lot of what we do is try to help people formulate their strategy before we even start talking about our product… and I think that’s really where the gap is right now in the market.”

For executives, that means:

  • Start by defining real patient populations and mapping their journeys.

  • Build teams that are truly multidisciplinary—and truly representative.

  • Prioritize connection: patient-to-system and workforce-to-workforce.

  • Avoid top-down dictates; let the passionate critics lead.

  • Focus on flexibility, configurability, and long-term integration, not just ROI.

By following these principles, healthcare organizations can ensure their digital health strategies deliver the results patients and staff actually need—and build a culture of innovation that lasts.