What determines whether a promising healthcare innovation spreads quickly across an organization, or stalls before it reaches the people who need it most?
Dr. Tom Lee, Editor-in-Chief of NEJM Catalyst, offers a timely and practical answer: the difference may not lie only in the technology itself, but in the strength of an organization’s social capital. Drawing on examples from ambient AI scribes, primary care, and health system leadership, Lee argues that trust, relationships, shared norms, and cross-organizational connections are not “soft” assets. They are strategic infrastructure.
Beyond Technological Innovation
Lee began by acknowledging a theme that had run throughout the Summit: healthcare leaders are focused intensely on technological innovation, from AI to new models of care. But alongside those advances, he pointed to another kind of innovation that is just as important: how organizations are structured, led, connected, and managed.
He used the term “social capital” to describe something familiar to every healthcare leader: culture, relationships, connectivity, trust, teamwork, and respect. But his choice of language was deliberate. By calling it capital, Lee emphasized that these assets should be managed with the same discipline and strategic intent as financial capital.
In complex healthcare systems, innovation rarely spreads simply because it is useful. It spreads when people trust one another, when networks are strong, and when teams are organized in ways that allow learning to move quickly across boundaries. As Lee framed it, social capital is central to solving some of healthcare’s most pressing challenges, from complexity and uncertainty to the dissemination of innovation.
Why Some Innovations Spread Faster
To illustrate the point, Lee turned to the rapid adoption of ambient AI scribes at The Permanente Medical Group, the largest part of Kaiser Permanente. In August 2023, the organization began with a two-week pilot involving just 47 physicians. By the end of that pilot, the results were promising enough that the organization signed a license for 10,000 users. A regional pilot with 3,442 physicians followed soon after, and the technology was then rolled out across thousands of providers.
Lee contrasted that speed with his own experience at Brigham and Women’s Hospital, where he waited much longer to use the same kind of tool. Once he did, he quickly recognized its value. Yet adoption among colleagues remained slower.
For Lee, the contrast was not simply about technology, procurement, or operational readiness. It pointed to something deeper: the social conditions that allow an organization to move from pilot to trust, from trust to adoption, and from adoption to system-wide change.
Managing Social Capital Like a Strategic Asset
Lee argued that healthcare managers should begin to think of themselves as “CFOs for social capital.” Financial capital gives organizations the resources to act. Human capital gives them the expertise to act. But social capital determines how people work together, how they interact with systems and technology, and how quickly they can align around change.
Its currencies are trust, teamwork, high reliability, and respect. These cannot be imported from outside the organization. Money can be raised externally, but no external source can simply give a healthcare system the trust required for frontline teams to adopt change, speak up, collaborate, or spread innovation.
That makes social capital not only strategic, but precious. It has to be built internally, through leadership behaviors, everyday interactions, and the norms that shape how people relate to one another.
Building the Connections That Help Innovation Move
Lee described three essential steps for strengthening social capital: build connections across the network, strengthen those connections, and transmit the right values and norms through them.
He distinguished between two kinds of connections. The first is bonding capital: the deep trust that forms within close teams that work together every day. This is the trust that supports psychological safety, high reliability, and the ability to speak up when something is not right.
The second is bridging capital: the trust that connects people who do not work together every day, or may only meet occasionally. Lee emphasized that this form of connection is increasingly important as healthcare organizations become more complex. Bridging capital allows knowledge, ideas, and innovations to move across departments, institutions, disciplines, and geographies.
In this sense, Lee described FOH itself as a bridging platform: a place where leaders who may only see one another at meetings or on Zoom can still build enough trust to learn from one another, believe one another, and bring new ideas back into their own organizations.
The Adoption Curve Is a Leadership Challenge
Lee closed by connecting social capital to the familiar adoption curve. Innovators and early adopters tend to have broader social networks. They are exposed to more ideas, more examples, and more signals from outside their immediate environment. Later adopters often have narrower networks and interact mostly with people who think and work like they do.
For organizations trying to spread innovation, this matters. If leaders simply allow adoption to happen on its own, change will move unevenly and often too slowly. But if they intentionally bridge gaps between early adopters and slower adopters, they can accelerate learning across the system.
Lee’s message was clear: technology will continue to advance, and most healthcare organizations will have access to powerful new tools. The more durable source of differentiation may be how well organizations are connected internally, how much trust they have built, and how deliberately they use those relationships to move from innovation to impact.
In the end, the future of healthcare may not be shaped by technology alone. It will also be shaped by the strength of the human networks that allow technology to take root.
