Membership› CHIEF Executive Forum› Report from CHIEF Executive Forum Fall25 Symposium

The Fall25 CHIEF Executive Forum Symposium in Toronto on October 1 brought together leaders from across healthcare, government, and industry to explore how to lead people and technology through ongoing system change.

From the opening remarks, there was a sense of optimism, purpose, and a shared commitment to making progress. The conversations reflected a shift from managing disruption to leading deliberate, system-level change, with a renewed focus on leadership, governance, and culture as the foundations for transformation. Sessions included:

From Vision to Action: Leading People and Technology Together

Leadership, workforce capacity, and organizational culture emerged as the foundation for everything discussed throughout the day. While executive turnover remains high (often within two to three years), participants agreed that stability and optimism are returning. The “climate check” word cloud said it all: impactful, dynamic, challenging, up and down—a noticeable shift from last year’s chaotic and stressful. Optimism is returning, and so is the focus on leadership as a learned and practiced discipline.

Yet one theme persisted: leaders haven’t always been taught how to lead in today’s environment. Some organizations continue to tighten training budgets, while others are doubling down on leadership development. The consensus: investing in people is the most strategic technology decision organizations can make. Participants also reinforced that effective change leadership depends on trust and communication. Change takes time, but transparency and engagement are what sustain it.

Being right is not enough. Leadership is about bringing others along.

Sticky Issues: Scaling, Procurement, and Skills

Following brief panel insights, attendees broke into lively table discussions to explore one of three long-standing challenges — each requiring a combination of creativity, collaboration, and practical problem-solving.

  1. Scaling without fragmentation – How can Canada sustain innovation without losing system cohesion? Groups agreed that alignment, not uniformity, is the goal. There was strong support for developing national standards that enable interoperability while allowing for regional flexibility. Several participants urged Canada to look internationally for lessons on scaling, data sharing, and system integration, with a clear call to adopt what works rather than reinvent locally. Key reflections included: True scale depends on shared standards and a willingness to adapt them locally; National data governance must enable, not constrain, collaboration across jurisdictions; Canada should leverage proven models from other countries that balance local autonomy with national coordination.
  2. Innovation to inertia – As always, procurement is a focal point and a friction point. Leaders spoke candidly about complex, shifting processes that discourage innovation and transparency. Attendees shared strategies for progress: engage procurement teams early, co-design requirements, build relationships with vendors, and bring patients and clinicians into the process. Procurement done well, members agreed, is a relationship, not a transaction. Key reflections included: Procurement must be viewed as part of innovation, not an obstacle to it; Early engagement between vendors, clinicians, and procurement teams leads to better outcomes and accountability; Clearer communication, transparency, and documentation across cycles will build trust and consistency.
  3. Educating for the future – Education discussions highlighted a structural gap in Canada’s approach to digital and clinical informatics training. Participants noted the absence of a formal medical informatics specialty, the need for AI literacy at every level, and limited exposure to digital tools during professional education. They called for national frameworks and stronger alignment between regulators, educators, and healthcare organizations.Another important insight that surfaced was the impact of generational differences on technology adoption. Participants noted that comfort levels and learning styles with digital tools can vary widely across age groups, from digital natives eager to experiment to experienced clinicians who value structured, hands-on learning. Acknowledging and addressing these differences through tailored training and support was seen as key to ensuring equitable and effective adoption across the workforce.

Training is not just about skill, it’s about retention, confidence, and keeping our best people engaged.

Key reflections across all discussions:

Across all three topics, one idea rang loud and clear: collaboration must replace competition across sectors and jurisdictions. “

If we don’t work together, none of us will succeed.

Hot Takes & Humble Lessons: Straight Talk on Leadership

This session captured the essence of the CHIEF Executive Forum: authentic, executive-level reflection under Chatham House rules. It created space for members to share the personal experiences that have shaped their leadership in complex environments. The discussion moved beyond organizational updates to the personal side of leadership: when to take a risk, when to admit a mistake, and how to lead with both conviction and humility. Participants reflected on the balance between bold action and thoughtful engagement, speaking candidly about what it takes to navigate uncertainty and lead change when the outcome isn’t guaranteed. Themes of self-awareness, reflection, and transparency carried through. Leaders agreed that success in digital transformation depends as much on empathy and adaptability as on technical competence.

Presentations included Reading the Signals: AI in Action, in which findings were shared from Canada’s first national Clinical AI Scan, documenting 151 verifiable AI initiatives across the country. Live polling revealed that members are seeing AI most often in scribes and chatbots. Fear and lack of funding remain the biggest barriers. Panelists encouraged measured experimentation over hesitation, emphasizing that:

The key message: AI is a tool, not a destination. Healthcare leaders must decide where and how it adds real value and have the courage to pause where it does not.

What Members Told Us

I live survey of CHIEF Executive Forum members in attendance reaffirmed that CHIEF’s value lies in its focus, format, and trust.

Beyond the numbers, members reaffirmed CHIEF’s purpose as a trusted, executive-level network and a place for candid dialogue among senior decision-makers driving digital transformation at scale. Comments highlighted the need to maintain CHIEF’s balanced public-private composition while clarifying its boundaries within Digital Health Canada’s broader community. Participants also expressed strong support for interactive, in-person engagement formats that balanced structured dialogue with unstructured networking, debates, or deep-dive sessions. Collectively, the results of this survey underscore CHIEF’s role in shaping national digital health priorities, informed by global perspective and grounded in authentic, peer-to-peer exchange.

Looking Ahead

Three themes emerged from the day:

  1. Collaboration
  2. Leadership and learning
  3. Trust.

Members want CHIEF to remain executive-level, nationally focused, globally informed, and anchored in authentic leadership dialogue.

The Fall25 Symposium reaffirmed what makes this community unique: CHIEF is a network that learns out loud, challenges respectfully, and leads with purpose. Next steps are already in motion. Planning for the Spring26 Symposium in progress, with a focus on building on the momentum and insights from Fall25. The Clinical AI Working Group will reconvene to continue advancing discussions on responsible implementation, and submissions are open for new working group topics. Take this opportunity to shape upcoming priorities and cross-sector collaboration areas—contact chief@digitalhealthcanada.com with your topic suggestions.

As CHIEF moves toward 2026, the emphasis remains clear: sustain the candour, deepen collaboration, and continue shaping Canada’s digital health leadership agenda together. CHIEF continues to stand apart as a trusted environment for candid, respectful conversations grounded in shared experience, where leaders learn from each other, exchange perspectives, and strengthen their collective capacity to lead.