But in practice, many of these projects prove to be bogged down by a difficult foundation: fragmented infrastructure, complex supply chains, and unclear management. Technologically, much is possible, but without control over data, access, and infrastructure, the promise of innovation remains just that—a promise.

What's missing is digital autonomy: the ability to determine where data is stored, who has access, and how technology is used. This isn't a conscious decision, but rather a consequence of organically developed systems, dependencies, and postponed decisions. In this article, we'll outline some recognizable symptoms. How do you, as a director or IT manager, notice that control is lacking?

Many healthcare organizations don't know exactly where their data is located or which legislation applies to it. Data floats between internal servers, external applications, and public cloud environments. In 2024, the Dutch Data Protection Authority reported that healthcare once again topped the data breach statistics with nearly 7.000 reports. A large portion of this is due to ambiguities and fragmentation. As long as data sovereignty is lacking, every new digital leap remains a leap into the unknown.

With the arrival of NIS2, compliance with laws and regulations is becoming more imperative than ever. Healthcare institutions must report incidents more quickly, demonstrably increase digital resilience, and report more effectively. When compliance feels like putting out fires or checking off checkboxes in an audit rather than an integrated part of digital policy, we can't speak of governance. Digital autonomy ensures that you can proactively fulfill these obligations yourself, rather than reactively and at high costs.

Innovation demands close collaboration between systems and suppliers. But if supply chains aren't properly integrated, or data is locked up in proprietary platforms, every new project becomes a struggle. Pilot projects fail, implementations take years, and healthcare professionals are primarily faced with additional administrative burdens. Autonomy means making your own choices, being able to switch independently, and enforcing interoperability.

The recent data breach during the population survey demonstrates the significant impact on trust and continuity. When organizations rely on external parties for recovery or decision-making, an incident leads to paralysis instead of action. With proper digital autonomy, you have the control to respond adequately and restore processes and data securely.

There's a world of opportunities in AI, for example, to reduce administrative burdens or support faster diagnoses. At the same time, there's a certain reluctance to use AI because it's unclear where data ends up or how the models are trained. This hinders innovation and results in missed opportunities. With digital autonomy, AI becomes a safe and reliable tool.

Digital autonomy requires choices: control over data processing, storage, and access, transparency in supply chains, and an infrastructure that is agile and robust enough to continue supporting legislation and technology. A sovereign cloud environment can form the foundation, but it all starts with awareness.

Digital autonomy is a management choice that can no longer be ignored. It determines whether a healthcare organization directs innovation itself or remains dependent on external agendas. Those who fail to make a decision now risk relinquishing control – and thus the future sustainability of their healthcare organization.