Background The increasing frequency of pandemics, and costs of healthcare services requires integrative, efficient and effective health systems.

Aim Describe the framework and distinctive outcomes of the Saudi National Health Command Centre (NHCC). Method: A review was performed to describe the system-based engineering approach utilised to design the Saudi NHCC. This smart centre creates a new model of care delivery which impacts clinical and operational indicators by adopting integrative and interdisciplinary methods to analyse, disseminate, manage, and measure outcomes.

Results The NHCC is structured into four main departments with data integration and real-time data visualisation to allow for rapid assessment of available resources. It’s organised to support technical incubators and empower several initiative. This enhanced the proactive capacity management in the centre and collectively contributed to several favourable outcomes. These included rapidly deploying medical staff and mechanical ventilators during its response to coronavirus disease (COVID-19); bending the curve early of the first wave of COVID-19 resulting in a low mortality rate (<2%); and reducing ICU lengths of stay by 10%, average lead-time of the supply chain from 60 days to 25 days, and surgery waiting times. It also supported the increment bed capacity from 6,000 to10,400, and maintaining the percentage of patients receiving care within 4 hours in emergency departments above 85%.

Conclusion The NHCC replaces the traditional reliance on the subjectivity of information-based processes with actionable data, which helps building fairer systems to tackle structural inequalities in healthcare access and outcomes, eliminating waste, and allocating resources more effectively and efficiently. Importantly, a command centre to healthcare design and delivery creates synergy between people, processes, and technology facilitating substantial improvements in both patient and service outcomes.