RT Journal Article SR Electronic T1 Digital innovative healthcare during a pandemic and beyond: a showcase of the large-scale and integrated Saudi smart national health command centre JF BMJ Leader JO BMJ Leader FD BMJ Publishing Group Ltd SP leader-2023-000890 DO 10.1136/leader-2023-000890 A1 Alharbi, Muaddi F A1 Senitan, Mohammmed A1 Mominkhan, Dalia A1 Smith, Sidney A1 ALOtaibi, Maram A1 Siwek, Michal A1 Ohanlon, Tim A1 Alqablan, Fahad A1 Alqahtani, Sarah A1 Alabdulaali, Mohammed K YR 2024 UL http://bmjleader.bmj.com/content/early/2024/07/17/leader-2023-000890.abstract AB Introduction The increasing frequency of pandemics, demand for healthcare and costs of healthcare services require efficient health systems with integrated care via a command centre that ensures a centralised and coordinated approach to exercise effective leadership.Description We present a case study using the conceptual framework of Franklin to describe the novel system-based engineering approach of the Saudi National Health Command Centre (NHCC) including its features and outcomes measured.Discussion The NHCC is structured into four departments and four zones with real-time data integration and visualisation on 88 dashboards. To empower leadership, it harnesses artificial intelligence affordances such as machine learning algorithms to enhance functionality, decision-making processes and overall performance. This allows for the rapid assessment of available resources and to monitor healthcare system efficiency at diverse levels of clinical and system indicators. Enhanced proactive capacity management has contributed to reducing lengths of stay, average supply chain lead time and surgery waiting list; early bending of the COVID-19 curve resulting in a low mortality rate; increasing bed capacity; deploying medical staff and mechanical ventilators rapidly; rolling out the COVID-19 vaccination programme and improving patient satisfaction.Conclusion Integrating a healthcare system with a command centre provides healthcare leaders with the necessary infrastructure to create synergy between people, processes and technologies. This substantially improves both patient and service outcomes. It also allows for immediate care coordination and resource allocations and safeguards ease of access to care.