Code Hack:
Everyone Is an Innovator
Program Design
Digital Transformation
Brand & Campaign
Annual health hackathon innovation series that brought frontline and patient voices into system-level problem solving.
Who gets to innovate in health care and how do they do it?
The people closest to care see problems and possibilities every day. The question was how their ideas could matter and how a regulated health system could be transformed from within.
Island Health is a regional public health authority serving 850,000 residents and employing more than 30,000 people across Vancouver Island and the surrounding coastal communities. That scale and complexity means there is structural distance between the people who make decisions, the people who deliver care, and patients.
Before the pandemic, innovation was a word I would see in org strategies and repeated in emails. Executive clearly signalled that innovation was needed to improve patient outcomes. What was not clear was how you actually innovate and who got to do it. There was no dedicated innovation department. No platform, no process, no clear pathway, and no dedicated budget.
In my role as the Director of Brand, Digital Engagement and Innovation, I had a vision to bring a cost-neutral, health-focused hackathon into the organization as a structured platform for collaboration, one that placed frontline voices and patients at the centre of system-level problem solving. Together with a talented crew of nurses, designers, clinicians, and organizers, we conceived the model of turning problems into possibilities, pitched it to executive, and built Code Hack from the ground up.
A healthcare hackathon for all
Code Hack ran annually at the Royal Jubilee Hospital, drawing up to 100 participants and dozens of volunteers, alongside sponsors, academic partners, and community organizations.
The hackathon was a fun, intense 24-hour event where qualified teams of staff, patients, physicians, industry experts, designers, and students competed against the clock and each other to solve the most challenging health problems.
Guided by the principles of courageous innovation, strong partnerships, excellence, and the belief that we are better together, the event gave teams the space, tools, and guidance to pitch real health problems and prototype solutions. Winning teams received cash prizes and six months of Innovation Lab support to continue refining their prototypes with mentors and community partners.
Teams were built using a colour-coded role system: Patient, Builder, Ally, Frontline, and Designer. Every team was required to include one of each. No team could form without lived experience alongside technical and clinical expertise.
The measure of success was not whether a prototype reached implementation, but whether the right people had been given the conditions to surface an idea worth pursuing. Across five years, the range of problems participants chose to tackle reflected the breadth of the program's clinical, social, and systemic reach. Selected prototypes include:
- First Nations medication access: An AI mobile app helping First Nations patients and pharmacists navigate medication coverage through BC's Plan W. Team FNRx.
- Hospital food waste: A system redirecting excess food from hospital kitchens to discharged patients at risk of malnutrition. Team Surplus for Purpose.
- Fentanyl detection: A discreet rapid-detection device built on existing strip technology. Team Fenta-Nil.
- Remote eye care and early diabetes detection: Bluetooth-connected kits enabling eye scans in vulnerable communities with data routed to specialists. Team Zero Blindness.
- Patient dignity: A bedside hygiene solution centred on dignity as the design principle. Team Ergo.
Matthew mentoring a team at Code Hack 2024.
Prototype. Build. Ship.
The security and privacy conditions inside a health authority, like most regulated environments, prevents staff, other organizations, and the public from collaborating in a shared digital space. Code Hack had to solve that problem right from the start.
Building a digital platform that could bring both communities together in a secure environment, manage innovation intake, protect participant intellectual property, support pre-event voting, and run a live event required the same iterative thinking the hackathon itself was built on. It took three iterations and everything we learned running the event to build a cost-effective platform that could be repurposed in any regulated or private-sector environment.
| Code Hack Platform Capabilities | 2019 & 2020 Prototype Event Portal | 2023 & 2024 Custom Build Community Forum + Jira Service Manager | 2025+ Production Platform Cloud Platform + Jira Service Manager |
|---|---|---|---|
| Participant registration | |||
| Automated communications | |||
| Challenge participant portal | |||
| Community voting | |||
| Live event display | |||
| Admin & data tracking | |||
| Dedicated event website |
An Open Invitation to Improve Health Care
I've described Code Hack as what happens when you take Dragon's Den and a 24-hour science camp for adults and host it in a hospital. The challenge was extending that invitation to people who had never been included in an innovation process before. These two event promos show how that call evolved from 2019 to 2025.
Fun. Collaborative. Inclusive.
Code Hack took place in person over a 24-hour period at the Royal Jubilee Hospital in Victoria, BC from 2019 to 2025.
A Coalition of Partners
Code Hack started with 0% budget, 100% goodwill. From the first event, the model depended on sponsors who understood that putting their name on a health care hackathon meant something different than a typical sponsorship.
Meaningful improvement in a health system is an all-in effort. Over five annual events, more than 150 volunteers and 23 sponsors and community partners made the event possible, including enterprise technology companies, health foundations, academic institutions, government bodies, and community organizations. That breadth was necessary and intentional. I am grateful for their trust.
- AWS
- Bayer
- BC Academic Health Science Network
- BC Ministry of Health
- CGI
- Camosun Innovates
- Centre for Interprofessional Clinical Simulation Learning
- Circle Innovation
- Doctors of BC
- Fasken
- Good Earth
- Health Quality BC
- Michael Smith Foundation
- Mural
- Nanaimo & District Hospital Foundation
- Nurses & Nurse Practitioners of BC
- Patient Voices Network
- RT Prime
- Semaphor
- TELUS
- TELUS Health
- UVic Innovation Centre
- Victoria Hospitals Foundation
Built to Evolve
Code Hack ran five events over seven years, including a two-year pause during COVID. Each edition refined the model, building toward a program that could outlast the event itself.
Best Day at Work Ever
Code Hack was designed to be open to everyone. That meant patients who had never been invited into a design process before. Nurses who had ideas but no platform for them. The feedback was immediate.
I love the Code Hack tagline: 'Everyone is an innovator.' We need that now more than ever. Bringing diverse minds together is the way forward and experiencing the energy at Code Hack fills me with hope for the future. Kathy MacNeil · President & CEO, Island Health, 2025
I've wanted to be part of a hackathon for so long, but I've been shut out by academia and by the tech sector because I am a patient. Thank you for doing this.
Patient Participant Code Hack 2019The opportunity to work on healthcare issues with people within the healthcare industries was the most impactful part. As frontline staff I do not get the opportunity to formally work through problems with designers, coders, and other non-healthcare stakeholders.
Frontline Participant Code Hack 2025What works so well is having all the key players on a team, including a patient representative, to provide continuous real-time feedback as the ideas develop.
UVic Innovation Centre Code Hack Sponsor 2025After 23 hours of thinking, creating, designing, building, and presenting a solution to a patient care challenge, it came down to one guiding inspiration for the team who earned the $1,500 first prize from the judges, and the people's choice award from participants: dignity.
Island Health Annual Report Code Hack 2023I strongly recommend Code Hack next year for anyone who wants to innovate in health care or simply wants to understand our system better.
Developer Participant Code Hack 2019The work done on the social media side helped me feel engaged and connected in a positive, meaningful way. I really appreciate this effort and wanted to thank all of those involved for their hard work.
Staff Participant Code Hack 2019Code Hack was a great opportunity for Circle Innovation to participate at the ground level with patients, clinicians, technologists and designers to stimulate innovative thinking and solutions for BC health care. As a non-profit, we build relationships between stakeholders, which is key to health-care innovation. And that's exactly what Code Hack delivered. We're already looking forward to next year!
Circle Innovation Code Hack 2024It's clear you are not just replicating and have to adapt to your local context and generate interest in creating innovation to solve genuine problems that your system's leaders want to have addressed.
Director Interior Health AuthorityThroughout the entire process, starting from sign up to the actual event, I felt very informed, making it a seamless transition from one step to the next.
Participant Code Hack 2025Part of what made this a great Code Hack was that we had a really young demographic. Some of our presenters were from high school. So we're getting young people with good ideas, influencing and being influenced by those who have been in the health-care system for decades.
Event Organizer Code Hack 2024Sources: Event surveys and Island Health publications.
Cited Nationally
Code Hack and the Innovation Lab were cited as a best-practice example in the Government of Canada Nurse Retention Toolkit, connecting frontline innovation programming directly to workforce sustainability. The program also appeared in Island Health's Annual Reports for 2023 and 2024, both board-approved publications.
Strategic Analysis
Code Hack was just one component within a sequence of a larger innovation strategy. I approached the work as building without a blueprint: starting things before the conditions to sustain them existed, trusting the sequence to close the gap. Healthcare is known as a VUCA environment: volatile, uncertain, complex, and ambiguous. Under those conditions I embraced navigating through ambiguity within a network of many nodes. In that shifting environment, I could hold a vision of many outcomes, knowing I could only control or influence one node at a time.
And while I couldn't control end states, I could imagine and design for certain types of failures, shaping when they would occur, how they would unfold, and to what degree. That meant designing and pitching innovative solutions that couldn't be implemented. Yet. That meant initiating an annual event that didn't have any resources to support people or outcomes. Yet. That meant starting an innovation lab without a physical space. Or a budget. Or equipment. Or staff. And yet all of those components fell into place within a planned sequence. In fact, they have all outlasted me, the final node over which I had no control. I am aware of the irony here.
I've created a Wardley map below to show the strategic business impact of Code Hack and how it connected across nodes within a complex health system over time.
Wardley maps are utilized by the UK's Government Digital Service, among others, for strategic planning. They take a user-centred approach by mapping the visible and invisible components of an organization's value chain on the y-axis in relation to their degree of capabilities along the x-axis. In short, Wardley maps measure where capabilities are created, customized, purchased, or utilized by an organization for the benefit of its end users and customers. For the case of Code Hack, the end users were event participants, the health authority itself, and the BC health care system.
This Wardley map shows that Code Hack was not just an event series. It was a platform that generated durable organizational capability (Innovation Culture), external credibility (National Recognition), and a transferable model (Open Outcome Model) from a foundation of genuinely novel enablers. Read it from bottom to top: genesis-stage enablers — patient co-design, frontline voice — fed custom-built program components that, over five years, evolved into commodity outputs adopted beyond Island Health.
Code Hack was built from nothing and evolved into a strategic commodity that was shared with other organizations.
What It Proved
Code Hack demonstrated that a nationally recognized innovation program can be built inside a regulated public health system, funded entirely from the outside, with no existing template.
What Worked
- Community ownership. Volunteers and sponsors built this program alongside us. It was never purely internal.
- Structure enabled creativity. A clear format gave participants confidence to take creative risks. The structure was the permission.
- Cross-sector reach. The partner list spanned government, industry, academia, and community. That breadth was the point.
- Iterative infrastructure. Three generations of platform development produced a cost-effective, secure collaboration tool that can be repurposed in any regulated environment.
What It Taught
- Make it real first. The hardest part is convincing yourself it can exist. Everything else follows from that.
- A pause isn't a finish. The pandemic stopped the event for two years. It came back with more sponsors, more volunteers, and 86.8% of participants saying they'd recommend it.
- Environment shapes behaviour. Healthcare workers showed up on their own time to fix a system that was shutting them out and grinding them down. They left feeling energized. A well-designed environment can turn individual resilience into collective antifragility.
- Make yourself unnecessary. My goal was always to hand off the event and then scaled it. When I was able to have a manager step into a fully funded, independently run lab to keep it going, I knew it had worked.
