This paper reports on the findings of an international case study in which researchers examined two mathematics departments (Canada/UK) in which the sustained use of technology was strategically established in a mathematics degree program. This case study forms part of a larger research initiative which involved an extensive literature review (Marshall, Jarvis, Lavicza and Buteau, 2012) and a national survey of Canadian Mathematicians (Buteau, Jarvis and Lavicza, 2014). Findings from the case study indicate that sustained implementation at the departmental level requires a unique combination of key factors such as: a dedicated core group led by a committed advocate in a position of influence/power; a strong and shared incentive for change; strategic hiring processes; an administration which supports creative pedagogical reform and well-considered risk-taking; and, a continuous and determined revisiting of the original vision and purpose. Significant challenges to implementation and sustained program development, with specific examples, are also discussed.