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Environmental Dynamics and Digital Transformation in Lower-Middle-Class Hospitals: Evidence from Indonesia

Year: 2026

Type: article

Abstract: Background/Objectives: Digital transformation is increasingly essential for healthcare organizations to improve operational efficiency and service quality. However, in developing countries such as Indonesia, many lower-middle-class hospitals lag due to limited financial, human, and infrastructural resources. This study examines how environmental dynamism—comprising regulatory changes, market pressures, and technological shifts—affects the digital capabilities of these hospitals. Methods: A quantitative, cross-sectional survey was conducted in Class C and D hospitals across Indonesia. Respondents included hospital directors, deputy directors, and IT heads. Data were collected through structured questionnaires measuring environmental dynamism and digital capability using a six-point Likert scale. Reliability testing yielded Cronbach’s alpha values above 0.96 for both constructs. Correlation analysis was performed to examine the relationship between environmental dynamism and digital capability. Results: Findings reveal a weak positive correlation (r = 0.1816) between environmental dynamism and digital capability. Although external factors such as policy regulations and technological competition encourage digital adoption, hospitals with limited internal resources struggle to translate these pressures into sustainable transformation. Key challenges include low ICT budgets, inconsistent staff training, and insufficient infrastructure. Conclusions: The results suggest that environmental change alone cannot drive digital readiness without internal capacity development. To foster resilient digital healthcare ecosystems, policy interventions should integrate regulatory frameworks with practical support programs that strengthen resources, leadership, and human capital in lower-middle-class hospitals.

Source: Healthcare

DOI: 10.3390/healthcare14020182

Authors: Faisal Binsar, Mohammad Hamsal, Mohammad Ichsan, Sri Bramantoro Abdinagoro, Diena Dwidienawati

Institutions: Universitas Muhammadiyah Berau, Binus University

Language: English

Topic: Healthcare Systems and Practices

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDGs: Industry, innovation and infrastructure, Decent work and economic growth, Good health and well-being

Open Access status: gold

Estimated APC paid: $3,258