Digital Health Transformation and Organizational Performance in Healthcare Systems: The Mediating Role of Digital Leadership

MohammadHadi Jalali

Authors

MohammadHadi Jalali Medical School, Isfahan University of Medical Sciences, Isfahan, Iran Corresponding Author https://orcid.org/0009-0003-1909-0560

Keywords:

Digital Health Transformation, Digital Leadership, Organizational Performance, Healthcare Systems, Healthcare Management, Structural Equation Modeling

Abstract

This study aimed to investigate the effect of digital health transformation on organizational performance in healthcare systems in Tehran and to determine the mediating role of digital leadership in this relationship. This applied, quantitative, cross-sectional correlational study was conducted among managers, supervisors, health information technology personnel, clinical coordinators, and professional administrative and clinical-support employees working in public and private healthcare organizations in Tehran, Iran, in 2026. A total of 420 questionnaires were distributed, of which 384 valid questionnaires were retained for analysis. Data were collected using a structured questionnaire assessing digital health transformation, digital leadership, and organizational performance on five-point Likert scales. Content validity was evaluated by academic and professional experts, while construct reliability and validity were assessed using Cronbach’s alpha, composite reliability, average variance extracted, and the heterotrait-monotrait ratio. Data were analyzed using SPSS version 27 and SmartPLS 4. Partial least squares structural equation modeling and bootstrapping with 5,000 resamples were applied to test direct and indirect effects. Digital health transformation had a significant positive effect on digital leadership (β = 0.684, t = 17.538, p < 0.001) and organizational performance (β = 0.268, t = 5.255, p < 0.001). Digital leadership also significantly predicted organizational performance (β = 0.531, t = 11.298, p < 0.001). The indirect effect of digital health transformation on organizational performance through digital leadership was significant (β = 0.363, t = 8.854, p < 0.001), confirming complementary partial mediation. The total effect of digital health transformation on organizational performance was β = 0.631 (p < 0.001). The model explained 46.8% of the variance in digital leadership and 60.3% of the variance in organizational performance. Digital health transformation significantly improves organizational performance both directly and indirectly through digital leadership, indicating that healthcare organizations can achieve greater performance gains when technological transformation is accompanied by strong leadership capabilities that facilitate digital adoption, innovation, and strategic integration.

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References

1. Richards TC, Han J, Ahmed-Kristensen PS. State-of-the-Art Technologies for the Digital Transformation of Healthcare Services – A Systematic Scoping Review. 2026. doi: 10.21203/rs.3.rs-8958823/v1.

2. Krotkiewicz M, Szynkaruk A, Stachyra A. Digital transformation in healthcare management: from artificial intelligence to blockchain. Wiadomości Lekarskie. 2025:578-83.

3. Maack K, Gillberg N, Wikström E. Adjustmentalisation – Digitalisation as Transformation Process and the Interplay Between a Digital Logic and Diverse Primary Care Logics in Sweden. Journal of Health Organization and Management. 2025. doi: 10.1108/jhom-07-2024-0281.

4. Dahal MK, Kreps GL. Bridging the Digital Divide: Examining the Role of Digital Health in Nepal's Healthcare Transformation. World Medical & Health Policy. 2026;18(1). doi: 10.1002/wmh3.70057.

5. Basheer Se. Artificial Intelligence in Human Resource Management: Opportunities for Digital Transformation and Administrative Performance Improvement Among Employees in the Palestinian Health Sector. 2026. doi: 10.21203/rs.3.rs-9666254/v1.

6. Swan EL, Peltier JW, Dahl AJ. Artificial Intelligence in Healthcare: The Value Co-Creation Process and the Influence of Other Digital Health Transformations. Journal of Research in Interactive Marketing. 2024;18(1):109-26. doi: 10.1108/JRIM-09-2022-0293.

7. Rahmani N, Naderi Nasab M, Taheri M, Biniaz SA. The Future of Sports Industry: AI and Economic Transformations. AI and Tech in Behavioral and Social Sciences. 2024:19-29.

8. Mauro M, Noto G, Prenestini A, Sarto F. Digital transformation in healthcare: Assessing the role of digital technologies for managerial support processes. Technological Forecasting and Social Change. 2024;209:123781.

9. Umoren J, Ajayi-Kaffi O, Kaiser F. An analytical framework for digital transformation in healthcare product supply chains. International Journal of Science and Research Archive. 2025;14(1):1920-30. doi: 10.30574/ijsra.2025.14.1.0190.

10. Kabra G. Determinants of Blockchain Adoption and Organizational Performance in the Healthcare Sector in India. American Journal of Business. 2023;38(3):152-71. doi: 10.1108/ajb-12-2022-0206.

11. Arofah U, Hakim MS, Alfarizi M. Capital Efficiency and Organizational Performance: A Dynamic Panel Analysis of Weighted Average Cost of Capital (WACC) and ROA in Indonesia’s Healthcare Sector. Journal of Applied Sciences in Accounting Finance and Tax. 2025;8(1):26-40. doi: 10.31940/jasafint.v8i1.26-40.

12. Lee SN. Examining the Impact of Organizational Culture and Risk Management and Internal Control on Performance in Healthcare Organizations. Advances in Management and Applied Economics. 2024;14(1):1-4.

13. Mosadeghrad AM, Parsaeian M, Hedayati P. Organizational culture of hospitals affiliated to Tehran University of Medical Sciences. payeshj. 2023;22(4):375-85. doi: 10.61186/payesh.22.4.375.

14. Darabi N, Zahedi M, Sarkhosh SMH. The effect of job satisfaction, employee motivation and organizational culture on improving the performance of hospital employees in the first district of Tehran during the Corona era, emphasizing the role of information technology. Journal of Healthcare Management. 2024;15(1):29-38.

15. Putranti HRD, Sulistiyani S. Leading the Digital Revolution Examining the Impact of Digital Leadership on Work Performance and Organizational Commitment in the Kawasan Industri Mitra (KIM). Jurnal Manajemen Industri Dan Logistik. 2024;7(2):308-19. doi: 10.30988/jmil.v7i2.1257.

16. Qiao G, Li Y, Hong A. The Strategic Role of Digital Transformation: Leveraging Digital Leadership to Enhance Employee Performance and Organizational Commitment in the Digital Era. Systems. 2024;12(11):457. doi: 10.3390/systems12110457.

17. Shin J, Mollah MA, Choi J. Sustainability and organizational performance in South Korea: The effect of digital leadership on digital culture and employees’ digital capabilities. 2023.

18. Muis I. The Effects of Knowledge Management, Digital Leadership and Organizational Culture on Employee Performance. Sjam. 2025;3(1):1-16. doi: 10.38035/sjam.v3i1.411.

19. Haris A, Nuraeni N. Adaptive Leadership in the Era of Disruption: Integrating Digital Transformation, Organizational Culture, and Teacher Performance (A Case Study of Muhammadiyah High Schools in Cianjur Regency). Dinasti International Journal of Education Management and Social Science. 2025;6(2):1649-61. doi: 10.38035/dijemss.v6i2.3961.

20. Arabiun A, Tajpour M, Zahedi MR. The effect of digital leadership on the performance of businesses: the mediating role of organizational entrepreneurship. International Journal of Human Capital in Urban Management. 2024;9(1):17-28.

21. Mahmood G, Khakwani MS, Zafar A, Abbas ZK. Impact of Digital Transformation and AI Through Fostering Digital Leadership Excellence: A Focus on Sustainable Organizational Performance. Journal of Accounting and Finance in Emerging Economies. 2024;10(1). doi: 10.26710/jafee.v10i1.2925.

22. Widodo SD, Winarno A, Saragih R, Puspitasari D. The Influence of Digital Leadership and Organizational Culture on Employee Performance: The Mediating Role of Digital Transformation. International Journal of Economics Business and Management Research. 2024;08(09):272-87. doi: 10.51505/ijebmr.2024.8916.

23. Shahzad MA, Chen S, Wang X, Li Z, Iqbal T. Impact of GHRM and Innovation Capabilities on Organizational Performance: The Role of Digital Transformation and Green Leadership. Journal of Manufacturing Technology Management. 2025:1-28. doi: 10.1108/jmtm-11-2024-0639.

24. Alhakimi W, Sallam F. Strategic leadership practices and organizational performance at healthcare organizations: The mediating role of crisis management. International Journal of Business Performance Management. 2025;1(1). doi: 10.1504/IJBPM.2025.10062184.