Best Practices in Organizing Digital Transformation: Qualitative Case Study in Dutch Hospital Care

The health care sector faces increasing pressure, with demand outpacing supply and multiple challenges in accessibility, affordability, and quality. The current organization of health care systems is unsustainable-exacerbated by labor shortages and escalating expenditures in Europe, particularly the Netherlands. To address these issues, hospitals are increasingly adopting digital transformation strategies. This digital transformation involves the systematic implementation of digital technologies and processes. To achieve high-quality hybrid care, hospitals must integrate digital health care seamlessly into existing workflows. However, there is no definitive strategy for implementing these transformations.

This study examines how Dutch hospitals organize their digital transformation, the strategies they employ, and the best practices they follow, to provide evidence-based recommendations for hospitals embarking on similar initiatives.

A qualitative multicase study was conducted using purposive sampling. A total of 11 Dutch hospitals were invited, and 8 participated. Professionals-project or program managers of digital care, or advisors in policy, management, strategy, or related positions-from these hospitals took part in semistructured interviews. Topics included digital transformation strategies, organizational structures, barriers and facilitators, and lessons learned. All interviews were recorded, transcribed verbatim, and analyzed using directed content analysis.

Although hospitals organize their digital transformation in different ways and with different teams or departments, they encounter similar facilitators and barriers. Inspired by the Consolidated Framework for Implementation Research, the ExpandNet Scaling Up framework, and the Hybrid Health Care Quality Assessment, these factors were grouped into the following categories: the structure of the digital program, cultural factors within the organization, financial factors (internal or external), political factors (internal or external), patient needs, resources and skills, and technical factors.

Despite variations in implementation, hospitals share key challenges and enablers in digital transformation. Common factors-such as organizational culture, financial resources, and technical infrastructure-may serve as foundational elements for effective digital transformation in hospital care.