Abstract
Even though Indonesia has a large number of hospitals and has experienced significant progress in realizing Universal Health Coverage (UHC), service performance is still relatively low, so many patients seek treatment abroad. The performance of services and care systems in hospitals is often associated with low use of digital technology. The complexity of adopting digital technology in a hospital environment is not an easy thing to do, with the majority of users carrying out digital technology functions being health officers and professionals. This research aims to explore the influence of Digital Leadership in encouraging the adoption of digital technology and its influence on Hospital Performance. Survey data conducted on 285 leaders of Class C and D hospitals spread throughout Indonesia, through Structural Equation Modeling (SEM) analysis using Lisrel 8.80, it was found that there was a positive and significant influence on the role of Digital Adoption Capability as a mediation on Hospital Performance. It was found that Digital Leadership has a positive and significant influence on hospital performance both directly and through the mediation of Digital Adoption Capability. Environmental Dynamism factors have also been proven to significantly influence hospital management’s desire to improve performance through the adoption of digital technology. The model resulting from this research provides a comprehensive view of hospital management in developing effective digital technology adoption strategies in facing an ever-changing environment.
References
- 2015). Country perspective on medical tourism: The Malaysian experience. Leadership in Health Services, 28, 1: 43–56, https://doi.org/10.1108/LHS-11-2013-0038. Crossref, Google Scholar (
- 2021). Linking authentic leadership and management capability to public hospital performance: the role of work engagement. International Journal of Organizational Analysis, 29, 5: 1350–1370, https://doi.org/10.1108/IJOA-10-2020-2436. Crossref, Google Scholar (
- 2018). Interest rate and financial performance of banks in Pakistan. International Journal of Applied Economics, Finance and Accounting, 2, 1: 1–7, https://doi.org/10.33094/8.2017.2018.21.1.7. Crossref, Google Scholar (
- 2013). Barriers to adopting electronic health records (EHRs) by physicians. Acta Informatica Medica, 21, 2: 129–134, https://doi.org/10.5455/aim.2013.21.129-134. Crossref, Google Scholar (
- 2022). Digital leadership: Attributes of modern healthcare leaders. Cureus, 14, 2, https://doi.org/10.7759/cureus.21969. Google Scholar (
- 2019). Technology adoption in emerging regions: case of the smartphone in Saudi Arabia. International Journal of Innovation and Technology Management, 17, 1: 2050003, https://doi.org/10.1142/S0219877020500030. Link, Google Scholar (
- 2017). How transformational leadership facilitates e-business adoption. Industrial Management & Data Systems, 117, 2: 382–397, https://doi.org/10.1108/IMDS-01-2016-0038. Crossref, Google Scholar (
- 2017). Interest rate spread on bank profitability: The case of Ghanaian Banks. Journal of Accounting, Business and Finance Research, 1, 1: 34–45, https://doi.org/10.20448/2002.11.34.45. Crossref, Google Scholar (
- 2022). Quality improvement: Understanding the adoption and diffusion of digital technologies related to surgical performance. International Journal of Quality & Reliability Management, 39, 6: 1506–1529, https://doi.org/10.1108/IJQRM-07-2021-0234. Crossref, Google Scholar (
- Appleby, C., Hendricks, J., Wurz, J., Shudes, C., Shukla, M. and Chang, C. (2021). Digital Transformation – From a buzzword to an imperative for health systems. Deloitte Insights. Google Scholar
- 2019). The internal ecosystem of high performance work system and employee service-providing capability: A contingency approach for servitizing firms. Journal of Business Research, 104: 402–410, https://doi.org/10.1016/j.jbusres.2019.02.028. Crossref, Google Scholar (
- 1991). Firm resources and sustained competitive advantage. Journal of Management, 17, 1: 99–120, https://doi.org/10.1177/014920639101700108. Crossref, Google Scholar (
- 1994). Improving Organizational Effectiveness Through Transformational Leadership. Sage Publications, Thousand Oaks, CA. Google Scholar (
- 2022). Impact of digital leadership capability on innovation performance: The role of platform digitization capability. Information & Management, 59, 2: 103590, https://doi.org/10.1016/j.im.2022.103590. Crossref, Google Scholar (
- 2020). Design of cloud computing outpatient registration model through SMS messages at hospitals using TOGAF ADM. International Journal of Recent Technology and Engineering, 8, 5: 3857–3865, https://doi.org/10.35940/ijrte.e4885.018520. Google Scholar (
- 2023). Gamification to grow motivation for interactive engagement of health nurses in using health information systems: A conceptual framework. In Proceedings of Asia Pacific Computer Systems Conference 2021,
Lecture Notes in Electrical Engineering , Vol 978. Springer, Singapore, pp. 99–120, https://doi.org/10.1007/978-981-19-7904-0_10. Crossref, Google Scholar ( - 2000). Designing, implementing and updating performance measurement systems. International Journal of Operations and Production Management, 20, 7: 754–771, https://doi.org/10.1108/01443570010330739. Crossref, Google Scholar (
- 2019). Evolving Digital Leadership: How to Be a Digital Leader in Tomorrow’s Disruptive World. In Evolving Digital Leadership. Forest Lodge, New South Wales, Australia, https://doi.org/10.1007/978-1-4842-3606-2. Crossref, Google Scholar (
- 2020). Theorizing on the normalization of digital transformations. In Proceedings of the 28th European Conference on Information Systems,
Marrakesh, Morocco , pp. 1–17. Google Scholar ( - Christensen, C. M. (1997). The innovator’s dilemma: When new technologies cause great firms to fail, Boston MA: Harvard Business School Press. Available at https://www.hbs.edu/faculty/Pages/item.aspx?num=46. Google Scholar
- 2015). What is disruptive innovation? Harvard Business Review, 93, 12: 44–53, https://hbr.org/2015/12/what-is-disruptive-innovation. Google Scholar (
- CNBC Indonesia (2021). Crazy Rich RI is passionate about the hospital business, what is this phenomenon? Available at https://www.cnbcindonesia.com/market/20210818112433-17-269266/crazy-rich-ri-getol-bisnis-rumah-sakit-fenomena-apa-ini?page=all [accessed on 27 July 2022]. Google Scholar
- 2020). Organizational performance — theoretical and practical approaches; study on students’ perceptions. Proceedings of the International Conference on Business Excellence, 14, 1: 398–406, https://doi.org/10.2478/picbe-2020-0038. Crossref, Google Scholar (
- 2023). System dynamics for E-Health: An experimental analysis of digital transformation scenarios in health care. IEEE Transactions on Engineering Management, 70, 8: 2920–2930, https://doi.org/10.1109/TEM.2022.3194720. Crossref, Google Scholar (
-
Deloitte Indonesia (2019). 21st Century Health Care Challenges: A Connected Health Approach. Deloitte Consultant Indonesia, pp. 1–114. Google Scholar - 1984). Dimensions of organizational task environments. Administrative Science Quarterly, 29, 1: 52–73, https://doi.org/10.2307/2393080. Crossref, Google Scholar (
- Directorate General of Health Care, Ministry of Health (2022). RS Online. Directorate General of Health Care Ministry of Health. Available at http://sirs.yankes.kemkes.go.id [accessed on 22 June 2022]. Google Scholar
- 2022). Building organizational resilience, and innovation through resource-based management initiatives, organizational learning, and environmental dynamism. Journal of Business Research, 141: 808–821, https://doi.org/10.1016/j.jbusres.2021.11.090. Crossref, Google Scholar (
- 1973). Rebel Leadership: Commitment and Charisma in the Revolutionary Process. Free Press, https://doi.org/10.2307/2129344. Google Scholar (
- 2000). Dynamic capabilities: What are they? Strategic Management Journal, 21, 10–11: 1105–1121, https://doi.org/10.1002/1097-0266(200010/11)21:10/11Γ1105::AID-SMJ133ø3.0.CO;2-E. Crossref, Google Scholar (
- 2016). Defining Management: Business Schools, Consultants, Media, Routledge, New York, 1st edn, https://doi.org/10.4324/9781315851921. Crossref, Google Scholar (
- 2019). Analysis of the Effect of Hospital Resources on Patients in Indonesian Hospitals. International Journal of Online and Biomedical Engineering, 15, 10: 121–125, https://doi.org/10.3991/ijoe.v15i10.10870. Google Scholar (
- 2021). Literacy and the workplace revolution: A social view of literate work practices in Industry 4.0. Discourse: Studies in the Cultural Politics of Education, 42, 6: 898–912, https://doi.org/10.1080/01596306.2020.1753016. Crossref, Google Scholar (
- 2021). The mediating role of school environment on the relationship between transformational leadership style and ICT integration in teaching and learning. International Journal of Education and Research, 9, 3: 1–16, www.ijern.com. Google Scholar (
- 2016). Which industries are the most digital (and why)? which industries are the most digital (and why)? Harvard Business Review. Available at https://hbr.org/2016/04/a-chart-that-shows-which-industries-are-the-most-digital-and-why [accessed on 19 June 2022]. Google Scholar (
- 2021). Artificial intelligence for classification of temporal lobe epilepsy with ROI-level MRI data: A worldwide ENIGMA-Epilepsy study. NeuroImage: Clinical, 31: 102765, https://doi.org/10.1016/j.nicl.2021.102765. Crossref, Google Scholar (
- 2017). Culture for a digital age McKinsey & Company. McKinsey, 94, 4: 96–105, https://www.mckinsey.com/business-functions/digital-mckinsey/our-insights/culture-for-a-digital-age. Google Scholar (
- 2022). Talent agility, innovation adoption, and sustainable business performance: Empirical evidence from the Indian automobile industry. International Journal of Productivity and Performance Management, 71, 6: 2582–2604, https://doi.org/10.1108/IJPPM-02-2021-0071. Crossref, Google Scholar (
- 2017). Population healthcare: Designing population-based systems. Journal of the Royal Society of Medicine, 110, 5: 183–187, https://doi.org/10.1177/0141076817703028. Crossref, Google Scholar (
- 2020). Soft skills: A key driver for digital transformation. In 14th International Conference on Digital Society Soft,
Valencia, Spain , 40–43. Available at https://www.researchgate.net/publication/346171713_Soft_Skills_A_Key_Driver_for_Digital_Transformation/citations. Google Scholar ( - 2019b). Multivariate Data Analysis. 8th edn., Cengage Learning, EMEA, https://doi.org/10.1002/9781119409137.ch4. Google Scholar (
- 2019a). When to use and how to report the results of PLS-SEM. European Business Review, 31, 1: 2–24, https://doi.org/10.1108/EBR-11-2018-0203. Crossref, Google Scholar (
- 2019b). Medical visit time and predictors in health facilities: a mega systematic review and meta-analysis. International Journal of Human Rights in Healthcare, 12, 5: 373–402, https://doi.org/10.1108/IJHRH-05-2019-0036. Crossref, Google Scholar (
- 1989). Organizational Ecology, Harvard University Press, https://doi.org/10.2307/j.ctvjz813k. Crossref, Google Scholar (
- Harlow, D. (2018). Health data access regulatory initiatives hold promise, but rollout remains unclear, from Healthcare IT News. Available at https://www.healthcareitnews.com/blog/health-data-access-regulatory-initiatives-hold-promise-rollout-remains-unclear [accessed on 19 June 2022]. Google Scholar
- 2017). Strategic Management: Competitiveness and Globalization. 12th edn., Cengage Learning, Canada. Google Scholar (
- 2020). Industry 4.0 readiness models: A systematic literature review of model dimensions. Information (Switzerland), 11, 7: 1–13, https://doi.org/10.3390/info11070364. Google Scholar (
- 2020). Virtually Perfect? Telemedicine for COVID-19. New England Journal of Medicine, 382, 18: 1679–1681, https://doi.org/10.1056/NEJMP2003539. Crossref, Google Scholar (
- 2021). Change management and digital innovations in hospitals of five European countries. Healthcare, 9, 11: 1–21, https://doi.org/10.3390/healthcare9111508. Crossref, Google Scholar (
- 2012). Handbook of Structural Equation Modeling. eds. S. G. W. David Kaplan and George A. Marcoulides , The Guilford Press, New York, London. Google Scholar (
- 2012). Organizations: Behavior, Structure, Processes. McGraw-Hill. Google Scholar (
- 2018). When titans meet — Can Industry 4.0 revolutionize the environmentally sustainable manufacturing wave? The role of critical success factors. Technological Forecasting and Social Change, 132: 18–25, https://doi.org/10.1016/j.techfore.2018.01.017. Crossref, Google Scholar (
- 2015). An overview of organizational performance index: definitions and measurements. SSRN Electronic Journal, https://doi.org/10.2139/ssrn.2599439. Crossref, Google Scholar (
- 2017). E-leadership case study and the impact of (un)faithful appropriation of technology. In Proceedings of the 5th International Conference on Management Leadership and Governance,
Johannesburg, South Africa , pp. 191–199, Available at https://www.scopus.com/inward/record.uri?eid=2-s2.0-85054287413&partnerID=40&md5=60c84370630239ebb6e9ba7a75d2e6a7. Google Scholar ( - Jöreskog, K. G., Olsson, U. H. and Wallentin, F. Y. (2016). Multivariate Analysis with LISREL. https://doi.org/10.1007/978-3-319-33153-9. Google Scholar
- 2019). How digital leadership is(n’t) different. MIT Sloan Management Review, 60, 3: 34–39. Retrieved from https://www.proquest.com/openview/344afd802ed85d6e1e3268c45af8407b/1?pq-origsite=gscholar&cbl=26142. Google Scholar (
- 2014). Diversification, Industry Dynamism, and Economic Performance, ed. M. Knecht . Springer Fachmedien Wiesbaden, https://doi.org/10.1007/978-3-658-02677-6_4. Crossref, Google Scholar (
- 2023).
Artificial intelligence and digital transformation in healthcare management . In Two Faces of Digital Transformation: Technological Opportunities Versus Social Threats, Emerald Group Publishing Ltd., pp. 87–100, https://doi.org/10.1108/978-1-83753-096-020231007. Google Scholar ( - 2023).
Innovation environment’s role in supporting Industry 4.0 technology adoption to address the effects of COVID-19 . In Trends in Innovation and Entrepreneurship Research, World Scientific, pp. 361–385, https://doi.org/10.1142/9789811273292_0014. Link, Google Scholar ( - 2021). Digital Leadership in the Agile World and the Present of Change Management BT — Digital Leadership, Agile Change, and the Emotional Organization: Emotion as a Success Factor for Digital Transformation Projects, ed. M. Kupiek , Springer Fachmedien Wiesbaden, https://doi.org/10.1007/978-3-658-33489-5_1. Crossref, Google Scholar (
- 2018). The effect of digital technologies adoption in the healthcare industry: A case-based analysis. Business Process Management Journal, 24, 5: 1124–1144, https://doi.org/10.1108/BPMJ-04-2017-0084. Crossref, Google Scholar (
- 2011). Environmental uncertainty and firm performance: An empirical study with strategic alignment in the healthcare industry. In 32nd International Conference on Information Systems,
Shanghai , pp. 1–35. Google Scholar ( - 2020). The impact of digital technologies on economic and environmental performance in the context of industry 4.0: A moderated mediation model. International Journal of Production Economics, 229: 107777, https://doi.org/10.1016/j.ijpe.2020.107777. Crossref, Google Scholar (
- 2021).
A look to the future: Pandemic-induced digital technologies in vascular surgery . Seminars in Vascular Surgery, https://doi.org/10.1053/j.semvascsurg.2021.08.003. Crossref, Google Scholar ( - 2017). The Republic of Indonesia Health System Review, Asia Pacific Observatory on Health Systems and Policies, Vol. 7. Google Scholar (
- 2019). Digital transformation and digital leadership. Healthcare Informatics Research, 25, 4: 350–351, https://doi.org/10.4258/hir.2019.25.4.350. Crossref, Google Scholar (
- 2014). Teaching hospital performance: Towards a community of shared values? Social Science and Medicine, 101: 107–112, https://doi.org/10.1016/j.socscimed.2013.11.027. Crossref, Google Scholar (
- 2019). The influence of digital leadership on innovation management based on dynamic capability: Market orientation as a moderator. Management Science Letters, 9, 7: 1059–1070, https://doi.org/10.5267/j.msl.2019.3.018. Crossref, Google Scholar (
- Ministry of Health of the Republic of Indonesia (2022). Results of the PERSI Rapid Survey on Electronic Medical Records (RME) and Hospital Digitalization: Current Condition of Hospital Digitalization in Indonesia. Google Scholar
-
MNC Sekuritas (2020). On the ground research report. MNC Securities Research Division, 1–23. Google Scholar - 2023). Managing digitization of industrial incumbents through innovation-oriented leadership. Industrial Marketing Management, 113: 232–242, https://doi.org/10.1016/j.indmarman.2023.06.009. Crossref, Google Scholar (
- 2016). Digital leadership, Twitter, and Pope Francis. Church, Communication and Culture, 1, 1: 90–109, https://doi.org/10.1080/23753234.2016.1181307. Crossref, Google Scholar (
- 1983). An Evolutionary Theory of Economic Change. Cambridge: Harvard University Press. Google Scholar (
- 2022). Workplace literacy skills — how information and digital literacy affect adoption of digital technology. Journal of Documentation, 78, 7: 371–391, https://doi.org/10.1108/JD-12-2021-0241. Crossref, Google Scholar (
- 2021). What is the performance in public hospitals? A longitudinal analysis of performance plans through topic modeling. BMC Health Services Research, 21, 1: 1–11, https://doi.org/10.1186/s12913-021-06332-4. Crossref, Google Scholar (
- 2017). An overview of e-Health in Indonesia: Past and present applications. International Journal of Electrical and Computer Engineering, 7, 5: 2441–2450, https://doi.org/10.11591/ijece.v7i5.pp2441-2450. Google Scholar (
- 2018). Disruptive innovation and dynamic capabilities in emerging economies: Evidence from the Indian automotive sector. Technological Forecasting and Social Change, 129: 323–329, https://doi.org/10.1016/j.techfore.2017.09.035. Crossref, Google Scholar (
- 2003). Digital innovation. Series on Technology Management, 8: 220, https://doi.org/10.1142/p283. Google Scholar (
- 2020). Strategic action fields of digital transformation. Journal of Strategy and Management, 13, 1: 160–180, https://doi.org/10.1108/JSMA-05-2019-0070. Crossref, Google Scholar (
- 2023). The effect of digital leadership, organizational culture, digital competence and organization’s commitment to organizational performance: Information technology system in Indonesian Navy. International Journal of Scientific Research and Management, 11, 4: 4833–4846, https://doi.org/10.18535/ijsrm/v11i04.em06. Google Scholar (
- 2019). The doctor in the digital age — competencies needed and a road map for their achievement. Harefuah, 158, 10: 648–653. Google Scholar (
- 2015). Impacts of information and communication technologies on nursing care: An overview of systematic reviews (protocol). Systematic Reviews, 4: 75, https://doi.org/10.1186/s13643-015-0062-y. Crossref, Google Scholar (
- 2020). Digital health technology enhances resilient behavior: Evidence from the ward. International Journal of Operations & Production Management, 40, 1: 34–67, https://doi.org/10.1108/IJOPM-02-2018-0057. Crossref, Google Scholar (
- 2023). Learning and knowledge transfer by humans and digital platforms: Which tools best support the decision-making process? Journal of Knowledge Management. https://doi.org/10.1108/JKM-07-2022-0597. Crossref, Google Scholar (
- 2015). Electronic health records: Critical success factors in implementation. Acta Informatica Medica, 23, 2: 102–104, https://doi.org/10.5455/aim.2015.23.102-104. Crossref, Google Scholar (
- 2019). Views of Indonesian consumers towards medical tourism experience in Malaysia. Journal of Asian Business Studies, 13, 4: 507–524, https://doi.org/10.1108/JABS-04-2018-0135. Crossref, Google Scholar (
- 2022). Contemporary communication conduit among exemplar school principals in Malaysian schools. Research and Practice in Technology Enhanced Learning, 17, 1, https://doi.org/10.1186/s41039-022-00179-x. Crossref, Google Scholar (
- 2016). Research Methods for Business, 7th edn., John Wiley & Sons, United Kingdom. Google Scholar (
- 2000). Environmental dynamism, capital structure and performance: A theoretical integration and an empirical test. Management Journal, 21, 1: 31–49, https://www.jstor.org/stable/3094118. Crossref, Google Scholar (
- 1992). Inside the Environmental Movement: Meeting the Leadership Challenge. Island Press. Google Scholar (
- 2019). The change-ready leadership of technology-savvy superintendents. Journal of Educational Administration, 57, 3: 227–242, https://doi.org/10.1108/JEA-09-2018-0160. Crossref, Google Scholar (
- 2020). Technological capabilities, open innovation and perceived operational performance in SMEs: The moderating role of environmental dynamism. Journal of Knowledge Management, 25, 6: 1486–1507, https://doi.org/10.1108/JKM-05-2020-0352. Crossref, Google Scholar (
- 1997). Dynamic capabilities and strategic management. Strategic Management Journal, 18, 7: 509–533. Crossref, Google Scholar (
- 2022). Is capabilities, supply chain collaboration and quality performance in services: The moderating effect of environmental dynamism. Industrial Management & Data Systems, 122, 7: 1592–1619, https://doi.org/10.1108/IMDS-08-2021-0496. Crossref, Google Scholar (
- 2023). Digital transformation in healthcare using eagle perching optimizer with deep learning model. Expert Systems, https://doi.org/10.1111/exsy.13390. Crossref, Google Scholar (
- 2019). The effect of electronic health records on patient safety: A qualitative exploratory study. Information Health Social Care, 44, 1: 79–91, https://doi.org/10.1080/17538157.2017.1398753. Crossref, Google Scholar (
- 2011). The role of non-financial performance measures in predicting hospital financial performance: The case of for-profit system hospitals. Journal of Health Care Finance, 38, 2: 12–23. Google Scholar (
- 2001). Learning, innovation and competitive advantage in not-for-profit aged care marketing: A conceptual model and research propositions. Journal of Nonprofit & Public Sector Marketing, 9, 3: 53–73, https://doi.org/10.1300/J054v09n03_04. Crossref, Google Scholar (
- 2018). What’s Your Digital Business Model? Six Questions to Help you Build the Next-Generation Enterprise. Harvard Business School Press, Boston, Massachusetts, USA. Google Scholar (
- 1984). A resource-based view of the firm. Strategic Management Journal, 5, 2: 171–180, https://doi.org/10.1002/smj.4250050207. Crossref, Google Scholar (
- 2003). An Organizational Performance Assessment System for Agricultural Research Organizations: Concepts, Methods, and Procedures. International Service for National Agricultural Research (ISNAR). Google Scholar (
- World Bank (2021). World Bank approves support to strengthen health insurance, improve quality of health care in Indonesia. Available at https://www.worldbank.org/in/news/press-release/2021/12/16/world-bank-approves-support-to-strengthen-health-insurance-improve-quality-of-health-care-in-Indonesia [accessed on 27 July 2022]. Google Scholar
- 2022). Perceived benefits of sustainable digital technologies adoption in manufacturing SMEs. International Journal of Innovation and Technology Management, 19, 4: 2250012, https://doi.org/10.1142/S0219877022500122. Link, Google Scholar (
- 2019). Digital leadership skills and associations with psychological well-being. International Journal of Environmental Research and Public Health, 16: 14, https://doi.org/10.3390/ijerph16142628. Crossref, Google Scholar (
- 2021). Social media strategic capability, organizational unlearning, and disruptive innovation of SMEs: The moderating roles of TMT heterogeneity and environmental dynamism. Journal of Business Research, 133: 183–193, https://doi.org/10.1016/j.jbusres.2021.04.071. Crossref, Google Scholar (