Adaptation of Digital Technologies in Primary Health Care Systems: A Socio-Technical Approach to Service Improvement
Keywords:
Digital health, Primary health care, Puskesmas, Socio-technical approach, Service improvementAbstract
This study aims to analyze the adaptation of digital technologies in primary health care systems using a socio-technical approach to understand how digital tools support service improvement in Puskesmas settings. Digital transformation in primary health care has expanded through electronic medical records, online registration, digital queues, referral platforms, and reporting systems, yet its implementation often faces challenges related to fragmented applications, workload, infrastructure, and patient digital literacy. This study used a qualitative exploratory case study design conducted at three Puskesmas in Bandar Lampung City, Indonesia, from May to August 2026. Data were collected through semi-structured interviews, non-participant observation, and document review involving 24 to 30 participants, including Puskesmas managers, physicians, nurses, midwives, administrative staff, health information system operators, and patients. Thematic analysis revealed four main themes: digital technology as a tool for service acceleration, mismatch between digital systems and daily workflows, human readiness as a determinant of adaptation, and patient digital literacy as a factor shaping service access. The findings show that digital technologies can improve service order, data management, and referral coordination, but their effectiveness depends on system integration, organizational support, user competence, and inclusive patient assistance. This study contributes to socio-technical understanding by showing that digital health adaptation is not only a technical change, but also a transformation of work culture, service relationships, and organizational practice.
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