Strengthening Health Systems through the Implementation of Digital Health Based on Social and Organizational Contexts
Keywords:
Digital health, Health system strengthening, Organizational readiness, Social context, Health service transformationAbstract
This study aims to analyze how digital health strengthens health systems through social and organizational contexts in health facilities. Digital health implementation has become increasingly important in improving service efficiency, documentation, coordination, and patient access. However, its success depends not only on technology availability, but also on workforce readiness, leadership support, organizational culture, workflow integration, and patient acceptance. This study used a qualitative multiple case study design conducted at Dr. H. Abdul Moeloek Provincial General Hospital, Sukarame Public Health Center, and Kedaton Public Health Center in Bandar Lampung City, Indonesia, from July to September 2026. Data were collected through semi-structured interviews, non-participant observation, and document review. Participants included managers, physicians, nurses, midwives, medical record officers, information technology staff, registration officers, and patients who had experience with digital health services. Data were analyzed using thematic analysis through coding, category development, theme identification, and cross-case interpretation. The findings revealed five main themes: digital health as an administrative efficiency tool, unequal digital readiness among health workers, organizational support as a key condition for implementation, patient acceptance shaped by assistance and trust, and fragmented integration between digital and manual workflows. These findings show that digital health can strengthen health systems when it is supported by reliable infrastructure, continuous training, responsive technical assistance, integrated systems, and inclusive patient support. The study contributes to digital health literature by positioning implementation as a socio-organizational process and offers practical insights for more contextual, equitable, and sustainable digital health policies.
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