Assessing the impact of digital transformation on healthcare performance: A case study of healthcare establishments in the province of Midelt
DOI:
https://doi.org/10.66130/g5tgrm44Keywords:
Digitalization, healthcare sector, quality of care, service efficiency, accessibility, equity of servicesAbstract
In Morocco, digitalization now stands among the primary levers for modernizing the healthcare sector, and a national programme supports the digital overhaul of care delivery and of the establishments providing it. Whether such change translates into better performance remains an open empirical question. The present study puts that question to the test in the province of Midelt, a mountainous territory characterised by a dispersed population and by highly uneven access to services. A structured questionnaire was administered to 103 healthcare professionals who mobilise digital tools in their daily work, and perceived performance was measured through four dimensions drawn from the literature, namely efficiency, quality of care, accessibility and equity of services. Descriptive statistics, Pearson correlations and multiple linear regression were computed with IBM SPSS Statistics (v.26). The model explains 60.4% of the variance in perceived performance. Two predictors reach significance, service efficiency (β = 0.371, p < 0.001) and quality of care (β = 0.342, p < 0.001), which supports H1 and H2. Accessibility (p = 0.273) and equity (p = 0.127) remain below the significance threshold, an outcome traced to local constraints, starting with a telemedicine programme still confined to the pilot stage. The findings plead for patient-centred digital solutions, sustained investment in suitable tools and continuous strengthening of the digital skills of healthcare personnel.
References
Agarwal, R., Gao, G. G., DesRoches, C., & Jha, A. K. (2010). Research commentary. The digital transformation of healthcare: Current status and the road ahead. Information Systems Research, 21(4), 796-809. https://doi.org/10.1287/isre.1100.0327
Agha, L. (2014). The effects of health information technology on the costs and quality of medical care. Journal of Health Economics, 34, 19-30. https://doi.org/10.1016/j.jhealeco.2013.12.005
Akhtar, N., Khan, N., & Qayyum, S. (2022). Efficacy and pitfalls of digital technologies in healthcare services: A systematic review of two decades. Frontiers in Public Health, 10, 869793. https://doi.org/10.3389/fpubh.2022.869793
Ammenwerth, E., & Shaw, N. T. (2005). Bad health informatics can kill. Is evaluation the answer? Methods of Information in Medicine, 44(1), 1-3.
Bates, D. W., Kuperman, G. J., Wang, S., Gandhi, T., Kittler, A., Volk, L., Spurr, C., Khorasani, R., Tanasijevic, M., & Middleton, B. (2003). Ten commandments for effective clinical decision support: Making the practice of evidence-based medicine a reality. Journal of the American Medical Informatics Association, 10(6), 523-530. https://doi.org/10.1197/jamia.M1370
Blumenthal, D., & Tavenner, M. (2010). The “meaningful use” regulation for electronic health records. The New England Journal of Medicine, 363(6), 501-504. https://doi.org/10.1056/NEJMp1006114
Brenner, S. K., Kaushal, R., Grinspan, Z., Joyce, C., Kim, I., Allard, R. J., Delgado, D., & Abramson, E. L. (2016). Effects of health information technology on patient outcomes: A systematic review. Journal of the American Medical Informatics Association, 23(5), 1016-1036. https://doi.org/10.1093/jamia/ocv138
Burton-Jones, A., Akhlaghpour, S., Ayre, S., Barde, P., Staib, A., & Sullivan, C. (2020). Changing the conversation on evaluating digital transformation in healthcare: Insights from an institutional analysis. Information and Organization, 30(1), 100255. https://doi.org/10.1016/j.infoandorg.2019.100255
Cresswell, K., & Sheikh, A. (2012). Organizational issues in the implementation and adoption of health information technology innovations. International Journal of Medical Informatics, 82(5), e73-e86. https://doi.org/10.1016/j.ijmedinf.2012.10.007
Dorsey, E. R., & Topol, E. J. (2016). State of telehealth. The New England Journal of Medicine, 375(2), 154-161. https://doi.org/10.1056/NEJMra1601705
Fang, M. L., Canham, S. L., Battersby, L., Sixsmith, J., Wada, M., & Sixsmith, A. (2018). Exploring privilege in the digital divide: Implications for theory, policy, and practice. The Gerontologist, 59(1), e1-e15. https://doi.org/10.1093/geront/gny037
Fichman, R. G., Kohli, R., & Krishnan, R. (2011). The role of information systems in healthcare: Current research and future trends. Information Systems Research, 22(3), 419-428. https://doi.org/10.1287/isre.1110.0382
Furukawa, M. F., Raghu, T. S., & Shao, B. B. M. (2010). Electronic medical records, nurse staffing, and nurse-sensitive patient outcomes: Evidence from California hospitals. Health Services Research, 45(4), 941-962. https://doi.org/10.1111/j.1475-6773.2010.01110.x
Golinelli, D., Boetto, E., Carullo, G., Nuzzolese, A. G., Landini, M. P., & Fantini, M. P. (2020). Adoption of digital technologies in health care during the COVID-19 pandemic: Systematic review of early scientific literature. Journal of Medical Internet Research, 22(11), e22280. https://doi.org/10.2196/22280
Grabenbauer, L., Fraser, R., McClay, J., Woelfl, N., Thompson, C., Campbell, J., & Windle, J. (2011). Adoption of electronic health records: A qualitative study of academic and private physicians and health administrators. Applied Clinical Informatics, 2(2), 165-176. https://doi.org/10.4338/ACI-2011-01-RA-0003
Inan, A. (2025). L'acceptabilité de l'usage de la télémédecine chez les infirmiers au Maroc : Perception des infirmiers des établissements de soins de santé primaires de Fès. 1, 104-118.
Jallal, M., Serhier, Z., Berrami, H., & Othmani, M. B. (2023). Current state and prospects of telemedicine in Morocco: Analysis of challenges, initiatives, and regulatory framework. Cureus, 15(12), e50963. https://doi.org/10.7759/cureus.50963
Kaihlanen, A.-M., Virtanen, L., Buchert, U., Safarov, N., Valkonen, P., Hietapakka, L., Hörhammer, I., Kujala, S., Kouvonen, A., & Heponiemi, T. (2022). Towards digital health equity. A qualitative study of the challenges experienced by vulnerable groups in using digital health services in the COVID-19 era. BMC Health Services Research, 22, 188. https://doi.org/10.1186/s12913-022-07584-4
Keesara, S., Jonas, A., & Schulman, K. (2020). Covid-19 and health care's digital revolution. The New England Journal of Medicine, 382(23), e82. https://doi.org/10.1056/NEJMp2005835
Kingdom of Morocco. (2025). Public policies on health and social protection: Generalization of social protection and the rehabilitation of the national health system. https://maroc.ma/sites/default/files/2025-01/canva-sante-en.pdf
Konttila, J., Siira, H., Kyngäs, H., Lahtinen, M., Elo, S., Kääriäinen, M., Kaakinen, P., Oikarinen, A., Yamakawa, M., Fukui, S., Utsumi, M., Higami, Y., Higuchi, A., & Mikkonen, K. (2019). Healthcare professionals' competence in digitalisation: A systematic review. Journal of Clinical Nursing, 28(5-6), 745-761. https://doi.org/10.1111/jocn.14710
Kraus, S., Schiavone, F., Pluzhnikova, A., & Invernizzi, A. C. (2021). Digital transformation in healthcare: Analyzing the current state-of-research. Journal of Business Research, 123, 557-567. https://doi.org/10.1016/j.jbusres.2020.10.030
Lamia, O., Eddine, H. I., Fadila, A., Nour, E. A., & Aya, E. L. H. (2025). Étude des connaissances et des perceptions des professionnels de la santé des établissements de soins de santé primaires sur l'utilisation du système d'information digitale au Maroc. 03.
Laukka, E., Huhtakangas, M., Heponiemi, T., & Kanste, O. (2020). Identifying the roles of healthcare leaders in health information technology implementation: A scoping review of the quantitative and qualitative evidence. International Journal of Environmental Research and Public Health, 17(8), 2865. https://doi.org/10.3390/ijerph17082865
Lee, J., McCullough, J. S., & Town, R. J. (2013). The impact of health information technology on hospital productivity. The RAND Journal of Economics, 44(3), 545-568. https://doi.org/10.1111/1756-2171.12030
Longhini, J., Rossettini, G., & Palese, A. (2022). Digital health competencies among health care professionals: Systematic review. Journal of Medical Internet Research, 24(8), e36414. https://doi.org/10.2196/36414
Lupton, D. (2013). The digitally engaged patient: Self-monitoring and self-care in the digital health era. Social Theory & Health, 11(3), 256-270. https://doi.org/10.1057/sth.2013.10
Maita, K. C., Maniaci, M. J., Haider, C. R., & Avila, F. R. (2024). The impact of digital health solutions on bridging the health care gap in rural areas: A scoping review. The Permanente Journal, 28(3), 130-143. https://doi.org/10.7812/TPP/23.134
McDonald, K. M., Schultz, E., Albin, L., Pineda, N., Lonhart, J., Sundaram, V., Smith-Spangler, C., Brustrom, J., Malcolm, E., Rohn, L., & Davies, S. (2014). Care coordination measures atlas (Version 4). Agency for Healthcare Research and Quality.
Ministry of Digital Transition and Administration Reform. (2024). Digital Morocco 2030.
Mrabet, Y., & Benfadel, R. (2024). La gouvernance des systèmes d'information sanitaire à l'ère de la digitalisation : Quels défis et quels apports ? Revue de Management et Cultures (REMAC), 12, 47-66.
Raghupathi, W., & Raghupathi, V. (2014). Big data analytics in healthcare: Promise and potential. Health Information Science and Systems, 2, 3. https://doi.org/10.1186/2047-2501-2-3
Richardson, S., Lawrence, K., Schoenthaler, A. M., & Mann, D. (2022). A framework for digital health equity. npj Digital Medicine, 5, 119. https://doi.org/10.1038/s41746-022-00663-0
Roberts, E. T., & Mehrotra, A. (2020). Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine. JAMA Internal Medicine, 180(10), 1386-1389. https://doi.org/10.1001/jamainternmed.2020.2666
Rogers, E. M. (1983). Diffusion of innovations (3rd ed.). The Free Press.
Shaw, J., Brewer, L. C., & Veinot, T. (2021). Recommendations for health equity and virtual care arising from the COVID-19 pandemic: Narrative review. JMIR Formative Research, 5(4), e23233. https://doi.org/10.2196/23233
Stoumpos, A. I., Kitsios, F., & Talias, M. A. (2023). Digital transformation in healthcare: Technology acceptance and its applications. International Journal of Environmental Research and Public Health, 20(4), 3407. https://doi.org/10.3390/ijerph20043407
Ting, D. S. W., Carin, L., Dzau, V., & Wong, T. Y. (2020). Digital technology and COVID-19. Nature Medicine, 26(4), 459-461. https://doi.org/10.1038/s41591-020-0824-5
Torre-Díez, I., López-Coronado, M., Vaca, C., Aguado, J. S., & de Castro, C. (2015). Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: A systematic review. Telemedicine and e-Health, 21(2), 81-85. https://doi.org/10.1089/tmj.2014.0053
Whitelaw, S., Mamas, M. A., Topol, E., & Van Spall, H. G. C. (2020). Applications of digital technology in COVID-19 pandemic planning and response. The Lancet Digital Health, 2(8), e435-e440. https://doi.org/10.1016/S2589-7500(20)30142-4
WHO. (2016). Global diffusion of eHealth: Making universal health coverage achievable. World Health Organization.
WHO. (2021). Global strategy on digital health 2020-2025. World Health Organization. Licence: CC BY-NC-SA 3.0 IGO. http://apps.who.int/iris
Yao, R., Zhang, W., Evans, R., Cao, G., Rui, T., & Shen, L. (2022). Inequities in health care services caused by the adoption of digital health technologies: Scoping review. Journal of Medical Internet Research, 24(9), e34144. https://doi.org/10.2196/34144
Zahidi, K. (2025). Digitalisation de la santé au Maroc : Un levier de gouvernance pour l'efficacité et l'équité / Healthcare digitalization in Morocco: A governance tool for efficiency and equity. 6(10), 649-661.
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The data that support the findings of this study are available from the corresponding author upon reasonable request.
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