From leadership to digital maturity in public healthcare: evidence from Pakistan’s digital transformation journey

PURPOSE: This research investigates the digital transformation (DTM) process in Pakistan's public healthcare organizations while analyzing organizational factors that influence their digital maturity levels. This study frames DTM using three key elements: digital transformational leadership (DTL) as the guiding force, employee commitment to digital transformation (ECDT) reflecting workforce engagement and employee artificial intelligence (AI) readiness culminating in organizational digital maturity (ODM). DESIGN/METHODOLOGY/APPROACH: The theoretical basis of this research is the technology-organization-environment (TOE) framework. The research used a moderated mediation model to analyze the DTM process. This research applied structural equation modeling and bootstrapping to assess hypotheses based on data from 258 employees collected at three different time points. FINDINGS: The results confirm that DTL positively impacts ECDT and that ECDT in turn positively enables ODM. The moderation analysis finds a suggestive trend indicating that ECDT translates to ODM more strongly when employees feel prepared to engage with and work alongside AI-based digital technologies. ORIGINALITY/VALUE: This study extends TOE theory by giving a more in-depth and salient focus on the employee-level psychological and capability-based elements of the "organization" dimension of TOE, which is under-theorized and underrepresented in digital health research. The study also empirically explores and tests digital leadership and transformation in a developing country context with practical implications for Sustainable Development Goal (SDG) 3 and SDG 9.