Benefits realization in digital transformation: the translation from policy to practice in health care

• Published in: Transforming government 2024-05, Vol.18 (2), p.303-317
• Main Authors: Isik, Leman, Nilsson, Christina, Magnusson, Johan, Koutsikouri, Dina
• Format: Article
• Language: English
• Subjects: Benefits; Case studies; Coercion; Comparative studies; Digital transformation; Health care; Health services; Organizational change; Organizations; Policy implementation; Policy making; Public health; Public sector; Sociology; Translation
• ISSN: 1750-6166; 1750-6174; 1750-6166
• DOI: 10.1108/TG-11-2023-0177

Purpose While digital transformation holds immense promise, organizations often fail to realize its benefits. This study aims to address how policies for digital transformation benefits realization are translated into practice. Design/methodology/approach The authors apply a qualitative, comparative case study of two large, public-sector health care organizations in Sweden. Through document and interview data, the authors analyze the process of translation. Findings The study finds that practice variation is primarily caused by two types of decoupling: policy-practice and means-ends. Contrary to previous studies, coercion in policy compliance is not found to decrease practice variation. Research limitations/implications The limitations primarily stem from the empirical selection of two large public health-care organizations in Sweden, affecting the study’s generalizability. Reducing practice variation is more effectively achieved through goal alignment than coercion, leading to implications for the design of governance and control. Practical implications Policymakers should, instead of focusing on control-related compliance, work to align organizational objectives and policies to decrease practice variation for successful benefits realization. Social implications The study contributes to better benefits realization of digital transformation initiatives in health care. As such, the authors contribute to a better functioning and more transformative health care in times of increased demand and decreased supply of health-care services. Originality/value The study challenges conventional wisdom by identifying that coercion is less effective than goal alignment in reducing practice variation, thereby enhancing the understanding of policy implementation dynamics in health-care settings.