Does System Choice Matter? Influence of Hospital Information Systems on Digital Maturity

Hospitals worldwide invest heavily in digital infrastructure to improve efficiency, safety, and patient-centeredness. Hospital Information Systems (HIS) form the backbone of these efforts. However, the HIS provider market remains fragmented and heterogeneous, thus potentially influencing hospitals' ability to achieve digital transformation. Empirical evidence on how HIS choice relates to digital maturity remains limited. Using data from more than 1,600 hospitals participating in the German-wide DigitalRadar (DR) project (i.e., covering about 90% of all hospitals), we examined the relationship between HIS provider characteristics and hospitals' digital maturity. The DR dataset comprises 234 standardized items per hospital and provides a maturity score from 0 to 100 for each hospital. Four HIS provider features (i.e., module utilization, integration ratio, external provider variation, and maximum hospital size coverage) were derived and used for k-means clustering. Multivariate linear regressions, controlling for hospital characteristics, quantified associations with digital maturity. K-means clustering identified four clusters of HIS providers. Higher module utilization (β = 6.87, p < 0.05) and integration ratios (β = 14.35, p < 0.01) were consistently associated with greater digital maturity. External provider variation and maximum hospital size coverage were not significantly associated with overall digital maturity. The choice of HIS provider is associated with hospitals' digital maturity, particularly with respect to broader module coverage and stronger integration. Providers with low module utilization and limited integration are associated with lower maturity. Our findings highlight the need for strategic HIS procurement, targeted system/organizational improvements, and policy incentives to accelerate digital transformation.