The digital-environmental tension: Managerial attention to digital transformation and energy consumption in healthcare organizations

Digital transformation is broadly recognized as a promising approach to solving complex and longstanding organizational challenges. However, its environmental implications, particularly within the public sector, remain underexplored. Drawing on the attention-based view, this study addresses this gap by investigating how managerial attention to digital transformation impacts organizational environmental performance. We utilize a fixed-effects model approach to conduct the analysis based on a sample of 118 NHS Foundation Trusts in England between 2016 and 2021. The results show that managerial attention to digital transformation is positively related to energy consumption intensity. Building on core assumptions from the behavioral theory of the firm, we further investigate the moderating role of R&D income intensity discrepancy on the link between digital transformation attention and energy consumption intensity. Our findings indicate that positive R&D income intensity discrepancy weakens the positive relationship between digital transformation attention and energy consumption, whereas negative discrepancy does not have any impact. This study contributes to the extant literature by advancing the understanding of the intersection between digital transformation and sustainability, while extending the theoretical applications of the attention-based view and behavioral theory of the firm within the public sector. The findings also offer insights for policymakers and practitioners seeking to mitigate unintended environmental consequences and promote more sustainable initiatives to digital transformation. • Digital transformation attention increases energy consumption intensity. • Positive R&D income intensity discrepancy weakens this relationship. • Negative R&D income intensity discrepancy does not affect this relationship.