Responsible digital transformation in rural primary healthcare services: critical factors from a Norwegian case study

Clinical Snapshot

Key Findings

• P Value: Not applicable for qualitative research

• Effect Size: Not applicable for qualitative research

• Primary Outcome: Six critical factors identified: structural readiness, digital competence, technology in practice, cultural change, autonomy and care, and motivation and dedication

• Nnt Or Sensitivity: Thematic saturation achieved across six key domains of digital transformation readiness

• Confidence Interval: Not applicable for qualitative research

Clinical Application

Moderate - requires significant organisational culture change, workforce development, and coordinated top-down/bottom-up implementation approaches Highly relevant to Australian rural healthcare challenges. Findings applicable to Rural Health Strategy implementation, PHN digital health initiatives, and aged care reform. Consider alignment with Australian Digital Health Strategy and rural workforce challenges addressed by RACGP Rural Rural primary healthcare services considering digital transformation initiatives, particularly home-based care services

Abstract

OBJECTIVE: To explore the critical factors that shape the potential for co-creating and implementing a virtual department for home-based healthcare in a rural municipality. METHODS: A qualitative case study was conducted in a rural municipality in Northern Norway. Data were collected through semi-structured interviews, focus groups, and co-creation workshops involving healthcare leaders, frontline staff, service users and relatives, and representative from the pensioners' federation. Thematic analysis was applied to identify organisational, contextual, and cultural factors influencing digital transformation. RESULTS: While the co-creation of virtual department for home-based healthcare showed potential for piloting, readiness for full implementation was limited. Six critical factors were identified: structural readiness, digital competence, technology in practice, cultural change, autonomy and care, and motivation and dedication. These factors highlight the importance of organisational culture, workforce capacity, and stakeholder engagement in shaping readiness for responsible digital transformation. CONCLUSION: Digital transformation holds potential for addressing healthcare challenges in rural municipalities, but success depends on more than technological efficacy. Effective coordination between bottom-up and top-down approaches is required to ensure responsible and sustainable transformation of primary healthcare services.

References

1. 1.Thapa, R. K., Bliksvær, T., Eines, T. F., Fabritius, M. K., Grønvik, C. K. U., Holm, S., Nilsen, N. J., Verlo, F. R., & Hartviksen, T. (2026). Responsible digital transformation in rural primary healthcare services: critical factors from a Norwegian case study. Scandinavian Journal of Primary Health Care, 44(4), 1-12. https://doi.org/10.1080/02813432.2026.2673135