Changes in Balanced Scorecard Performance Following Digital Hospital Transformation: A Before and After HIMSS Level 7 Analysis

Özet

Purpose – The aim of this study is to examine changes in Balanced Scorecard dimensions by comparing institutional performance indicators from 2019 (pre-HIMSS Level 7) and 2023 (post-HIMSS Level 7). Furthermore, the study aims to present an adapted performance assessment framework that integrates the Balanced Scorecard approach with Health Quality Standards (HQS).

Design/methodology/approach – This study is a descriptive comparative case study based on secondary data from 2019 and 2023 from a single hospital in Türkiye that attained HIMSS Level 7. The Balanced Scorecard framework was expanded to include a sustainability dimension to provide a more holistic assessment. The measurement framework was structured based on adapted HQS indicators, and performance was evaluated using a weighted and standardized scoring system. Rather than developing a new, independently validated measurement instrument, this study applies an adapted performance assessment framework derived directly from official HQS criteria.

Findings – The findings indicate notable changes in the total performance score and across several Balanced Scorecard dimensions between 2019 and 2023. The total performance score increased from 80.8 to 93.4, with particularly notable increases in financial performance, sustainability, and internal process efficiency. However, these findings are based on descriptive comparisons and do not establish a direct causal relationship between digital transformation and performance outcomes.

Discussion – The findings suggest that positive co-changes may occur between digital hospital transformation and selected performance indicators. Advancements in technological infrastructure and employee training activities may be associated with operational efficiency and service quality; however, these relationships were not directly tested in the present study. Human-centered factors, including employee satisfaction, should also be considered when assessing the sustainability of organizational improvements. The study contributes to the literature by demonstrating a multidimensional framework for descriptively assessing changes in hospital performance in the context of digital transformation.