1 Introduction

1.1 Digital Transformation

The digital transition impacts all aspects of society, particularly the economy. Companies today
have the chance to dramatically alter their business prototypes thanks to novel digital
technologies such as social networks, mobile, big data, the Internet of things, and other
developments. This mostly demands amendments to basic company deeds, as well as
modifications to goods and methods, as well as institutional arrangements, since organizations
must begin management strategies to accomplish these complicated transitions. Society as a
whole is undergoing deep upheaval as a product of the advancement of digital technologies and
its broad use in all marketplaces. In addition to rising client interest, organizations are
experiencing more competition as a result of globalization, exerting pressure on them to embrace
digital first in order to persist and prosper.

The concept of digital transformation has been extensively researched in several academic fields,
yielding a rough overview of the topic. What is currently missing is a clear definition of digital
changes to business models, a practice for digitizing business models, which phases and
appliances should be examined, and what simulations and enabling stimuli exist (S. Ziyadin,
2019).

The notion of digital transformation is established by the convergence of personal and business
IT contexts, and it encompasses the transformative influence of emerging digital technologies
such as social, mobile, analytical, cloud, and Internet of Things technologies (SMACIT) (White,
2008). Digital transformation is defined broadly as the implementation of digital technology and
business processes in a digital economy (Liu, 2011). A comparable limitless viewpoint regards it
as the use of innovation to radially improve the activity or reach of endeavors (Westerman,
2014).

1.2 Business Shift – Change in Business Model

It is not a mistake to say that, midst the utmost important issues affecting modern nations, such
as resource depletion and climate variation, public well-being are critical and consume a large
number of federal resources (Agarwal & Gao, 2010). The healthcare industry is seeing enormous
improvement and innovation as a result of digital transformation. Adopting modern technology
solutions may greatly improve employee experience, improve patient care, and enable for better
and faster diagnostics. Implementing digital transformation in healthcare may also provide
healthcare organizations with the agility needed to streamline operational operations while
lowering expenses. Furthermore, gathering and evaluating data offered by digital technology will
aid in understanding of target consumers' demands and activities. As a result, healthcare
practitioners will be able to devise innovative tactics to offer value and foster consumer loyalty
and trust (Singh, 2020).

Paper-based medical records contribute to the majority of healthcare systems' inefficiency and
inadequate delivery of high-quality treatment. These record structures do not permit key clinical
data to be easily accessible to decision-makers just at phase they make medical judgments,
resulting in service redundancy and medical mistakes. There is broad agreement that digitalizing
healthcare over extensive and deep usage Health Information Technology (HIT) through the
healthcare network, in associated with further harmonizing alterations, can shrink expenses and
advance excellence (IOM 2001), though difficult barriers occur to experience the welfares, and
the probability of unforeseen effects has been recognized (Agarwal & Gao, 2010).

Many health centers have implemented digital technology in an effort to improve patient service
quality while also increasing productivity and efficiency in healthcare delivery. Digital records,
healthcare, observing device (including portable devices), digital information, the use of internet
and internet toolkits, and data processing are just a few examples of how new tech is being used
in healthcare to improve treatment, the manpower, and hospital performance. Companies have
been stimulated to devote not just in innovation, but moreover in organizational programs and
alteration in order to care the knowledge requisite to feat the new technology. The development
of medical technology that assists authorities in consultation needs quickly and productively is
on the rise (Marques & Ferreira, 2019).
 Figure 1: Digital Transformation in Health Care (aeologictech, 2021)

1.3 Agility and Flexibility

Out focused phrase is agility. It shows how an organization may adapt its procedures and operate
successfully in a range of scenarios caused by external market, economic, policy, and political
factors, among other things. According to this definition, agility is an organization's capacity to
succeed and change fast in response to a range of scenarios produced by external market,
commercial, economic, and political factors. To get an advantage over competitors, a business
should also detect and recognize the customers' latent demands based on the consumers'
reactions to various scenarios and their experiences. Agile systems are crucial in the healthcare
sector because critical care centers must be dynamic and responsive quickly to patients' health
situations, anticipate patients' healthcare demands, and optimize performance and price for care
services. Agility is critical for lowering wait times in the emergency room and providing timely
healthcare treatments to minimize dangerous outcomes for patients. It is also critical for
physicians, as the postponement in treatment time has transformed the physician's task to cure
the patient's condition into stress, which might be fatal for the patient (Chakraborty, Bhatt, &
Chakrav, 2020).
There are two prominent conceptions of flexibility, according to the evaluations. One point of
view concerns "absorption" or the system's aptitude to "bounce back." There is no true adaptation
(i.e., development with change) to shifting conditions in this scenario (Linnenluecke, 2017).
Such a "backup" system offers the equivalent practicality as the original structure to keep it
running as it was formerly the alteration. The second elucidation, on the other hand, involves the
ability to adapt its utilities progressively in the period of amendment. In this manner, the
structure "learns" and changes in response to change (McCarthy, Collard, & Johnson, 2017).
Considering this difference, determining the quantity of "disturbance" that the structure can
endure is critical, as it will dictate the reaction and course of action in the times of challenge. It is
critical to comprehend not just the character of adjustment, but also the system's notch of self-
organization, as well as the system's erudition and adaptive capacity (Miceli, Hagen, Pia Riccard,
Sotti, & Settembre-Blundo, 2021).

It is therefore unclear if the first circumstances and/or the fresh situations are the further
advantageous ones. In the first situation, absorption, elasticity work implies that the initial
conditions are better than the fresh ones—the goal is to come back; in the second instance,
adaptation, effort appears to presume that the new conditions are better than the starting ones. In
the same vein, neither absorption nor process of continuous modification may be sufficient
responses to changing situations. To flourish rather than stay alive, the association would not
only require but also wish to vigorously influence surroundings, attempt to formulate for, and
confront transformation in order to achieve long-term growth. (Miceli, Hagen, Pia Riccard, Sotti,
& Settembre-Blundo, 2021).
2 Literature review
The purpose of this investigation is to explore the influence of digitalization on healthcare sector.
The use of information tool to support intra- and inter-organizational decision-making,
workflows, and structures is referred to as digitalization (Khan, Siddique, & Lee, 2020). Prior to
healthcare digitalization, ideas about digitization and other processes involved with the transition
of analog information management to digital platforms have piqued the interest of researchers.
However, as AI, augmented reality (AR), and the Internet of Things (IoT) were applied to
industrial processes, a transition from healthcare digitization to digitalization occurred. As a
result, adopting a digitization theory to digitalization is no longer applicable (Kim & Lee, 2018).

Digital technology are a necessary element and facilitator of long-term health systems and
universal health care. To realize their full potential, digital health initiatives must be integrated
into the larger health prerequisites and the digital health environment, and they must be directed
by a solid approach that incorporates leadership, commercial, institutional, human, and
technological assets and serves as the foundation for a coasted action plan that allows
coordination among multiple stakeholders. Strong governance frameworks should guide these
endeavors. The plan should address a method for integrating numerous health goals that is
supported by standards and a design that allows for this inclusion (World Health Organization,
2021).

Telehealth research and development has been ongoing since the 1960s. It delivers clinical
attention remotely, whereas telehealth is a medical procedure that incorporates the use of
technology to give treatment at a range (Leite, Gruber, & Hodgkinson, 2020). Telehealth and
digital care, which entail the delivery of medicinal services using information and
communication technology (ICT), have shown the ability supply effective healthcare services at
a low cost (Whaibeh, Mahmoud, & Naal, 2020). Given the constant pressure on the medical
sector to cut costs while delivering better treatment, digital care might be considered as a vital
instrument that reduces the need for patients to travel and provides remote services. The
significance of telehealth and digital treatment in moments of medical emergencies and national
and international emergencies triggered by the COVID-19 pandemic cannot be overstated.
Health institutions throughout the world are focusing in telemedicine and digital treatment to
combat the spread of COVID-19 and limit direct patient engagement at emergency rooms (Leite,
Gruber, & Hodgkinson, 2020).

Telecommunication technology, for example, alters people's perceptions and communication

methods all over the world. With the advancement of technology, every industry must make a
decision in favor of digitalization. Telehealth is a component of digitization in a massive virtual
health care system in the health industry. Telehealth is related with many digital data networks
that are helpful for the future and investigate various medicinal, economic, social, and cultural
factors (Darkins & Cary, 2021). The internet, cloud computing, AI and more digital technologies
are causing tremendous expansion in medical facilities (LAPÃO, 2018). Telehealth, or health at
a distance, has developed a beneficial method for boosting growth in the health services.

Telehealth and remote patient monitoring will become essential components of healthcare,
supporting in-person treatment. For patients with chronic diseases, most of the care that is
presently provided in hospitals will be moved to lower-cost locations such as the patient's home.
Retail health clinics, for example, will bring services closer to local communities. Virtual
cooperation among healthcare professionals will also aid in the expansion of specialty treatment
to remote and rural areas where specialist staff is scarce. Using real-time video streaming,
experienced doctors may give remote instruction and assistance to less experienced colleagues.
This strategy has the potential to make specialist treatment more accessible and inexpensive
while also enhancing consistency in care quality (Philips, 2021).
3 Research Methodology
3.1 Business Case
A business case is a project management document that elucidates why the assistances of a
project outweigh the charges and thus to be pursued. These cases are designed to encompass all
of the project's intentions, budgets, and assistances in order to persuade investors of its
significance. It is a necessary project document that shows a client, customer, or stakeholder why
the project is a smart investment. A business case is essential because it combines the financial
analysis, proposition, strategy, and publicity campaign into a single document and gives a
holistic understanding of how the operation will profit the firm. For this organization the case of
digital transformation is outlined below.

3.1.1 Purpose and Need

Digital transformation in the health industry is now a must for all health organizations. It is a
cornerstone of a patient-centered approach to healthcare since it will assist healthcare providers
simplify operations, understand what patients need, establish loyalty, and trust, and give a better
user experience. The advent of on-demand healthcare and wearable medical devices, as well as
the necessity for data analysis to reduce medication mistakes, facilitate preventative care, correct
staffing, and remote patient treatment, has resulted in the emergence of digital transformation in
the health industry. EHRs, telehealth solutions, and cloud security technologies all contribute to
this transformation as they improve the workflow and efficiency of health care.

As part of its digital transformation, Norvic International Hospital has implemented high-tech
laboratory services, a Catheterization lab for Invasive and Non-Invasive Cardiac facilities, an
audio-visual aided CT scan system, telemedicine implementation, and the development of digital
doors.

3.1.2 Cost, Benefits, and Risks

The healthcare sector in Nepal is fragmented as the health ministry does not even have a proper
database for storing patient records. Comparing the health sector with other sector like banking
where digital has already so much effect, proper standardization and segmentation of hospitals
seems a necessary change. As of now, the demand for digitalized healthcare is high in the
market. Even though the cost of implementation is high, the benefits provided by this
digitalization with careful and proper usage can outwit the cost of its implementation. Some of
the advantages gained by the organization are:

a) The reduction of expenses in a hospital is related to several procedures and materials,

including paper records, storage space, administration, time management, personnel,
supplies, and orders to the departments (Zimmermannova, Pavlik, & Chytilova, 2022).
This may be accomplished through digitization, which stops wasting money on outdated
service delivery techniques and enables businesses to offer services at a low cost.
b) Because digital records may replace paper ones, the organization's workflow is also
improved. This results in shorter patient examination times as well as simpler access to a
secure database that holds patient health details. Additionally, it makes it feasible to
communicate with patients both offline and online more successfully.
c) Hospitals may minimize supply chain and inventory management expenses by
automating the collection of information, obtaining, validating, and dealing with health,
surgical, and medicinal supplies.
d) In addition to this, digitization also helps to increase hospitals' revenue. Free storage
space, for example, may be transformed and converted to various rooms related to health
services such as dietary counseling. Furthermore, a seamless workflow enables for more
patients to be handled, which helps in generating more revenue for the hospital.
e) Machine learning and decision-support algorithms may also be utilized at the ward level
to anticipate the expected number of admissions, discharges, and transfers to and from
the ward, which can then be used to guide future actions. This can speed up the bed
turnover process, resulting in better patient flow and a shorter duration of stay.

Along with the benefits comes the challenges the digital system holds which should be analyzed
and solved properly. Some of the challenges of implementation of digital system are:

a) Unless adequate rules are implemented, education is offered, and best practices are
enforced for individuals who deal with patient data on a daily basis, the danger of illegal
acquisition, use, and revelation of personal health information will exist.
b) The acceptance of new technologies by the public is slow in the context of Nepal. People
who can use digital devices is not that high in number. Aging and growing people, who
are the frequent visitors in hospital may not be able to adapt to such changes.
 c) Failure to provide controls to secure patients' personal health information can result in
data cracks, which can lead to privacy objections for the licensed staff involved, and
extensive and costly lawsuits.
d) The more people begin to adopt the technology and its benefits, the expectation and
curiosity of depth understanding increases demand of more personalized care. Unless a
proper analysis is and strategy is formulated, the supply and demand chain will not be
balanced.
e) Organizations frequently use technology to participate in continual product and service
improvement. Continuous improvement is always a good concept, but it is not the same
as a significant shift in a company model. Companies that set their aims too low may fail
to adapt and, as a result, remain exposed to rivals that have established business models
that shift the basis of industry rivalry.

3.1.3 Overall Gain

Because of 24/7 access to the patient's health information and real-time coordination, digital
transformation may assist companies manage important time for employees and patients. By
integrating technology, advanced techniques for accurate and correct diagnosis and treatment
may be obtained, improving the total health services supplied by the organization.
Communication between stakeholders may also be efficient and seamless. All these adjustments
result in an increase in the number of regular patients who are pleased with the services offered.
This, in turn, assists the firm in expanding its service area, reducing time-consuming procedures,
providing quick and efficient services, dealing with suitable personnel allocation, operation
scheduling, and overall supply chain.

3.2 Data Collection and Analysis

This study relies on both primary and secondary data. Primary data are those gathered from own
experience. The major sources of this data are restricted and difficult to get due to a lack of
collaboration. Primary data is more trustworthy. Secondary data analysis is the examination of
information gathered by someone other than the originator. Secondary data might be quantitative
as well as qualitative. Paper, journals, books, and other sources are used to collect qualitative
data. An overview, insights, and several sorts of budget reports provide quantitative data. For my
research paper, I performed research on the hospital ‘Norvic International Hospital’ which
provides health care services.

The major data concerning telehealth in 'Norvic International Hospital' is collected through a
questionnaire survey. The hospital's management was consulted to learn about its business
strategy and digital transformation. A questionnaire is a popular way for collecting quantitative
primary data. A questionnaire is just a series of questions that a researcher asks a responder who
shares his or her opinion (Roopa & Rani, 2012). In this study, primary data is gathered by
conducting a telephone poll with two persons. One of them is a 'Norvic International Hospital'
health worker, while the other is a 'Norvic International Hospital' regular patient.

Secondary data is accessed in order to have a thorough picture of telehealth and telemedicine.
Secondary data contributes to a comprehensive picture of telehealth across the world, from its
inception to its ultimate purpose. Qualitative data is used as secondary data in this research
report. Paper, books, articles, websites, media, Internet articles, data archives, and records are the
primary sources of qualitative secondary data. The internet is utilized to locate numerous online
health care amenities. The main advantages of applying such data are that it is freely accessible,
less expensive, and the researcher is not solely accountable for quality data.
4 Conclusion and Recommendation
In the long term, digital health infrastructure and telemedical types of care would influence
the medical quality and a health system's economic viability. The "clinical workspace" is the
heart of a hospital's information technology infrastructure. This is an aspect of medical
information systems that comprise medical patient data that is interconnected in terms of content
and utility and ensures the correlation to specific visibly oriented amenities (e.g., second-opinion
procedures via teleradiology, arrhythmia (irregular heartbeat) patient monitoring via home, big
data analysis over timely evaluation of genetic sequences). A comprehensive hospital
information system is completed by the incorporation of patient administration, records, and
business-related along with logistical data.
The "digitalization of healthcare" will help to relieve medicinal amenity providers of regular
activities while also enhancing diagnostic and therapeutic accuracy (precision medicine,
theragnostic, big data). Furthermore, it will promote the use of Point-of-Care Testing
Technologies (POCT) in all sectors of the medical system (primary overhaul, emergency care,
severe treatment, recovery).
The First-Line Digital Industry will be created as a new healthcare sector. This is distinguished
by teleconference, telenursing, and extensive use of POCT, mostly with patients at home. As a
result, patients will be capable to be supervised and cared for pathologically in the solitude of
their own residences, without needing to leave their accustomed social context. Needless hospital
admittances be averted, but the division will also be released of all hospital-based immobile
treatment. However, more patient independence is contingent on better patient defiance in
addition to provide acceptable and optimal medical outcomes. Around is innovative fundamental
premise in facilitating health amenities: virtual services foremost, GP/outpatient facilities second,
acute care services third, and the mobile phone will replace the 21st century stethoscope.
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