KMAN Publication Inc. (KMANPUB) Health Nexus 3 Serial Number 10 2025 06 01 Digital Health Transformation and Organizational Performance in Healthcare Systems: The Mediating Role of Digital Leadership Digital Health Transformation and Organizational Performance in Healthcare Systems: The Mediating Role of Digital Leadership 159 175 EN Journal Article 2025 02 04 <p>This study aimed to investigate the effect of digital health transformation on organizational performance in healthcare systems in Tehran and to determine the mediating role of digital leadership in this relationship. This applied, quantitative, cross-sectional correlational study was conducted among managers, supervisors, health information technology personnel, clinical coordinators, and professional administrative and clinical-support employees working in public and private healthcare organizations in Tehran, Iran, in 2026. A total of 420 questionnaires were distributed, of which 384 valid questionnaires were retained for analysis. Data were collected using a structured questionnaire assessing digital health transformation, digital leadership, and organizational performance on five-point Likert scales. Content validity was evaluated by academic and professional experts, while construct reliability and validity were assessed using Cronbach’s alpha, composite reliability, average variance extracted, and the heterotrait-monotrait ratio. Data were analyzed using SPSS version 27 and SmartPLS 4. Partial least squares structural equation modeling and bootstrapping with 5,000 resamples were applied to test direct and indirect effects. Digital health transformation had a significant positive effect on digital leadership (β = 0.684, t = 17.538, p &lt; 0.001) and organizational performance (β = 0.268, t = 5.255, p &lt; 0.001). Digital leadership also significantly predicted organizational performance (β = 0.531, t = 11.298, p &lt; 0.001). The indirect effect of digital health transformation on organizational performance through digital leadership was significant (β = 0.363, t = 8.854, p &lt; 0.001), confirming complementary partial mediation. The total effect of digital health transformation on organizational performance was β = 0.631 (p &lt; 0.001). The model explained 46.8% of the variance in digital leadership and 60.3% of the variance in organizational performance. Digital health transformation significantly improves organizational performance both directly and indirectly through digital leadership, indicating that healthcare organizations can achieve greater performance gains when technological transformation is accompanied by strong leadership capabilities that facilitate digital adoption, innovation, and strategic integration.</p> https://www.journals.kmanpub.com/index.php/Health-Nexus/article/download/6147/11790