Abstract
BACKGROUND: Digital health technologies (DHT) have become an integral component of modern healthcare systems, offering the potential to improve healthcare delivery and outcomes. Guided by the Technology-Organization-Environment (TOE) framework, this study examines the impact of DHT adoption on healthcare workers' performance and workload in public and private hospitals in Mogadishu, Somalia. METHOD: A stratified random sampling approach was used to collect data from 286 healthcare workers in public and private hospitals. Data were analyzed using Structural Equation Modeling (SEM) to test hypotheses and assess direct and mediating relationships among variables. RESULTS: The analysis revealed that DHT significantly improves healthcare workers' performance and workload respectively (β = 0.452, C.R. = 10.150, p < 0.001) and (β = 0.594, C.R. = 9.972, p < 0.001), organizational and environmental factors are positively impacting on healthcare workers' performance (β = 0.327, C.R. = 8.709, p < 0.001) and (β = 0.102, C.R. = 2.872, p = 0.004). Healthcare workers' performance significantly reduces workload (β = 0.594, C.R. = 9.972, p < 0.001) and the mediating role of healthcare workers' performance between DHT and workload were also confirmed (β = 0.281, C.R. = 5.9787, p < 0.001). CONCLUSION: The findings underscore the critical role of DHT in enhancing healthcare workers' performance and reducing workload, with the TOE framework and performance acting as significant mediators. These results provide actionable insights for healthcare administrators and policymakers to optimize DHT implementation, support workforce efficiency, and address workload challenges through strategic organizational and environmental adaptations.