Digital transformation of professional healthcare practices: fitness seeking across a rugged value landscape

Digital transformation (DT) is typically described as a strategic, top-down initiative where new digital technologies fundamentally disrupt an organisation’s structure, procedures, and processes to enhance its value proposition. We propose a middle-range theory which highlights that DT of professional practices in healthcare follows a different path. To build this theory, we transpose the metaphor of a “fitness landscape” from evolutionary biology to a professional healthcare context to build an intermediate conceptualisation, which is then refined through an empirical study. Our theory highlights that external events, such as the COVID-19 pandemic, changing patient behaviours or the availability of new digital resources, transform the “value landscape” upon which healthcare professionals create and deliver healthcare services to patients. Empowered by their professional autonomy and driven by their service orientation, healthcare professionals search for new paths and peaks for value creation and delivery across a rugged landscape. As digital resources are leveraged, new value propositions in practice emerge, and professional healthcare practices are digitally transformed.