Abstract
This paper develops a theoretical framework explaining how healthcare organisations navigate the twin transformations of digital innovation and environmental sustainability under complex, conflicting, institutional demands.
Although scholarship has begun to examine sustainable digital health systems, a gap remains in understanding how organisations build capabilities to manage the competing logics underpinning this domain. Drawing on institutional logics and dynamic capabilities, the microfoundations of an institutionally situated dynamic capability - the Sustainable Digital Health Capability (SDHC) - are theorized to enable strategic responses to institutional complexity.
A multi-level model in which SDHC mediates the relationship between field-level pressures (coercive, mimetic, normative) and firm-level outcomes, allowing organisations to reconfigure resources and, crucially, achieve a triad of performance outcomes: operational efficiency, environmental integrity, and enhanced institutional legitimacy.
By articulating testable research propositions, the study offers a new lens on the digital–sustainability nexus in healthcare and outlines a robust agenda for future empirical investigation.