Abstract

In this study, we identify bundles of technologies and associated implementation barriers that could be viewed as part of Healthcare 4.0 (H4.0) and test their impact on performance improvement in a sample of hospitals. For that, we carried out a cross-sectional study with 181 leaders from hospitals in different countries that have already started H4.0 implementation. The collected data were analyzed using multivariate statistical techniques. Results indicate that H4.0 technologies could be organized into two different bundles according to their role within the hospital. Common barriers to H4.0 implementation were also empirically organized in two groups, following the sociotechnical systems theory. Bundles of H4.0 technologies presented a positive and significant effect on hospitals' performance. As their interaction with H4.0 barriers displayed a significant effect on performance improvement, it is important to concurrently consider H4.0 technologies and barriers. Our results allow hospital managers to anticipate potential issues in H4.0 implementation, enabling more assertive efforts to improve performance and deliver high-quality and low-cost care in the fourth industrial revolution era.