Does IT ambidexterity, digital dynamic capability and patient agility capability influence the performance of outpatient installation services?

Authors

DOI:

https://doi.org/10.47989/ir31360403

Keywords:

IT Ambidexterity, Digital Dynamic, Patient Agility, Patient Service Performance, Hospital Management

Abstract

Introduction. Utilizing information technology (IT) can accelerate operational procedures, enhance service quality, and increase the accessibility of patient medical data for doctors and medical practitioners. Hospitals need digital dynamic capability to adapt to environmental conditions and patient needs, as well as patient agility capability to achieve superior health service performance.

Method. This study aims to examine the relationships among IT ambidexterity, digital dynamic capability, patient agility capability, and patient service performance. Quantitative research was conducted through questionnaire assessments using Google Forms, targeting managerial-level health workers in outpatient installations at Class C hospitals in Surabaya City, Indonesia.

Analysis. The empirical hypotheses were tested using Partial Least Squares Structural Equation Modeling (PLS-SEM) with data from 114 health worker respondents.

Results. The results indicate that IT ambidexterity and patient agility capability positively influence patient service performance. Nevertheless, digital dynamic capability does not have a significant impact on improving patient service performance. Additionally, digital dynamic capability and patient agility capability serve as mediating variables between IT ambidexterity and hospital patient service performance.

Conclusion. This study contributes to the literature by expanding the conceptual framework linking IT ambidexterity to digital dynamic capability, patient agility capability, and patient service performance within the hospital environment.

References

Acuña, S. T., Castro, J. W., & Juristo, N. (2012). A HCI technique for improving requirements elicitation. Information and Software Technology, 54(12), 1357-1375. https://doi.org/10.1016/j.infsof.2012.07.011

Adler, P., & Hecksher, C. (2013). The collaborative ambidextrous enterprises. Universia Business Review, 40, 34–51.

Al-Damen, R. (2017). Health care service quality and its impact on patient satisfaction: Case of Al-Bashir hospital. International Journal of Business and Management, 12(9), 136–152. https://doi.org/10.5539/ijbm.v12n9p136

Alolayyan, M. N., Alyahya, M. S., Alalain, A. H., Shoukat, A., & Nusairat, F. T. (2020). Health information technology and hospital performance the role of health information quality in teaching hospitals. Heliyon, 6(10), e05040. https://doi.org/10.1016/j.heliyon.2020.e05040

Andriopoulos, C., & Lewis, M. W. (2009). Exploitation-exploration tensions and organizational ambidexterity: Managing paradoxes of innovation. Organization Science, 20(4), 696–717. https://doi.org/10.1287/orsc.1080.0406

Ashok, M., Narula, R., & Martinez-Noya, A. (2016). How do collaboration and investments in knowledge management affect process innovation in services?. Journal of Knowledge Management, 20(5), 1004–1024. https://doi.org/10.1108/JKM-11-2015-0429

Atobishi, T., Moh’d Abu Bakir, S., & Nosratabadi, S. (2024). How do digital capabilities affect organizational performance in the public sector? The mediating role of the organizational agility. Administrative Sciences, 14(2), 37. https://doi.org/10.3390/admsci14020037

Awwad, A. S., Ababneh, O. M. A., & Karasneh, M. (2022). The mediating impact of IT capabilities on the association between dynamic capabilities and organizational agility: The case of the Jordanian IT sector. Global Journal of Flexible Systems Management, 23(6), 315–330. https://doi.org/10.1007/s40171-022-00303-2

Barney, J. (1991). Firm resources and sustained competitive advantage. Journal of Management, 17(1), 99–120. https://doi.org/10.1177/014920639101700108

Bawono, M., Gautama, I., Bandur, A., & Alamsjah, F. (2022). The influence of ambidextrous leadership mediated by organizational agility and digital business model innovation on the performance of telecommunication companies in Indonesia during the Covid-19 pandemic. WSEAS Transactions on Information Science and Applications, 19, 78–88. https://doi.org/10.37394/23209.2022.19.8

Broekharst, D. S. E., van de Wetering, R., Ooms, W., Helms, R. W., & Roijakkers, N. (2023). Deploying predictive analytics to enhance patient agility and patient value in hospitals: A position paper and research proposal. Healthcare Analytics, 3, 100141. https://doi.org/10.1016/j.health.2023.100141

Burns J. P. (1998). Performance improvement with patient service partners. Journal of Nursing Administration, 28(1), 31–37. https://doi.org/10.1097/00005110-199801000-00007

Çelik, D., & Uzunçarşılı, Ü. (2023). Is the effect of organizational ambidexterity and technological innovation capability on firm performance mediated by competitive advantage? An empirical research on Turkish manufacturing and service industries. Sage Open, 13(4), 21582440231. https://doi.org/10.1177/21582440231206367

Cepeda, G., & Vera, D., (2007). Dynamic capabilities and operational capabilities: A knowledge management perspective. Journal of Business Research, 60(5), 426–437. https://doi.org/10.1016/j.jbusres.2007.01.013

Chakraborty, S., Bhatt, V., & Chakravorty, T. (2019). Impact of IoT adoption on agility and flexibility of healthcare organization. International Journal of Innovative Technology and Exploring Engineering, 8(11), 2673–2681. https://doi.org/10.35940/ijitee.K2119.0981119

Chahal, H., & Kumari, N. (2012). Service quality and performance in the public health-care sector. Health Marketing Quarterly, 29(3), 181–205. https://doi.org/10.1080/07359683.2012.704837

Chen, Y., Wang, Y., Nevo, S., Jin, J., Wang, L., & Chow, W. S. (2014). IT capability and organizational performance: The roles of business process agility and environmental factors. European Journal of Information Systems, 23(3), 326–342. https://doi.org/10.1057/ejis.2013.4

Chicco, D., Warrens, M. J., & Jurman, G. (2021). The coefficient of determination R-squared is more informative than SMAPE, MAE, MAPE, MSE and RMSE in regression analysis evaluation. PeerJ Computer Science, 7(3), e623. https://doi.org/10.7717/peerj-cs.623

Clauss, T., Sascha, K., Friedrich, L. K., Peter, M. B., & Alexander, B. (2021). Organizational ambidexterity and competitive advantage: The role of strategic agility in the exploration-exploitation paradox. Journal of Innovation & Knowledge, 6(4), 203–213. https://doi.org/10.1016/j.jik.2020.07.003

Cowing, M., Davino-Ramaya, C. M., Ramaya, K., & Szmerekovsky, J. (2009). Health care delivery performance: Service, outcomes, and resource stewardship. The Permanente Journal, 13(4), 72–78. https://doi.org/10.7812/TPP/08-100

Evans, J. M., Brown, A., & Baker, G. R. (2017). Organizational knowledge and capabilities in healthcare: Deconstructing and integrating diverse perspectives. SAGE Open Medicine, 5, 205031211771265. https://doi.org/10.1177/2050312117712655

Farzaneh, M., Wilden, R., Afshari, L., & Mehralian, G. (2022). Dynamic capabilities and innovation ambidexterity: The roles of intellectual capital and innovation orientation. Journal of Business Research, 148, 47–59. https://doi.org/10.1016/j.jbusres.2022.04.030

Foglia, E., Ferrario, L., Lettieri, E., Porazzi, E., & Gastaldi, L. (2019). What drives hospital wards' ambidexterity: Insights on the determinants of exploration and exploitation. Health Policy, 123(12), 1298–1307. https://doi.org/10.1016/j.healthpol.2019.10.004

Figueiredo, M., Ferreira, J. J., & Vrontis, D. (2024). Perspectives on dynamic capabilities and ambidexterity in born-global companies: Theoretical framing, review and research agenda. Journal of International Management, 30(1), 101099. https://doi.org/10.1016/j.intman.2023.101099

Govindasamy, S., & Wattal, S. (2018). Linking dynamic capabilities and healthcare innovations: A case study approach. Engaged Management Scholarship Conference, Philadelphia, USA, 31 August 2018. http://dx.doi.org/10.4108/eai.20-4-2018.2276424

Hair, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2017). A Primer on partial least squares structural equation modeling (PLS-SEM), 2nd ed. Thousand Oaks: Sage Publications Inc.

Hair, J. F., & Alamer, A. (2022). Partial least squares structural equation modeling (PLS-SEM) in second language and education research: Guidelines using an applied example. Research Methods in Applied Linguistics, 1(3), 100027 https://doi.org/10.1016/j.rmal.2022.100027

Hermanto, I. R., Widyarini, L. A., & Darma, D. C. (2024). Digitalization impact on sustainable firm performance of small, medium, and large businesses. Virtual Economics, 7(1), 7–24. https://doi.org/10.34021/ve.2024.07.01(1)

Husien, W. A., Alhamdany, S. N., & Kataa, I. A. (2020). The mediating role of organizational ambidexterity in the relationship between business intelligence systems and the learning organization exploratory study at the Ramadi's Hospitals. The 2nd Annual International Conference on Information and Sciences (AiCIS), Fallujah, Iraq, 24–25 November 2020. https://doi.org/10.1109/AiCIS51645.2020.00041

Jensen, J. A., Cobbs, J. B., & Turner, B. A. (2016). Evaluating sponsorship through the lens of the resource-based view: The potential for sustained competitive advantage. Business Horizons, 59(2), 163–173. https://doi.org/10.1016/j.bushor.2015.11.001

Karali, E., Angeli, F., Sidhu, J. S., & Volberda, H. (2018). Understanding healthcare innovation through a dynamic capabilities lens, 1st Edition. Oxfordshire: Routledge.

Kero, C. A., & Bogale, A. T. (2023). A systematic review of resource-based view and dynamic capabilities of firms and future research avenues. International Journal of Sustainable Development and Planning, 18(10), 3137–3154. https://doi.org/10.18280/ijsdp.181016

Khin, S., & Ho, T. C. (2019). Digital technology, digital capability, and organizational performance: A mediating role of digital innovation. International Journal of Innovation Science, 11(2), 177–195. https://doi.org/10.1108/IJIS-08-2018-0083

Kim, M., Song, J., & Triche, J. (2015). Toward an integrated framework for innovation in service: A resource-based view and dynamic capabilities approach. Information Systems Frontiers, 17(3), 533–546. https://doi.org/10.1007/s10796-014-9505-6

Kuntz, J., Wong, J. H. K., & Budge, S. (2023). Motive, mindset and opportunity: Exploring leader ambidexterity factors in health-care. The Learning Organization, 30(3), 355–374. https://doi.org/10.1108/TLO-12-2022-0153

Lee, O-K. D., Sambamurthy, V., Lim, K. H., & Wei, K. K. (2015). How does IT ambidexterity impact organizational agility. Information Systems Research, 26(2), 398–417. https://doi.org/10.1287/isre.2015.0577

Levinthal, D. A., & March, J. G. (1993). The myopia of learning. Strategic Management Journal, 14(S2), 95–112. https://doi.org/10.1002/smj.4250141009

Mahmoudi, G., & Talarposhti, M. A. (2018). An assessment of agility in selected hospitals of Mazandaran province, Iran. Journal of Basic Research Medical Sciences, 5(3), 32–41. https://doi.org/10.29252/jbrms.5.3.32

Mandal, S. (2020). Exploring the impact of healthcare agility and resilience on sustainable healthcare performance: Moderating role of technology orientation. International Journal of Sustainable Strategic Management, 8(1), 3–23. https://doi.org/10.1504/IJSSM.2020.105600

Mao, H., Gong, Y., & Titah, R. (2023). Understanding the relationship between IT capabilities and operational agility: A multi-method approach. Journal of Enterprise Information Management, 36(2), 409–436. https://doi.org/10.1108/JEIM-12-2021-0521

Mao, H., Liu, S., & Zhang, J. (2015). How the effects of IT and knowledge capability on organizational agility are contingent on environmental uncertainty and information intensity. Information Development, 31(4), 358–382. https://doi.org/10.1177/0266666913518059

McCullough, J. S., Casey, M., Moscovice, I., & Prasad, S. (2010). The effect of health information technology on quality in U.S. hospitals. Health Affairs, 29(4), 647–654. https://doi.org/10.1377/hlthaff.2010.0155

Ministry of Health of the Republic of Indonesia. (2021). Health digital transformation strategy blueprint in 2024. Available online: https://repository.kemkes.go.id/book/710 (accessed on 5 June 2023).

Ministry of Health of the Republic of Indonesia (2022). Indonesia health profile in 2022. Available online: https://kemkes.go.id/id/profil-kesehatan-indonesia-2022 (accessed on 23 April 2023).

Ochie, C., Nyuur, R. B., Ludwig, G., & Cunningham, J. A. (2022). Dynamic capabilities and organizational ambidexterity: New strategies from emerging market multinational enterprises in Nigeria. Thunderbird International Business Review, 64(5), 493–509. https://doi.org/10.1002/tie.22266

Oktawiranti, A., Rahmawati, R., Achmad, G. N., & ZA, S. Z. (2025). Exploring the factors influencing the intention to use digital banking: The role of resonance FOMO as a moderator. Banks and Bank Systems, 20(1), 161–173. http://dx.doi.org/10.21511/bbs.20(1).2025.14

Park, Y., El Sawy, O. A., & Fiss, P. C. (2017). The role of business intelligence and communication technologies in organizational agility: A configurational approach. Journal of the Association for Information Systems, 18(9), 648–686. https://doi.org/10.17705/1jais.00467

Peng, M. Y-P., Zhang, Z., Yen, H-Y., & Yang, S-M. (2019). Dynamic capabilities and firm performance in the high-tech industry: Quadratic and moderating effects under differing ambidexterity levels. Sustainability, 11(18), 5004. https://doi.org/10.3390/su11185004

Popadiuk, S., Luz, A. R. S., & Kretschmer, C. (2018). Dynamic capabilities and ambidexterity: How are these concepts related?. Revista de Administração Contemporânea, 22(5), 639–660. https://doi.org/10.1590/1982-7849rac2018180135

Popescu, C., El-Chaarani, H., El-Abiad, Z., & Gigauri, I. (2022). Implementation of health information systems to improve patient identification. International Journal of Environmental Research and Public Health, 19(22), 15236. https://doi.org/10.3390/ijerph192215236

Rahmawati, R., Hudayah, S., & Paminto, A. (2023). Social media, saving the food & beverages business in the COVID-19 era?. Cogent Business & Management, 10(3), 2258637. https://doi.org/10.1080/23311975.2023.2258637

Roberts, N., & Grover, N. (2012). Investigating firm's customer agility and firm performance: The importance of aligning sense and respond capabilities. Journal of Business Research, 65(5), 579–585. https://doi.org/10.1016/j.jbusres.2011.02.009

Rohmah, N. (2022). How port service is important for logistic companies? Examining role of service ambidexterity and service agility. Management Analysis Journal, 11(3), 219–226. https://doi.org/10.15294/MAJ.V11I3.60882

Russolillo, G. (2012). Non-metric partial least squares. Electronic Journal of Statistics, 6, 1641–1669. https://doi.org/10.1214/12-EJS724

Salge, T. O., & Vera, A., (2009). Hospital innovativeness and organizational performance: Evidence from English public acute care. Health Care Management Review, 34(1), 54–67. https://doi.org/10.1097/01.HMR.0000342978.84307.80

Sarmiento Falla, J. F., & Karwowski, W. (2024). Survey-based studies of the agility construct in the healthcare sector: A systematic literature review. Applied Sciences, 14(3), 1097. https://doi.org/10.3390/app14031097

Schnellbächer, B., & Heidenreich, S. (2020). The role of individual ambidexterity for organizational performance: Examining effects of ambidextrous knowledge seeking and offering. The Journal of Technology Transfer, 45(5), 1535–1561. https://doi.org/10.1007/s10961-020-09781-x

Simatupang, L., Solvia, I., Kaban, K., & Nasution, S. L. R. (2022). Analysis of factors affecting the acceptance of hospital information system using UTAUT method in Budi Kemuliaan Hospital Batam year 2021. International Journal of Health and Pharmaceutical, 3(1), 133–145. https://doi.org/10.51601/ijhp.v3i1.135

Stoumpos, A. I., Kitsios, F., & Talias, M. A. (2023). Digital transformation in healthcare: Technology acceptance and its applications. International Journal of Environmental Research and Public Health, 20(4), 3407. https://doi.org/10.3390/ijerph20043407

Suhan, S., Samartha, V., & Kodikal, R. (2018). Measuring the effect size of coefficient of determination and predictive relevance of exogenous latent variables on endogenous latent variables through PLS-SEM. International Journal of Pure and Applied Mathematics, 119(18), 39–48.

Teece, D., Peteraf, M., & Leih, S. (2016). Dynamic capabilities and organizational agility: Risk, uncertainty, and strategy in the innovation economy. California Management Review, 58(4), 13–35. https://doi.org/10.1525/cmr.2016.58.4.13

Teece, D. J., Pisano, G., & Shuen, A. (1997). Dynamic capabilities and strategic management. Strategic Management Journal, 18(7), 509–533. https://doi.org/10.1002/(SICI)1097-0266(199708)18:7<509::AID-SMJ882>3.0.CO;2-Z

Trieu, H. D. X., Nguyen, P. V., Nguyen, T. T. M., Vu, H. T. M., & Tran, K. T. (2023). Information technology capabilities and organizational ambidexterity facilitating organizational resilience and firm performance of SMEs. Asia Pacific Management Review, 28(4), 544–555. https://doi.org/10.1016/j.apmrv.2023.03.004

van Lieshout, J. W. F. C., van der Velden, J. M., Blomme, R. J., & Peters, P. (2021). The interrelatedness of organizational ambidexterity, dynamic capabilities and open innovation: A conceptual model towards a competitive advantage. European Journal of Management Studies, 26(2/3), 39–62. https://doi.org/10.1108/EJMS-01-2021-0007

van de Wetering, R. (2021a). IT ambidexterity driven patient agility and hospital patient service performance: A variance approach. Department of Information Sciences, 1, 1–12. https://doi.org/10.1101/2021.07.20.21258538

van de Wetering, R. (2021b). IT ambidexterity and patient agility: The mediating role of digital dynamic capability. The Twenty-Ninth European Conference on Information Systems (ECIS 2021), Marrakesh, Morocco. Available online: https://arxiv.org/abs/2105.09013

van de Wetering, R., Bosua, R., Boersma, C., & Dohmen, D. (2022). Information technology ambidexterity-driven patient agility, patient service- and market performance: A variance and fsQCA approach. Sustainability, 14(7), 4371. https://doi.org/10.3390/su14074371

Wade, M., & Hulland, J. (2004). The resource-based view and information systems research: Review, extension, and suggestions for future research. MIS Quarterly, 28(1), 107–142. https://doi.org/10.2307/25148626

Werder, K., & Richter, J. (2022). A meta-analysis on the effects of IT capability toward agility and performance: New directions for information systems research. PloS ONE, 17(10), e0268761. https://doi.org/10.1371/journal.pone.0268761

Wernerfelt, B. (1984). A resource-based view of the firm. Strategic Management Journal, 5(2), 171–180. https://doi.org/10.1002/smj.4250050207

Wilden, R., & Gudergan, S. P. (2015). The impact of dynamic capabilities on operational marketing and technological capabilities: Investigating the role of environmental turbulence. Journal of the Academy of Marketing Science, 43(2), 181–199. https://doi.org/10.1007/s11747-014-0380-y

Wu, L., & Hu, Y. P. (2012). Examining knowledge management enabled performance for hospital professionals: A dynamic capability view and the mediating role of process capability. Journal of the Association for Information Systems, 13(12), 976–999. https://doi.org/10.17705/1jais.00319

Zayas-Cabán, T., & Wald, J. S. (2020). Opportunities for the use of health information technology to support research. JAMIA Open, 3(3), 321–325. https://doi.org/10.1093/jamiaopen/ooaa037

Zhang, Y. I., Wei, F., & van Horne, C. (2019). Individual ambidexterity and antecedents in a changing context. International Journal of Innovation Management, 23(03), 1950021. https://doi.org/10.1142/S136391961950021X

Zheng, X., Sun, S., Mukkamala, R. R., Vatrapu, R., & Ordieres-Meré, J. (2019). Accelerating health data sharing: A solution based on the internet of things and distributed ledger technologies. Journal of Medical Internet Research, 21(6), e13583. https://doi.org/10.2196/13583

Downloads

Published

2026-10-15

How to Cite

Widyarini, L. A., Wiarto, J., Louis, A. W., Darma, D. C., Kasuma, J., & Ariani, M. (2026). Does IT ambidexterity, digital dynamic capability and patient agility capability influence the performance of outpatient installation services?. Information Research an International Electronic Journal, 31(3), 255–278. https://doi.org/10.47989/ir31360403

Issue

Section

Peer-reviewed papers