Customer Engagement in Digital Health Transformation as Strategic Change: Evidence from Saudi Arabia’s Vision 2030

Purpose: The purpose of this paper is to explore how perceptions of digital health transformation play a role in Saudi Arabia’s customer engagement in healthcare, according to Vision 2030. Saudi Vision 2030, a national reform agenda, has prioritized healthcare digitalization to enhance efficiency, access, and patient-centered care. In particular, the research attempts to explore the attitude of the patient and whether cultural values and infrastructure issues play a mediator role in the perception–engagement relationship. Design/methodology/approach: The study used a mixed-method approach, with qualitative interviews from providers and consumers, along with survey responses from 402 users of digital health. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to examine hypothesized relationships and moderation effects. Findings: Findings establish that digital health perceptions are a crucial driver in enhancing engagement (β = 0.386; p < 0.001). Perceived ease of use (β = 0.368) and usefulness (β = 0.530) exhibited strong positive influences. Moderation analysis revealed that cultural values (β = 0.343) and infrastructure (β = 0.253) further enhance engagement. The findings highlight usability, usefulness, and context as foundational enablers of long-term patient engagement. Originality/value: By combining Technology Acceptance Model (TAM) variables and applying cultural and infrastructural moderators, this research provides new empirical evidence of Saudi Arabian digital health adoption. It provides policy and practical advice in the creation of accessible, culturally appropriate, and adequately supported digital health solutions toward Vision 2030. It also supports United Nations Sustainable Development Goals (SDGs). The study aligns with SDG 3 (Good Health and Well-Being), SDG 9 (Industry, Innovation and Infrastructure), SDG 12 (Responsible Consumption and Production) and SDG 13 (Climate Action) by further promoting sustainable healthcare transformation in a global development agenda.