How Does Digital Transformation Contribute to Medical Waste Management? A Case Study on Shanghai, China

Medical waste surged during the initial response to COVID-19, greatly increasing the risk of medical waste pollution. Medical waste management involves numerous stakeholders, including environmental, healthcare, agricultural, and laboratory regulatory authorities, organizations generating medical waste, and transportation and disposal companies. The traditional regulatory system suffers from inter-departmental obstacles and opportunistic behavior by stakeholders. All of these issues have drawn widespread attention from the government and the public in the wake of the pandemic. To address these issues, Shanghai has taken the lead in implementing digital transformation to enhance the effectiveness of medical waste management. This study constructs an innovative analytical framework encompassing function, structure, and institution to comprehensively examine digital transformation. This framework reveals how functional enhancements through digital technologies first improve operations via real-time information transmission, process reengineering, and increased efficiency, and then subsequently reshape inter-organizational relationships while requiring calibrated institutional adaptation for effective implementation. It also indicates a critical role of technological-institutional alignment in determining transformation outcomes. Based on this framework, a quadratic assignment procedure and social network analysis are used to compare the planned, traditional, and digital networks formed before and after the digital transformation of medical waste management in Shanghai. Through systematic analysis of these networks, this study investigates how digital transformation can enhance medical waste management effectiveness and provides a nuanced analysis that goes beyond mere issues of technological implementation to reveal the complex interplay between digital capabilities and institutional adaptation, and to uncover the challenges involved in achieving comprehensive collaboration.