Digital transformation of radiology services in Moroccan public hospitals: drivers and challenges for smart hospital governance

Objectives: This study aims to analyze the drivers and barriers of digital transformation in radiology services within Moroccan public hospitals, identifying conditions necessary to guide these services toward a smart hospital model that enhances efficiency, quality, and governance. Prior Work: Previous research has highlighted the global importance of digitalization in healthcare, with radiology being central due to high data dependence and technological complexity. In Morocco, studies focus mostly on broad health system digitalization, with limited attention to public hospital radiology services. Approach: A narrative literature review was conducted, integrating academic publications, institutional reports (WHO, OECD, Moroccan Ministry of Health), and national strategic documents. Keywords related to digital health, hospital information systems, radiology services, and smart hospital governance were used to identify relevant sources between 2010 and 2025. The analysis built a conceptual framework linking technological infrastructure, interoperability, governance, workforce capacity, and cybersecurity with digital transformation outcomes. Results: The review identified key drivers, including robust infrastructures, interoperable PACS/RIS systems, strategic leadership, and staff training. Major barriers include heterogeneous equipment, system fragmentation, limited digital competencies, financial constraints, organizational resistance, and cybersecurity risks. Moroccan public hospitals show opportunities for modernization, particularly when digitalization is embedded within broader smart government strategies. Implications: Effective digital transformation in radiology requires integrated planning, investment in technology and workforce, phased adoption strategies, and robust governance structures. Aligning hospital digitalization with urban and national digital health initiatives can improve efficiency, quality, and patient safety.Value: This study provides a foundation for strategic planning and operational guidance to develop “intelligent radiology services” in Moroccan public hospitals, contributing to the broader modernization of healthcare delivery and digital governance.