Digital transformation and operational performance in Indonesian aesthetic clinics: The mediating role of operational efficiency

This study examines the relationship between digital transformation and operational outcomes in Indonesian aesthetic healthcare small and medium-sized enterprises (SMEs), with operational efficiency modelled as a mediating mechanism. An explanatory sequential mixed-method design was applied in ten aesthetic clinics using DERMATECH, an integrated clinic-management information system. The quantitative phase analysed 120 valid employee responses through partial least squares structural equation modelling (PLS-SEM), followed by semi-structured interviews with nine operational users selected to explain the statistical results. Digital transformation exhibited a strong positive association with operational efficiency (β = 0.72, p < 0.001), operational efficiency was positively related to operational performance (β = 0.46, p < 0.001), and digital transformation retained a direct positive relationship with operational performance (β = 0.38, p < 0.001). The significant indirect effect (β = 0.33, p < 0.001) indicates complementary partial mediation, interpreted within the boundaries of a cross-sectional design. The qualitative phase explains that integrated registration, scheduling, clinical records, inventory, billing, and reporting reduce repeated data entry, improve information availability, and support faster operational decisions. The study contributes contextual evidence from healthcare service SMEs, refines operational efficiency as a process-level mechanism, and demonstrates how mixed-method integration can explain why digital transformation affects performance. Engineering-management implications concern workflow standardisation, process ownership, data-quality control, capacity planning, inventory monitoring, role-based dashboards, and continuous capability development.