Digital transformation has revolutionized public organizations, posing significant challenges in terms of adaptation. These challenges necessitate the need for revised working methods, processes, and procedures and streamlined integration of digital technologies and novel systems. However, adjusting daily habits, established procedures, and operational methods is often perceived as demanding and can provoke a reluctance to embrace change. This study aimed to explore whether factors within the organizational culture in a Swedish healthcare organization create a gap between top managers, middlemanagers, and employees in the digital transformation process. The purpose of the study was also to investigate how IT Governance and the IT Governance framework COBIT2019 can support digital transformation.

To investigate this topic, a qualitative approach was employed, utilizing unstructured semi-structured interviews that encourage participants to freely discuss the matters at hand. The ten participants in the study all have a role in either implementing or developing digitalization initiatives in the organization. The findings indicate that numerous factors hinder the organization's digital transformation process, impeding its ability to obtain the benefits of digitalization. The factors identified in the empirical data align with the IT governance framework, highlighting the importance of engagement, prioritization of time and resources, unclear strategies, bureaucracy and legal aspects, and access to the right information. Specifically, communication and dialogue pose significant challenges within the organizational culture on all levels, from management to employees in the organization. 

In sum, the study confirms a gap exists between top managers, middle managers, and healthcare professionals regarding how to achieve successful digital transformation. Based on the results, the study concludes that organizational culture, especially communication and dialogue, influences digital transformation and that IT governance mechanisms, with COBIT 2019 as a control framework, can act as a bridge in the digital transformation processes.