Baseline comparison.

This study investigates the specific impacts of Industry 4.0 technologies—such as artificial intelligence, Internet of Things (IoT), and data-driven automation—on collaboration, communication, service efficiency, and organizational performance within high-complexity hospitals in Colombia. Despite growing global interest, empirical evidence from developing countries remains scarce. To address this gap, we conducted a survey involving 272 respondents—comprising administrative personnel, healthcare providers, and supply chain staff—across hospitals classified as Level III and IV in complexity under Colombian healthcare regulations. The data were analyzed using Structural Equation Modeling (SEM) to examine hypothesized relationships between technological innovation and operational variables. Results demonstrate that Industry 4.0 technologies significantly enhance internal collaboration and communication among stakeholders, contributing to improved organizational performance. However, the anticipated reduction in patient service time through technology adoption was not statistically supported, highlighting challenges in the integration and usability of these technologies. Barriers such as inadequate staff training, limited interoperability, and financial constraints were identified as critical obstacles. The model confirms the role of collaboration in reducing service times and underscores the need for targeted strategies to fully leverage technological investments. By articulating clear relationships and practical implications, this study offers evidence-based guidance for healthcare managers, policymakers, and technologists seeking to optimize the deployment of Industry 4.0 tools in resource-constrained healthcare environments..