In light of the rapid digital development, the Omani healthcare sector has faced challenges and opportunities for digital transformation. This study aimed to identify the challenges and requirements for successful digital transformation and propose a structured framework to guide implementation. The research relied on a quantitative approach, and data was collected through questionnaires distributed to 382 healthcare providers and administrators in the Sultanate of Oman. The results revealed significant challenges that include human challenges (such as skill shortages and resistance to change), and they ranked first, followed by financial and administrative challenges. The study also indicated that a strong focus on hierarchy levels to ensure systems integration, lifetime and value stream management, and meeting technical layer needs defines the major criteria for an effective digital transformation framework. Based on these findings, the research presents a digital transformation framework, an updated Reference Model for Industry 4.0 (RAMI 4.0) version. The study also indicated that a strong focus on hierarchy levels to ensure systems integration, lifetime and value stream management, and meeting technical layer needs defines the major criteria for an effective digital transformation framework. Based on these findings, the research presented a digital transformation framework by adding a technical layer to the RAMI 4.0 layers. This framework provides a means for arranging digital transformation across hospital departments to improve interoperability, data security and support patient outcomes and operational efficiency in line with the goals of the Oman Vision 2040.