Background: The worldwide acceleration of digital transformation in healthcare underscores the need for professionals to continuously adapt and sustain robust digital health competence, shaped not only by individual characteristics and institutional environments but also by broader social, cultural, and geopolitical factors.

Objective: This study aimed to identify distinct clusters of digital health competence among healthcare professionals across 19 diverse countries and regions, and to examine the factors influencing the development and distribution of these competence clusters.

Methods: A cross-sectional international survey study was conducted between 2023 and 2024, using a validated survey instrument measuring digital health competence and its influencing factors. Data were collected from healthcare professionals in 19 countries and regions (n = 6440; n = 5945 used for this study), following a harmonised protocol with shared demographic templates and instruments. K-means cluster analysis was employed to derive digital competence profiles, with comparative analyses conducted to investigate associations between the identified clusters and individual characteristics (e.g., age, education, professional experience).

Results: Five distinct clusters of digital health competence were identified: (1) Beginners, (2) Developing Professionals, (3) Emerging Users, (4) Proficient Practitioners, and (5) Pioneers. Higher competence clusters (4 and 5) were associated with younger age, higher education, hospital-based work, and stronger perceived support from management, organisational structures, and colleagues. In contrast, lower-performing clusters reported limited digital engagement and minimal support. Perceived leadership influence, particularly managerial commitment to digital change, was a key differentiator across clusters.

Conclusions: The findings demonstrate substantial variation in digital health competence across healthcare professionals internationally. Cluster-specific strategies, such as targeted upskilling, peer mentoring, and leadership engagement, are needed to address competence gaps. The results provide a foundation for policy development and workforce training frameworks aimed at strengthening digital readiness in global healthcare systems. Future research should explore longitudinal competence development and evaluate targeted interventions. © 2026 The Authors. Published by Elsevier Ltd.