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Background Upgrading and replacing existing medical information systems is one of the important means of digital transformation in primary healthcare, the Consolidated Framework for Implementation Research Constructs (CFIR) is widely used to guide implementation research across various stages and states, however, there are few research reports on the application of CFIR in medical service scenarios in China. Objective To analyze the implementation elements of digital transformation in primary healthcare based on CFIR. Methods In January 2023, 12 community health service institution managers and family doctor team members in Wuhou District, Chengdu, were selected as the subjects of the survey. A self-designed questionnaire was used for the survey, and statistical analysis was conducted using the SPSSAU software. Results The effective recovery rate of the questionnaire was 100% (279/279), group and the family doctor team group is different (57.15% vs. 23.64%), and their perceptions of the sources of pressure for urgency also vary. The top three overall pressures are the demand for the supporting of the grassroots medical service model (59.14%), the strategic development needs of the institution (11.83%), and the efficiency support for personal business operations (9.68%). Respondents believe that the upgrade of the information system still needs adjustments in the transformation of service models and information technology function support (80.29%), the establishment of a unified organizational structure for promoting information technology construction (65.59%), and an independent data aggregation and management mechanism (65.23%). The top three tasks for completing digital transformation are the improvement of medical staff's health management and digital capabilities (6.21 points), the optimization and capability reshaping of the family doctor team (5.84 points), and the upgrade and transformation of the information system (5.22 points). 59.86% of the respondents support or strongly support the digital transformation goals and logic, but only 32.26% believe they can complete or lead other members to quickly implement digital transformation in their positions, and only 0.72% believe they can become members of the district-level "combat" team. The results of Logistic regression analysis showed that the clarity of the district-level strategic communication (OR=1.933), the degree of recognition of the transformation goals and logic of the above service model (OR=1.640), choosing to gain patient trust and support as the main external pressure (OR=1.159), and the expectations for the future district-level information system (OR=1.540) were positive influencing factors for individual efficiency; the impact of the current information system on daily business (OR=0.700) and the acceptance of the time for upgrading the system (OR=0.728) were negative influencing factors for individual efficiency. The above six influencing factors were distributed across five CFIR dimensions, and the implementation process accounts for two. Conclusion The timing for implementing the upgrade and transformation of the information system in Wuhou District, Chengdu, is relatively mature. Digital transformation is a systematic project involving multiple roles and links, and it requires a systematic organizational structure to drive the implementation process. CFIR can help enhance the insight into internal and external environments during the implementation process of digital transformation and successfully identify implementation elements.