INTRODUCTION: The main objective of the present study was to analyze the new job profile "Chief Digital Officer (CDO) in German hospitals". Here, best practices for the introduction of the job profile should be determined and the need for a CDO position to execute the digital transformation should be evaluated. METHODS: A standardized three-stage online Delphi process (expert consensus finding) followed by a roundtable discussion was performed, including 16 experts. RESULTS: The survey showed that most CDOs have been employed as CDOs in a hospital for a maximum of two years. Just over half of these hospitals already have a digitization strategy. Lack of human resources, underfunding of projects, lack of willingness to change among operational staff and management as well as legal hurdles have been reported as the primary problems in digital transformation. In addition to project management skills, CDOs should also have change management expertise and the ability to abstract and simplify complex processes. They should have a high level of knowledge about everyday work and technical content of interdisciplinary health professions. A CDO can be considered as the fourth pillar of responsibility, in addition to the business, medical and nursing director at the management level, and should be responsible in this role for the implementation of digital transformation. DISCUSSION: This study was able to show which activities CDOs are involved in and which coping strategies they use to handle the hurdles.