Prior accounting research problematizes the implications of individual technologies on digitization, digitalization, and digital transformation. However, it often conflates such terms and ignores the pervasive role of datafication. To address these issues, this study develops a processual view of digital transformation to explore how multiple accounting technologies and widespread digitization, digitalization, and datafication practices are implicated in the digital transformation of a public sector organization. In doing so, we draw on longitudinal, case-study evidence of a healthcare provider in England and highlight both the evolutionary and revolutionary ways through which organizational change manifested. The study develops a threefold contribution to the accounting and public administration literature. First, it offers a processual view of digital transformation that is conceptually distinct yet interlinked with entangled digitization, digitalization, and datafication practices. Second, it indicates that revolutionary change manifests in tandem with datafication practices which centralize control and empower diverse actors, while also creating inter-organizational tensions. Third, it contributes an understanding of how potentially contested datafication practices, novel digital infrastructures, and hybrid organizational forms gain social approval in the process of digital transformation.