Organizing Digital Innovation in Healthcare

This PhD thesis examines the organizing of digital innovation in the healthcare sector, by drawing on process and practice-based approaches and by utilizing comparative field and longitudinal ethnographic methods, at three different hospital sites. Health care systems across the globe are under pressure, and digital innovation is seen as having tremendous potential and hope for transforming healthcare delivery. Digital innovation introduces a new, open-ended value landscape for generating or capturing value, which is integral to organizing.

The thesis examines the overarching question of how to address the ongoing challenges of organizing for digital innovation at different stages of the process, including the underexplored allocation stage, as well as the usage and appropriation stages. To do so, the thesis employs a novel theoretical framework that focuses on three specific areas of the phenomenon. First, to address the challenge of justifying and establishing the value of digital innovations, the first paper devises a performative framing perspective to examine how practitioners’ temporally oriented framing practices matter in justifying and enacting different possibilities for reputational value. Value is conceptualized as fluid and mutable over time in the digital age.

The second paper examines how and why places are consequential for the scaling of the digital innovation of 3D printing, at the usage stage. By taking seriously the role of materiality in scaling, I propose a broader understanding of scaling as processes of place bending, framing and jumping, which are intertwined with considerations of resourcing, materiality and location meaning.

Finally, the third paper focuses on how occupations defend, contest and create boundaries at the implementation stage. The paper shows how the materiality of artifacts and spaces is constitutive of the way occupations mobilize, maintain and expand their jurisdictional boundaries. The dissertation concludes by discussing two overarching contributions that provide opportunities for future research.