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Electronic Health Records and the Logics of Care: Complementarity and Conflict in the U.S. Healthcare System

Author

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  • Sean Hansen

    (Saunders College of Business, Rochester Institute of Technology, Rochester, New York 14623)

  • A. James Baroody

    (Saunders College of Business, Rochester Institute of Technology, Rochester, New York 14623)

Abstract

The U.S. healthcare system has experienced rapid growth in the adoption and use of clinical health information technology, such as electronic health record (EHR) systems. In a field as complex and pluralistic as healthcare, the introduction of these sweeping information technology platforms is transforming the practices, roles, interdependencies, and communication mechanisms that connect a heterogeneous mix of stakeholders. In this study, we assess the impact of EHR adoption and use on the practices of U.S. healthcare stakeholders and the institutional logics that they instantiate. We identify four prominent logics around the adoption and use of EHR systems—medical professionalism, private sector managerialism, technical design, and regulatory oversight. Our analysis reveals the ways in which practices enacted through EHR systems interact to engender a confluence of the institutional logics that mark the field. Specifically, we theorize a mechanism by which the reticulation, or intertwining, of practices mediated by an EHR system variously fosters complementarity and conflict between institutional logics based on the commensurability of the organizing principles invoked. This proposed framework offers a novel approach to the role of information system use in the institutional dynamics of the healthcare system. In addition, this research offers a range of practical insights regarding the ways in which the diverse institutional logics of the U.S. healthcare system may be impacted by the growth of EHR system use.

Suggested Citation

  • Sean Hansen & A. James Baroody, 2020. "Electronic Health Records and the Logics of Care: Complementarity and Conflict in the U.S. Healthcare System," Information Systems Research, INFORMS, vol. 31(1), pages 57-75, March.
    • Handle: RePEc:inm:orisre:v:31:y:2020:i:1:p:57-75
    DOI: 10.1287/isre.2019.0875
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    3. Oliver Thomas & Simon Hagen & Ulrich Frank & Jan Recker & Lauri Wessel & Friedemann Kammler & Novica Zarvic & Ingo Timm, 2020. "Global Crises and the Role of BISE," Business & Information Systems Engineering: The International Journal of WIRTSCHAFTSINFORMATIK, Springer;Gesellschaft für Informatik e.V. (GI), vol. 62(4), pages 385-396, August.
    4. Asta Pundziene & Neringa Gerulaitiene & Sea Matilda Bez & Irène Georgescu & Christopher Mathieu & Jordi Carrabina-Bordoll & Josep Rialp-Criado & Hannu Nieminen & Alpo Varri & Susanne Boethius & Mark v, 2023. "Value capture and embeddedness in social-purpose-driven ecosystems," Post-Print hal-04147723, HAL.
    5. Pundziene, Asta & Gerulaitiene, Neringa & Bez, Sea Matilda & Georgescu, Irène & Mathieu, Christopher & Carrabina-Bordoll, Jordi & Rialp-Criado, Josep & Nieminen, Hannu & Varri, Alpo & Boethius, Susann, 2023. "Value capture and embeddedness in social-purpose-driven ecosystems. A multiple-case study of European digital healthcare platforms," Technovation, Elsevier, vol. 124(C).
    6. Abhay Nath Mishra & Youyou Tao & Mark Keil & Jeong-ha (Cath) Oh, 2022. "Functional IT Complementarity and Hospital Performance in the United States: A Longitudinal Investigation," Information Systems Research, INFORMS, vol. 33(1), pages 55-75, March.
    7. Hannes Rothe & Katharina Barbara Lauer & Callum Talbot-Cooper & Daniel Juan Sivizaca Conde, 2023. "Digital entrepreneurship from cellular data: How omics afford the emergence of a new wave of digital ventures in health," Electronic Markets, Springer;IIM University of St. Gallen, vol. 33(1), pages 1-17, December.
    8. Huarng, Kun-Huang & Lee, Cheng-Fang & Yu, Tiffany Hui-Kuang, 2023. "Case study of a healthcare virtual community model," Technological Forecasting and Social Change, Elsevier, vol. 188(C).

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