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Plurality of institutional logics in digital healthcare: The rise of the hybrid patient


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@ 31st EGOS Colloquium, July 2–4, 2015, Athens, Greece
In this paper, we explore field emergence, as it happens, aiming to enrich the theoretical understanding of this understudied phenomena and of institutional complexity. Our inductive case study is the nascent field of collaborative digital health technologies, which we follow from 2007 to present. We employ an institutional logics perspective, and drawing on existing theorization of field emergence, we point out the complex intertwine of logics and stakeholders as they reveal in time. Although preliminary, our findings present four distinct emergence phases: ingenuous age, legitimation, mobilization and stabilization, along with particular aspects like the role of legitimizing actors and the granularity of the field during mobilization. Additionally, we discuss digital technologies as enablers and material mediators of institutional change, and highlight the emerging role of the hybrid patient, with practical implications for the evolution of healthcare, as we know it.

Published in: Health & Medicine
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Plurality of institutional logics in digital healthcare: The rise of the hybrid patient

  1. 1. Sub-theme 55: Re-examining the organization of healthcare: institutional, technological and clinical challenges plurality of institutional logics in digital healthcare: the rise of the hybrid patient lorena macnaughtan, gerardo patriotta, lorraine pinnington & sujatha raman
  2. 2. how do fields emerge?
  3. 3. what is the process of field emergence? what are the institutional logics and their representative stakeholders?
  4. 4. collaborative digital health technology(cdht) inductive case study
  5. 5. medical profession citizenmarket state science regulators payers consultancies ict & cdht producers healthcare managers distributors integrators pharma R&D centers academic programs
  6. 6. ingenuous phase citizen logic experimentation evidence reimbursement business models
  7. 7. ingenuous phase legitimation socio-political legitimacy health citizen consumer stakeholder regulation interoperability governance
  8. 8. ingenuous phase legitimation mobilization All rush in
  9. 9. ingenuous phase 2007 - 2009 legitimation 2010 - 2012 mobilization 2013 - ongoing stabilization … intense hybridization critical mass cognitive/legitimacy legitimizing actors socio-political legitimacy critical and significant mass democratization intense ambivalence granularity segmentation assimilation failure autonomy
  10. 10. field 2 field 3 field 1 field failures (socio-political context) economic triggers technology enablers resources state interstitial space
  11. 11. Scanadu [n.d.]. Still from future of healthcare. [video] retrieved June 23, 2015
  12. 12. ? Macnaughtan, L. 2015. All Eyes on Digital Health. graphic design nuviun. retrieved June 23, 2015
  13. 13. institutional logics all bind value, practice, and object. Institutional logics are, one might say, practical forms of value rationality (Friedland, 2013, p. 36) …brings theoretical insights into this process and institutional complexity practical implications of researching how digital technologies cause and enable change across the spectrum in… “and if I had to start a company and fail a thousand times and start it over again and fail, I would do that. And so when I realized that, then it was about doing whatever it takes to make this a reality. Because it's a change that can happen and has to happen in our world!” – Elizabeth Holmes, Theranos (CS, 2014)
  14. 14. References Aldrich, H. E., & Fiol, C. M. (1994). Fools Rush in? The Institutional Context of Industry Creation. The Academy of Management Review, 19(4), 645–670. Friedland, R. (2013). God, Love, and Other Good Reasons for Practice: Thinking Through Institutional Logics. In Institutional Logics in Action, Part A (Vol. Part A, pp. 25–50). Bingley, UK: Emerald Group Publishing Limited. Macnaughtan, L. 2015. All Eyes on Digital Health. graphic design nuviun. retrieved June 23, 2015 Scanadu [n.d.]. future of healthcare. [video]. retrieved June 23, 2015 CHM Revolutionaries (2014)Theranos Founder & CEO Elizabeth Holmes in Conversation with Michael Krasny [video]. retrieved March 30, 2015 thank you!