With the lack of timely and relevant patient information at the point of care increasingly being linked to adverse medical outcomes, effective management and exchange of patient data has emerged as a strategic imperative for the healthcare industry. Healthcare informaticians have suggested that electronic health record systems (EHRS) can facilitate information sharing within and between healthcare stakeholders such as physician practices, hospitals, insurance companies, and laboratories. We examine the assimilation of EHRS in physician practices through a novel and understudied theoretical lens of physicians' identities. Physician practices and the physicians that lead them occupy a central position in the healthcare value chain and possess a number of unique characteristics that differentiate them from other institutional contexts, including a strong sense of affiliation with other physicians, potent professional identities, and a desire for autonomy. We investigate two salient physician identities, those of careprovider and physician community, grounded in the roles physicians play and the groups with which they affiliate. We argue that these identities and their evolution, triggered by EHRS, manifest as both identity reinforcement and deterioration, and are important drivers of EHRS assimilation. We use survey data from 206 physician practices, spread across the United States, to test our theoretical model. Results suggest that physician community identity reinforcement and physician community identity deterioration directly influence the assimilation of EHRS. We further find that the effects of careprovider identity reinforcement and careprovider identity deterioration on EHRS assimilation are moderated by governmental influence. Theoretical and pragmatic implications of the findings are discussed.
The process by which organizations incorporate technological innovations into existing routines and use them on a regular basis persists as a central concern in the literature. Although we now have a fairly robust understanding of the drivers of innovation adoption, the use of innovations is less understood. In this paper, we draw on two streams of literature, managerial and organizational sensemaking, and organizational capabilities that have hitherto been used independently, to investigate organizational use of information technology (IT)-based innovations. Building on and extending prior work, we posit that organizational capabilities serve as complements to managers' technological frames related to an innovation. We focus on the use of an important technological innovation-business-to-business (B2B) electronic markets for procurement. We examine interactions between three technological frames-benefits frame, threat frame, and adjustment frame, and two organizational capabilities-technological opportunism and technological sophistication, and their relationship with the use of B2B electronic markets in firms. We test our research model using survey data collected from 292 firms. Results largely support the proposed conceptualization and shed new light on the key factors associated with firms' use of B2B electronic markets. Theoretical and practical implications of the findings are discussed.
This paper examines the antecedents and consequences of Internet use in the procurement process. Drawing upon the resource-based view (RBV) of the firm and the technology, organization, and environment framework, we develop an integrative model that examines the antecedents and consequences of Internet use in two stages--the search stage and the order initiation and completion (OIC) stage--of the procurement process. The model enables us to deconstruct both the usage and the performance aspects of information technology (IT) in business processes, and to provide insights into the enablers of use and business value. The model is estimated with survey data from 412 firms. Our results suggest that while some resources, such as procurement-process digitization, influence Internet use in both the procurement stages, other resources, such as the diversity of organizational procurement knowledge, impact Internet use in only one stage. We also find that Internet use in the OIC stage has a more significant impact on procurement-process performance than use in search. This study extends the digital capabilities and firm performance literature in the context of electronic procurement. This study also contributes to the small but emerging stream of literature that investigates antecedents, the extent, and implications of IT use holistically.