Institutional Logics and Digital Innovations in Healthcare Organizations in Response to Crisis

In all countries with advanced welfare systems, healthcare organizations operate in complex institutional systems, which define their space of autonomy in relation to health policy choices and affect their strategic choices, organizational design and management. Healthcare systems are a particularly fruitful context in which to examine how a range of contrasting norms and practices shape innovation. They are in fact confronted with multiple values and demands and the challenge is to simultaneously enhance the quality and reduce the costs of care. The paper examines how competing institutional logics shape innovation development through the use of digital technologies in healthcare organizations responding to emerging events, such as Covid-19 pandemic. Specifically, we adopt an institutional logics perspective to provide insight into the process of innovation, with a focus on the role of telemedicine. The need for social distancing and minimal physical contact challenged and interrupted hospital practices and, in response, digital technologies lead to new processes and services. Remote audio-visual functionality of digital technologies were appropriated in different ways, as stakeholders (state actors, managers, health professionals, and family members) sought to improvise and enhance the protection of persons concerned. Through remote monitoring of patients, telehealth works as a preventative measure to avoid admissions and is therefore a carrier of the managerialist logic of reducing costs by enabling, at the same time, a fast and accurate response to patients’ needs.