Integrating Information Systems and Institutional Insights: Advancing the Conversation with Examples from Digital Health

Digital transformations represent an increasingly salient empirical phenomena for institutionalists studying the processes by which institutions evolve, erode, or otherwise change. Yet, there have been few meaningful attempts to engage with insights from the information systems (IS) literature, despite digital innovation and diffusion falling squarely within its domain. This essay makes an initial attempt at integration by offering a two-by-two framework which crosses salient theoretical categories within the IS and institutional literatures. From the former, we draw on concepts of system acceptance and resistance, and from the latter, we draw on concepts of institutional maintenance and change. Each quadrant in our framework represents user responses happening because of, in reaction to, or toward various institutional dynamics. We illustrate each quadrant with data collected as part of a study of digital transformation in the field of public healthcare in Australia. We use our illustrative case to open up research questions which researchers might use to frame their own studies of digital transformations as a form of institutional change. We conclude with a discussion of what other theoretical advances or insights might be yielded from greater collaboration between institutionalists and IS scholars. This essay contributes to the nascent study of digital transformations as a form of institutional change through examining how complementary concepts of the IS and institutional literatures might be used simultaneously to understand the intersection of digital innovation and diffusion and the institutional arrangements governing the fields which they change.