Institutional Logics, Technology Affordances and Hybrid Professionals: Developing a Billing App for Hospital Physicians

We bring together the institutional theory literature on institutional logics and the information systems (IS) literature that conceptualizes a relational view of affordances to explore the digital changes unfolding in the delivery of professional services. Through a qualitative inductive study of the development of an app led by a clinician manager in an Australian hospital, we investigate how multiple institutional logics shape the design of affordances when an organization develops new digital technologies for frontline professional work. Our findings show how a billing function was designed into the app by the development team over four episodes to afford potential physician users with billing usability, billing acceptability, billing authority and billing discretion. These affordances emerged as different elements of professional, state, managerial and market logics became activated, interpreted, evaluated, negotiated and designed into the digital technology through the team’s interactions with the clinician manager, a hybrid professional, during the app development process. Our findings contribute new insight to the affordance-based logics perspective by deepening understanding of the process through which multiple institutional logics play out in the design of affordances of digital technology. We also highlight the role of hybrid professionals in this digital transformation of frontline professional work.