The Role of Managers and Professionals Within IT Related Change Processes. The Case of Healthcare Organizations

  • A. Francesconi


IT is often depicted as a force that will transform the production and delivery of healthcare services, promising lower costs and improvements in service quality. However, research on IT and organizational change emphasizes that the organizational consequences of new technology are not straightforward and easy to predict. In this paper we study why IT is framed as determining organizational consequences in the context of digital radiology implementation, showing that, contrary to the view of technological determinism as a case of repeated bad practice, the construction and enactment of technological determinism can be understood as an emergent strategy for coercive organizational change within a particular context of relationships between managers and professionals.


Healthcare Organization Health Information Technology Organizational Consequence Professional Autonomy Computer Support Cooperative Work 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ratib, O., Swiernik, M., and McCoy, J.M. (2002). From PACS to integrated EMR. Computerized Medical Imaging and Graphics 27, 207-215 CrossRefGoogle Scholar
  2. 2.
    Huang, H.K. (2003). Some historical remarks on picture archiving and communication systems. Computerized Medical Imaging and Graphics. 27, 93-99 CrossRefGoogle Scholar
  3. 3.
    Bryan, S., Weatherburn, T.D.C., Watkins, J.R., and Buxon, M.J. (1999). The benefits of hospital-wide PACS: A survey of clinical users of radiology services. British Journal of Radiology 72, 469-472 Google Scholar
  4. 4.
    Lundberg, N. and Tellioglu, H. (1999). Impacts of PACS on the Work Practices in Radiology Departments. New York: ACM Press Google Scholar
  5. 5.
    Hanseth, O. and Lundberg, N. (2001). Designing work oriented infrastructures. Computer Supported Cooperative Work 10(3-4), 347-372CrossRefGoogle Scholar
  6. 6.
    Barley, S.R. (1986). Technology as an occasion for structuring: Evidence from observation of CT scanners and the social order of radiology departments. Administrative Science Quarterly 31,78-108CrossRefGoogle Scholar
  7. 7.
    Leonard-Barton, D. (1988). Implementation as mutual adaptation of technology and organization. Research Policy 17(5), 251-267CrossRefGoogle Scholar
  8. 8.
    Markus, M.L. and Robey D. (1988). Information technology and organizational change: Causal structure in theory and research. Management Science 34(5), 583-598CrossRefGoogle Scholar
  9. 9.
    Orlikowski, W.J. (1992). The duality of technology: Rethinking the concept of technology in organizations. Organization Science 3 (3), 398-427 CrossRefGoogle Scholar
  10. 10.
    Robey, D., Boudreau, M.C. (1999). Accounting for the contradictory organizational consequences of information technology: theoretical directions and methodological implications. Information Systems Research 10(2), 167-185 CrossRefGoogle Scholar
  11. 11.
    Fuchs, V.R. (1968). The Service Economy. National Bureau of Economic Research and Columbia University Press (Eds.), Columbia: Columbia University Google Scholar
  12. 12.
    Drummond, M. (1987). Methods for economic appraisal of health technology. In Drummond M.S. (Ed.), Economic Appraisal of Health Technology in European Community. Oxford: Oxford University Press Google Scholar
  13. 13.
    Warren, K. and Mosteller, F. (1993). Doing More Good than Harm: The Evaluation of Health Care Interventions. New York: New York Academy of Sciences Google Scholar
  14. 14.
    Muir Gray, J.A. (1997). Evidence-Based Health Care: How to Make Health Policy and Management Decisions. London: Churchill Livingstone Google Scholar
  15. 15.
    Thompson, T.G. and Brailer, D.J. (2004). The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care. Framework for Strategic Action. Bethesda, MD: Office of the Secretary, National Coordinator for Health Information Technology, US Department of Health and Human Services Google Scholar
  16. 16.
    Abbott, A. (1988). The System of Professions - An Essay on the Division of Expert Labor.Chicago: The University of Chicago PressGoogle Scholar
  17. 17.
    Scott, W.R., Reuf, M., Mendel, P.J., and Caronna, C.A. (2000). Institutional Change and Healthcare Organizations. Chicago: The University of Chicago PressGoogle Scholar
  18. 18.
    Kitchener, M. (2002). Mobilizing the logic of managerialism in professional fields: The case of academic health centre mergers. Organization Studies 23(3), 391-420CrossRefGoogle Scholar
  19. 19.
    Mintzberg, H. (1983). Structure in Fives. Designing Effective Organizations. Englewood-Cliffs: Prentice HallGoogle Scholar
  20. 20.
    Kinding, D.A. and Konver A.R. (1992). The Role of Physician Executive. Ann Arbor, Mitchigan: Health Administration PressGoogle Scholar
  21. 21.
    Kurtz, M.E. (1992). The dual role dilemma. In Kinding, D.A. and Konver A.R. (Eds.), The Role of Physician Executive. Ann Arbor, Mitchigan: Health Administration Press Google Scholar
  22. 22.
    Cicchetti, A. (2004). La progettazione organizzativa. Principi, strumenti e applicazioni nelle organizzazioni sanitarie. Milano: FrancoAngeli Google Scholar
  23. 23.
    Freidson, E. (1970). Profession of Medicine. New York: Dodd MeadGoogle Scholar
  24. 24.
    Smith, D.B. and Kaluzny, A.D. (1975). The White Labyrinth: Understanding the Organization of Health Care. Berkeley: McCulhanGoogle Scholar
  25. 25.
    Weick, K.E. (1990). Technology as Equivoque. In Goodman, P.S. and Sproull L.S., (eds.), et al.Technology and organizations. San Fransisco, CA: Jossey-Bass Google Scholar
  26. 26.
    Orlikowski, W.J. and Gash D.C. (1994). Technological frames: Making sense of information technology in organizations. ACM Transactions on Information Systems 12(2), 174-207 CrossRefGoogle Scholar
  27. 27.
    Griffith, T.L. (1999). Technology features as triggers for sensemaking. Academy of Managment Review 24 (3), 472-488 CrossRefGoogle Scholar

Copyright information

© Physica-Verlag Heidelberg 2008

Authors and Affiliations

  • A. Francesconi
    • 1
  1. 1.Università di PaviaPaviaItaly

Personalised recommendations