Revenue Cycle Management in the Wake of EMR Implementation: A Competing Logics Perspective

Abstract

The health information technology (HIT) literature has focused on how healthcare organizations use electronic medical record (EMR) systems and other clinical IT for care delivery and coordination. However, few studies have examined how implementation of these technologies impact the organizations’ revenue cycle management (RCM) and consequent financial sustainability. Against that backdrop, we draw on institutional logics perspective to analyze experiences from two action research engagements that leveraged EMR implementations in medical clinics to improve RCM. As a result, we identify four coexisting yet competing logics—logic of care, logic of business, logic of management, and logic of technology—that shaped how the clinics addressed challenges in their revenue cycle. While IT transformed practices and information exchanges, the competing logics shaped the clinics’ RCM in the wake of their EMR implementation. We conclude with contributions to research and practice.