Competing Institutional Logics in the Health Information Exchange Field of US Healthcare Industry

Abstract

Inter-organizational collaboration on health information exchange (HIE) has been identified as one of the major challenges for further advancing the development of inter-organizational HIE networks in the US. Heterogeneous collaboration initiatives on HIE need to be overhauled from a holistic view to better understand future evolving directions. Key concepts in institutional theory, such as organizational field and institutional logic, provide an appropriate lens for digging deeper into this phenomenon. The structuration of the HIE organizational field informs that HIE stakeholders are not only social actors who conform to macro institutional environments - policies and regulations in healthcare, but also social agents who generate micro institutional environments in inter-organizational HIE networks - social networks of health provider (HP) organizations. Furthermore, the social networks weaved by different kinds of inter-organizational relationships become collaboration anchors for inter-organizational HIE networks.