@ 31st EGOS Colloquium, July 2–4, 2015, Athens, Greece Abstract: In this paper, we explore field emergence, as it happens, aiming to enrich the theoretical understanding of this understudied phenomena and of institutional complexity. Our inductive case study is the nascent field of collaborative digital health technologies, which we follow from 2007 to present. We employ an institutional logics perspective, and drawing on existing theorization of field emergence, we point out the complex intertwine of logics and stakeholders as they reveal in time. Although preliminary, our findings present four distinct emergence phases: ingenuous age, legitimation, mobilization and stabilization, along with particular aspects like the role of legitimizing actors and the granularity of the field during mobilization. Additionally, we discuss digital technologies as enablers and material mediators of institutional change, and highlight the emerging role of the hybrid patient, with practical implications for the evolution of healthcare, as we know it.

1. Sub-theme 55: Re-examining the organization of healthcare:
institutional, technological and clinical challenges
plurality of institutional
logics in digital healthcare:
the rise of the hybrid patient
lorena macnaughtan, gerardo patriotta,
lorraine pinnington & sujatha raman

2. how do
fields
emerge?

3. what is the process of field emergence?
what are the institutional logics and
their representative stakeholders?

4. collaborative digital health
technology(cdht)
inductive case study

5. medical profession
citizenmarket
state
science
regulators
payers
consultancies
ict & cdht producers
healthcare managers
distributors
integrators
pharma
R&D
centers
academic
programs

6. ingenuous phase
citizen logic
experimentation
evidence
reimbursement
business models

7. ingenuous phase
legitimation
socio-political
legitimacy
health citizen
consumer
stakeholder
regulation
interoperability
governance

8. ingenuous phase
legitimation
mobilization
All rush in

9. ingenuous phase
2007 - 2009
legitimation
2010 - 2012
mobilization
2013 - ongoing
stabilization
…
intense hybridization
critical mass
cognitive/legitimacy
legitimizing actors
socio-political legitimacy
critical and significant mass
democratization
intense ambivalence
granularity
segmentation
assimilation
failure
autonomy

10. field 2
field 3
field 1
field failures (socio-political context)
economic triggers
technology enablers
resources
state
interstitial
space

11. Scanadu [n.d.]. Still from future of healthcare. [video] retrieved June 23, 2015

12. ?
Macnaughtan, L. 2015. All Eyes on Digital Health. graphic design nuviun. retrieved
June 23, 2015

13. institutional logics all bind value,
practice, and object. Institutional
logics are, one might say, practical
forms of value rationality (Friedland,
2013, p. 36)
…brings theoretical
insights into this
process and institutional
complexity
practical implications of
researching how digital
technologies cause and
enable change across the
spectrum in…
“and if I had to start a company and fail a
thousand times and start it over again and fail,
I would do that. And so when I realized that,
then it was about doing whatever it takes to make
this a reality. Because it's a change that can
happen and has to happen in our world!” –
Elizabeth Holmes, Theranos (CS, 2014)

14. References
Aldrich, H. E., & Fiol, C. M. (1994). Fools Rush in? The Institutional Context of
Industry Creation. The Academy of Management Review, 19(4), 645–670.
Friedland, R. (2013). God, Love, and Other Good Reasons for Practice: Thinking
Through Institutional Logics. In Institutional Logics in Action, Part A (Vol. Part
A, pp. 25–50). Bingley, UK: Emerald Group Publishing Limited.
Macnaughtan, L. 2015. All Eyes on Digital Health. graphic design nuviun. retrieved
June 23, 2015
Scanadu [n.d.]. future of healthcare. [video]. retrieved June 23, 2015
CHM Revolutionaries (2014)Theranos Founder & CEO Elizabeth Holmes in Conversation
with Michael Krasny [video]. retrieved March 30, 2015
thank
you!