Institutionalization of Digital Innovation Practices in Large and Complex User Organizations

Abstract

Digital innovation (DIN) is crucial for managing the steady growth of resource use in the hospital sector. DIN includes the co-creation of novel services, such as digital remote care (DRC) solutions. Our empirical setting, consisting of 27 hospitals in Norway, is characterized by a complex organizational structure with an overall centralized IT governance, but not for the DRC initiatives. In the healthcare sector, there is limited knowledge of organizational practices to empower DIN at local levels in the intersection of central and local governance. Our in-depth case study exploring 70 different DRC trajectories reveals the interplay among three key mechanisms in a productive local DIN environment - idealistic entrepreneurship, organizational anchoring, and remote infrastructure - which reflect DIN practices. Our contribution to the DIN literature is a dynamic model showing the interplay among these key mechanisms, which increases the innovation pace, improves the innovations' scalability, and makes organizations robust in implementing DIN practices.