Clinical managers' identity at the crossroad of multiple institutional logics in IT innovation: the case study of a health care organization in England

Clinical managers play a crucial role in securing the implementation and sustainability of information technology (IT) innovation in health care. Yet, not all clinical managers are willing and able to support IT innovation, particularly when the institutional logics of an IT innovation challenge their professional practice. We investigate how clinical managers use their hybrid identities to reconcile differences among competing institutional logics that affect IT innovation. Based on three examples of IT innovation (telehealth for obstructive sleep apnoea, telehealth for heart failure, and electrocardiograms) in a health care organization in England, we identify three roles in IT innovation (innovation advocate, innovation broker, and innovation laggard) that clinical managers enacted in response to three degrees of conflict between institutional logics (no conflict, moderate conflict, and high conflict), respectively. We make the following contributions. First, we demonstrate how clinical managers' perception of their hybrid role in relation to their professional identity influences their response to the conflicting institutional demands of IT innovation. We conclude that clinical managers' fragmented identities can compromise their ability to effectively manage IT innovation in health care. Second, our findings raise implications for understanding the role of professionals' hybrid identities in the implementation of digital transformation at the intersection of multiple institutional logics.