How Technology-Afforded Practices at the Micro-Level Can Generate Change at the Field Level: Theorizing the Recursive Mechanism Actualized in Swedish Rheumatology 2000–2014

Recursive mechanism, micro-level enactments, technology affordances, healthcare, longitudinal case study, field-level change, institutional logics, critical realism The information systems literature has paid a great deal of attention to how macro-level structures shape local technology enactments. Less research has focused on the mutual shaping of situated technology enactments and such extra-organizational structures. This study explores how technology-afforded human action at the micro-level may transform field-level social structures and thus generate institutional change. We use a critical realist approach and institutional logics lens and draw on empirical data about the development and implementation of an e-health service in Swedish rheumatology between 2000 and 2014. We identify a recursive mechanism consisting of three recursive practices—material reconstruction, discursive reconstruction, and emergent use—that fostered a shift in the field’s constellation of institutional logics, moving from a competitive to an additive relationship between logics