Justifying health IT investments: a process model of framing practices and reputational value

Despite important research contributions on the financial and operational dimensions of information technology (IT) value, justifying health IT (HIT) investments remains a difficult and enduring issue for IT managers. Recent work has expanded our understanding of HIT value, by focusing on the initial resource allocation stage, and through conceptualizations of value across multiple dimensions. Building on these developments, we adopt a performative perspective to examine the research question of how practitioners justify early stage HIT investments, with a focus on reputational value. We explored this question through a comparative field study of two hospital organizations in the English National Health Service (NHS). We found that practitioners' temporally orientated framing practices matter in justifying HIT investments, enacting different possibilities for reputational value. We develop a process model to explain these dynamics and highlight the mutability of reputational value, which can lead to different possibilities for restoring, enhancing, or maintaining reputation. We conclude by discussing the implications for justifying HIT investments.Stavros was supported by a scholarship from the Economic and Social Research Council (Grant Number: 1491536). Eivor Oborn was supported by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care West Midlands

Containing the Not-Invented-Here Syndrome in external knowledge absorption and open innovation: The role of indirect countermeasures

This paper builds new theory and provides supporting evidence to contain the Not-Invented-Here Syndrome (NIHS) – a persistent decision-making error arising from an attitude-based bias against external knowledge. Conceptually, we draw on the 4i framework of organizational learning to develop a novel process perspective on NIHS. This allows us not only to unpack how and where NIHS impedes organizational learning, but also to identify the key requirements for effective NIHS countermeasures. Importantly, countermeasures fall into two categories: those that seek to change the negative attitude directly (direct NIHS countermeasures) and those that seek to attenuate the behavioral impact of negative attitudes without addressing the attitudes as such (indirect NIHS countermeasures). While the evidence base on direct NIHS countermeasures has grown over the last decade, indirect NIHS countermeasures have received little research attention. To address this gap, we adopt a mixed methods research design composed of two complementary empirical studies – the first qualitative and the second quantitative. Study 1 explores the prevalence of distinct NIHS countermeasures in collaborative R&D practice. Based on 32 interviews and three focus group meetings with R&D employees, we find that a broad array of primarily direct NIHS countermeasures is employed in R&D practice. Study 2 addresses the scarcity of scholarly and managerial insights on indirect NIHS countermeasures by testing the effectiveness of perspective taking as a debiasing technique to contain negative attitudes at the level of the individual. Based on quantitative survey data from 565 global R&D projects, it provides empirical evidence not only for the prevalence and negative effects of NIHS on project success as mediated by external knowledge absorption, but also for the effectiveness of perspective taking as an exemplary indirect NIHS countermeasure

Harnessing the value of open innovation: The moderating role of innovation management

In this paper, we develop and test a firm-level contingency model of inbound open innovation in an attempt to contribute to explaining the substantial disparities in open innovation payoff that exist between firms. Integrating elements from the resource-and knowledge-based views and the absorptive capacity literature, we propose that specific innovation management activities can play an important moderating role as they are likely to enhance firms' capacity to identify, assimilate and utilise external knowledge inputs. Drawing on longitudinal data from 1,170 German manufacturing and service firms, econometric analyses reveal that returns from open innovation are greatest when firms maintain their internal research capacity, employ a dedicated incentive system for innovation and advocate strong cross-functional collaboration. Decision-makers are thus well advised not to take positive returns from open innovation for granted. Rather, they need to achieve excellence in key innovation management activities, if their firm is to fully harness the value of openness. © 2012 Imperial College Press

Reconceptualizing the paradox of openness: How solvers navigate sharing-protecting tensions in crowdsourcing

The paradox of openness describes the fundamental tension between knowledge sharing and knowledge protection in open innovation. While sharing is vital for value creation, protecting is critical for value appropriation. Prior research has examined this paradox of openness from the perspective of the seeking firm, focusing on the firm-level challenges of inbound open innovation. In this article, we complement that research by illuminating the tensions between sharing and protecting in individual-level outbound open innovation, where we argue that the paradox of openness is most prevalent, yet much less well understood. Drawing on the experience of individual participants, or solvers, in intermediated crowdsourcing contests, we analyze textual data from 2,149 answers to five open-ended narrative questions embedded in a large-scale solver survey, as well as 43 in-depth interviews of solvers. Our findings indicate that individual solvers face fundamental sharing-protecting tensions that carry considerable economic and psychological costs. We also document how solvers attempt to navigate the paradox of openness by employing three formal and four informal value appropriation practices. They build elaborate configurations of these practices, which they tailor to the idiosyncrasies of each contest. They also dynamically adjust these configurations over time, as the contest and the interaction with the seeker unfold. We end by outlining how these findings contribute to a more multifaceted conceptualization and a richer understanding of the paradox of openness

What is mine is yours, or is it? Exploring solvers’ value appropriation strategies in crowdsourcing contests

Despite the growing interest in crowdsourcing contests organized by intermediaries, little is known about the risks and challenges that solvers face. Although solvers are inclined to win the contest, they likewise fear that participation sets their intellectual property (IP) at risk of being infringed. Consequently, they employ strategies to safeguard their IP. In this study, we contribute to the literature by investigating solvers’ value appropriation strategies. Results from our analysis of 27 semi-structured interviews indicate that they employ eight different strategies as safeguards against IP infringement. These findings comprise theoretical as well as practical implications for solvers, seekers, and intermediaries

How IT investments help hospitals gain and sustain reputation in the media: the role of signaling and framing

How can information technology (IT) help hospitals gain and sustain reputation in the media? Combining signaling theory and technology frames, we examine if, how, and to what extent IT investments over time shape three facets of reputation: generalized favorability, being known, and being known for something. In accessing healthcare services, most patients are unable to assess a hospital’s quality of care directly. Faced with such information asymmetries, patients tend to consider a hospital’s reputation in the media when making care decisions. Indeed, journalists are well positioned to detect even the weaker quality signals – among which are state-of-the-art IT – that a hospital emits. As information interme¬diaries, journalists aggregate and interpret IT-related signals against the backdrop of their technology frames, that reflect their expectations of how a modern hospital IT should look. Perceived congruence between their IT-related expectations and observations on the ground is likely to translate into less critical writing about a hospital. We test our theorizing based on a comprehensive panel dataset of 152 English hospital organizations spanning five consecutive years of IT investments and subsequent changes in media reputation as reflected in 175,973 articles in English newspapers. We find that investments in IT staff increase the “being known” facet of reputation as evidenced in the volume of media coverage. Investments in IT equipment, in contrast, positively affect a hospital’s general favorability as mirrored in the tenor of its media coverage. Our econometric analysis as well as our complementary content analysis of newspaper articles and follow up interviews with journalists allow us to attribute this effect primarily to more visible IT equipment investments that prompt journalists to write less negatively about a hospital. These findings suggest that investments in IT equipment can buffer hospitals from negative press, thereby helping them to gain and maintain a strong reputation in the media.Eivor Oborn is supported in part by the National Institute for Health Research (NIHR) Applied Research Centre (ARC) West Midlands

How IT investments help hospitals gain and sustain reputation in the media: the role of signaling and framing

How can information technology (IT) help hospitals gain and sustain reputation in the media? Combining signaling theory and technology frames, we examine if, how, and to what extent IT investments over time shape three facets of reputation: generalized favorability, being known, and being known for something. In accessing healthcare services, most patients are unable to assess a hospital’s quality of care directly. Faced with such information asymmetries, patients tend to consider a hospital’s reputation in the media when making care decisions. Indeed, journalists are well positioned to detect even the weaker quality signals – among which are state-of-the-art IT – that a hospital emits. As information interme¬diaries, journalists aggregate and interpret IT-related signals against the backdrop of their technology frames, that reflect their expectations of how a modern hospital IT should look. Perceived congruence between their IT-related expectations and observations on the ground is likely to translate into less critical writing about a hospital. We test our theorizing based on a comprehensive panel dataset of 152 English hospital organizations spanning five consecutive years of IT investments and subsequent changes in media reputation as reflected in 175,973 articles in English newspapers. We find that investments in IT staff increase the “being known” facet of reputation as evidenced in the volume of media coverage. Investments in IT equipment, in contrast, positively affect a hospital’s general favorability as mirrored in the tenor of its media coverage. Our econometric analysis as well as our complementary content analysis of newspaper articles and follow up interviews with journalists allow us to attribute this effect primarily to more visible IT equipment investments that prompt journalists to write less negatively about a hospital. These findings suggest that investments in IT equipment can buffer hospitals from negative press, thereby helping them to gain and maintain a strong reputation in the media.Eivor Oborn is supported in part by the National Institute for Health Research (NIHR) Applied Research Centre (ARC) West Midlands