We link the concept of an ‘organizing vision’ to the idea of ‘performativity’
in order to better understand the challenges associated with implementing
integrated care, i.e. the usage of ICT in order to coordinate medical
treatments of the same patient by multiple medical professionals. More
specifically, we focus on how medical autonomy affects the performativity of
an organizing vision. Through an inductive case study of one German integrated
care provider, we indicate that medical autonomy seems to be positively
related to adoption decisions of ICT by medical professionals if an ICT-based
business model embraces medical autonomy. However, through looking at the
first four years of the implementation process, we also find that medical
autonomy seems to be negatively related to important ICT-related outcomes of
integrated care. Our study implies that a focus only on how actors translate
organizing visions may run the risk of underemphasizing context factors that
affect the adoption of integrated care on the organizational level. To depict
how such contexts influence the degree at which an organizing vision is
performative, we introduce the concept of ‘performative cohesion’.1. Auflag
