Enacting ambidextrous IT governance in healthcare

Abstract: With digitalization, Information Technology (IT) has become an integral part of digital business strategies and future solutions and this calls for organizations to prioritize the governance of IT if they are to succeed or remain relevant. IS research has focused on the transformation of the IT function, where IT governance is considered one component of the IT function profile. At the same time, previous research in IT Governance has been criticized for an over-emphasis on design (mechanisms) rather than enactment and an over emphasis of efficiency through diagnostic control at the expense of innovation capabilities. Future research should focus on the enactment of governance as well. In line with this bias, the empirical studies in this thesis focusing on how IT governance is enacted in healthcare organizations are guided by the theory of organizational ambidexterity which suggests that successful organizations need to exploit existing opportunities to achieve efficiency, while at the same time exploring new opportunities to achieve innovation. In the health sector, the use of IT in hospitals over the years has been that IT is slowly adopted in comparison to other sectors but things have changed and healthcare has embraced the use of IT in digitalization. The adoption of IT is attributed to the intense pressure placed on hospitals to provide better quality of care, lower costs, and more and easier access to medical information for patients. Moreover, the use of IT in hospitals has followed a predictable pattern that has occurred in other sectors with more advanced IT resources. More hospitals have implemented integrated IT applications and span several functions. Some of the implementations include enterprise resource planning systems, electronic medical records and electronic medical administration records. This has contributed to the increase in complexity and sophistication of the IT capability in hospitals/healthcare and in turn increased the importance of IT governance in healthcare organizations. This empirical research adds to theoretical insights in the field of IT governance through the resource orchestration and ambidexterity perspective. This research employs qualitative data collection and analysis strategies following on the research question which is open ended and exploratory in nature. The research was carried out in two different settings i.e. Sweden and Uganda. This thesis contributes to research through offering a path ahead for future studies of IT governance. This was done by offering a unique account of how ambidextrous IT governance is enacted and operationalized through the resource orchestration lens. Second, the thesis contributes to the role of policy in the dynamic process of ambidextrous balancing, as well as on the role of policy in the digitalization of healthcare. As such, this thesis suggests that digital policy design should utilize the findings and method of the cross-country ambidextrous policy study herein to inform future design decisions.