Navigating digital transformation in primary care: Implementation, intention, normalization, and institutional logics

Abstract

This compilation thesis examines the implementation of video consultations in primary care, focusing on how healthcare professionals navigate the digital transformation amidst conflicting priorities. It explores the value conflicts arising from the introduction of video consultations and how these are managed in practice. The research delves into the perceptions of practitioners, including doctors, nurses, and psychologists, as well as other actors involved like IT-specialists and implementation coordinators. By employing frameworks such as the theory of planned behavior and normalization process theory, this study analyzes factors influencing the successful integration of video consultations. It highlights the importance of balancing managerial, market, patient, and professional logics during the digital transformation process. The findings in this thesis suggest three key strategies for implementation of video consultations in primary care. First, healthcare professionals must continuously adapt and adjust to multiple institutional logics, balancing clinical values with organizational and technological demands. Second, managing nodes of adjustmentalisation, are central in coordinating interactions between different logics and actors. Third, an active governance though engaging in the development of standards and protocols ensures alignment with both clinical and organizational requirements. The thesis contributes to both theoretical understanding and practical strategies for managing digital transformations in healthcare, emphasizing the need for a nuanced approach that considers diverse stakeholder perspectives.