Search

The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS. [ABSTRACT FROM AUTHOR]

In the field of civil society and democracy promotion, the relevance and effectiveness of donor strategies is often linked to their ability to adjust to local contextual factors. Despite the importance attached to tailor-made approaches, donor-sponsored democracy promoting NGOs in such different parts of the world as Ghana and Indonesia have very similar organizational characteristics. This paper explores the question of why they are so similar. We draw on institutional theory and use the concept of organizational isomorphism to illustrate how different pressures result in the homogenization of organizational characteristics. We find that besides the more commonly identified unequal power relation between donor and recipient, homogenization also stems from the NGOs themselves and from the relation between their various organizational characteristics (i.e., mission, staff, strategy, and structure). Furthermore, we argue that the process of homogenization can be seen as the institutionalization of trust between donor and recipient. In our discussion, we reflect on the limitations of our findings and on what they mean for donor support to NGOs and democracy. [ABSTRACT FROM AUTHOR]