Digital innovation and organizational changes in the healthcare sector: Multiple case studies of telemedicine project implementation

Over the past two decades, different drivers have prompted institutional players to adopt digital innovations in healthcare systems. Telemedicine represents a digital innovation solution to guaranteeing the continuity of care, and patient and personnel safety. However, despite its potential benefits (such as improving care access in rural areas, reduction in hospitalization stay, and saving time for patients and healthcare professionals) and its rapid acceleration in use during the Covid-19 pandemic, the diffusion of telemedicine services remains limited and uneven across Europe. Adopting an explorative approach, this paper analyzes the implementation of telemedi-cine projects, investigating not only the factors but also the ways in which the analyzed organizations, in order to move from the design to implementation phase, managed the change needed to overcome barriers and to leverage enabling factors. Our research focus is on Southern Italy; a disadvantaged area in comparison to other Italian and European regions. The goal of the paper is to shed light on the characterization of leverages and barriers, as well as the related managerial actions for change implemented in a context whereby the diffusion of telemedicine remains limited.