Challenging Dominant Frames in Policies for IS Innovation in Healthcare through Rhetorical Strategies

Information systems (IS) innovation in healthcare is a contested area often characterized by complex and conflicted relationships among different stakeholders. In this paper, we provide a systematic understanding of the mechanisms through which various actors translate competing visions about health sector reforms into policy and action and, thus, generate contradictions in IS innovation. We argue that we can learn more about the source of such contradictions by examining how competing frames can affect IS innovation in healthcare. We adopt frame theory and rhetorical strategies analysis in the case of health sector reforms in Kenya and focus specifically on the deployment of health information systems (HIS). We make several contributions. First, we demonstrate that policy actors' adherence to the interests and values represented in a frame is important in determining the choice of a rhetorical strategy and its influence on policy transformation and IS innovation. Second, we develop an understanding of how technology mediates the rhetorical strategies of different actors. In particular, we demonstrate the role of technology in giving continuity to frames, which affects policy change and IS innovation.