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. This paper aims to provide a systematic understanding of the mechanisms through which competing visions about health sector reforms are translated into policy and action generating contradictions in IS innovation. The paper argues 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, with a specific focus on the deployment of health information systems. We make the following 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, thus affecting policy change and IS innovation.