Abstract
1. Sustaining public good in an era of marketization
2. Relationships between governments, networks, institutions, and the market
3. Methodology: a longitudinal case study of network formation and management
4. EcoNet – a government effort to create and legitimate a market management proxy
5. Managing-by-proxy: using the network to bring about shifts in institutional logics and market context
6. Conclusion
Acknowledgements
References
Abstract
Governments must ensure the sustainability of public goods in the face of evolutionary pressures: increasing private market power, escalating resource constraints and heightening consumer expectations. Research has demonstrated that organizational networks can be used to drive and shape markets but that institutionalized norms, values, and practices can block market change. I ask how governments can use networks to shape markets by proxy, complementing direct regulatory intervention. I draw on organizational networks literature, institutional theory, and longitudinal empirical evidence to examine government efforts to form a new interorganizational network to challenge institutional norms in Ireland’s eHealth market. I identify three key processes that governments engage in when using networks to influence institutional change in evolving markets: empowering institutional challengers, reconciling competing institutional logics, and bridging policy and practice.
Sustaining public good in an era of marketization
“The Health Service Executive (HSE) would now like to invite tenders from suitably qualified companies/individuals to assist the Health Service Executive (HSE) with the setup, development and management of an eHealth Ecosystem for the Republic of Ireland.” (ROI) (Invitation to tender for an external eHealth Network (hereafter referred to as ‘EcoNet’) facilitator, March 2015, emphasis in the original) As people live longer, many nations will see public healthcare expenditure increase to unsustainable levels1,2 . One response is eHealth, the use of technology to change the way care is delivered. This involves “a paradigm shift” (Mountford et al., 2016) in a context of multiple incompatible institutional logics (Dorado, 2005; Scott, 2000). A new market logic, based on the belief that markets will more efficiently allocate scarce resources (Djelic, 2006), is inserted into a context where a professional logic traditionally secured the clinician’s decision-making and gate-keeping role (Reay & Hinings, 2005).