ABSTRACT
Adoption of e-business technologies such as electronic supply chain management (eSCM) systems has the potential to improve efficiencies, reduces costs, improve competitiveness of organisations and facilitate building relationships with trading partners (Johnson et al., 2007; Silveira and Cagliano 2006; Auramo et al., 2005). However, the e-business adoption debate has been studied largely from a single organisation or a dyadic perspective (Cullen andTaylor, 2009; Sanders, 2007; Power and Simon, 2004). Further, since these decisions are complex and require coordination among multiple trading partners in the supply chain to be implemented effectively, it is more likely that taking an holistic view of the supply chain will yield more meaningful insights (Power, 2005).This is important as these technologies play a pivotal role in facilitating integration between complex arrays of trading partners and thereby facilitating collaborative relationships (Bhakoo and Chan, 2011).The literature is also skewed towards understanding the internal drivers of e-business adoption that focus on financial, operational and strategic issues (Bakker et al., 2008), with the result that the traditional theories of the firm that focus on profit maximisation (e.g. transaction cost economics and resource-based view) have dominated the literature (Johnson et al., 2007; Zhu and Kraemer, 2005).Although past studies provide useful insights, these in essence assume a ‘static state of play’ in terms of the interactions between trading partners.As a result, these studies neglect the dynamic nature of the institutional environment and the role played by institutional forces between trading partners.This is of importance for public hospitals that operate in a complex and dynamic environment, are comprised of trading partners with conflicting objectives and often intersect with supply chains of different industries (Bhakoo and Chan, 2011). Further, the role of commercial trading partners and regulatory bodies (as sources of distinct possible institutional pressures) in e-business adoption becomes crucial for industry sectors such as health care.With the potential for cost savings and efficiencies, there is tremendous pressure from regulatory authorities to accelerate the uptake of these technologies (More and McGrath, 2002). We propose institutional theory as a useful lens for studying inter-organisational
innovation adoption decisions (Rogers et al., 2007; Ketokivi and Schroeder, 2004; Teo et al., 2003). Institutional theory takes into account a set of critical contextual
factors and it is increasingly being recognised that technology adoption decisions in the supply chain are influenced by an institutional rationale rather than solely by the potential for technical efficiency (Roberts andToleman, 2007;Teo et al., 2003). Although institutional theory is advancing the debate on e-SCM adoption, it is still in an embryonic state in terms of its application within a supply chain context.This is essentially because most studies are based on cross-sectional surveys sent to single focal organisations (Khalifa and Davison, 2006; Teo et al., 2003). By capturing the perspective of a specific trading partner in the supply chain, these studies have been narrowly focussed in their endeavour to thoroughly comprehend how different trading partners are influencing e-business adoption. Against this background, we employ a qualitative research design that seeks to
answer the following research question:
How sensitive are different entities in the health care supply chain to institutional pressures in the adoption of e-SCM systems?
