Public, Private, Health Care and User Innovation at Odds: Institutional Logics and Governance Tensions on an Open Source EMR Ecosystem

This paper explores tensions in user-led open-source software production due to multiple institutional logics steering the actions of multiple stakeholders on an OSS (open-source software) ecosystem. It discusses how tensions... [ view full abstract ]

This paper explores tensions in user-led open-source software production due to multiple institutional logics steering the actions of multiple stakeholders on an OSS (open-source software) ecosystem. It discusses how tensions evolve and how they get resolved through various governance mechanisms. These tensions are a result of incongruent transfers of worth given their origins in different institutional logics. Understanding the implicit rules under which actors guide their actions is crucial for the long term sustainability of such initiatives. This study offers findings from an OSS electronic medical record to contribute to the debate of institutional logics in the context of OSS production.
This paper is organized as follows: first, we introduce institutional logics as a lens to analyze governance tensions on an OSS ecosystem. This literature review is followed by a description of our methods and the OSCAR open-source EMR research site. Then, we present four episodes that emphasize the generative tensions that occur in the OSS ecosystem. From the analysis of the evolution of these episodes, we identify four types of institutional logics that influence how user-led OSS communities govern themselves. We conclude with a discussion of how the management of these tensions is crucial for the continued health of an OSS community.