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Kohli, R., and Kettinger, W. J., 2004, “Informating the Clan: Controlling Physician
Costs and Outcomes,” MIS Quarterly(28:3), pp. 363-394.
Past literature recognizes the power of information technology to establish greater
transparency and, in turn, the potential for greater control .Theoretical perspectives
such as informating and agency theory describe situations whereby legitimized management
authority can control goal divergence by implementing information systems to better
monitor agents’ behavior and outcomes. But what happens when the principal does not
possess legitimacy to impose an agent’s use of information and/or behavioral conformance?
This study investigates this situation. Through an action research project, a physicians’
profiling system (PPS) was used to monitor and benchmark physicians’ clinical practices
and outcomes resulting in changed practice behaviors in closer congruence with management’s
goals.
The PPS project represents a successful attempt of a hospital’s management (principal)
to "informate the clan" of physicians (agents) to reduce clinical procedural costs
and adopt practices benchmarked to produce better outcomes. This research moves beyond
directly controlling informated workers through legitimized managerial authority to
a better understanding of how to informate autonomous professionals. Emerging insights
suggest that a clan can be informated if the principal can improve the perceived legitimacy
of the information (the message), legitimize the technical messenger (customized user
interface), legitimize the human messenger (boundary spanners and influential clan
members), and facilitate an environment where clan-based discussion, using the information
provided by the principal, is incorporated into the process of concertive control.
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