We link the concept of an ‘organizing vision’ to the idea of ‘performativity’ in order to better understand \ the challenges associated with implementing integrated care, i.e. the usage of ICT in order to coordinate \ medical treatments of the same patient by multiple medical professionals. More specifically, we focus on \ how medical autonomy affects the performativity of an organizing vision. Through an inductive case study \ of one German integrated care provider, we indicate that medical autonomy seems to be positively related \ to adoption decisions of ICT by medical professionals if an ICT-based business model embraces medical \ autonomy. However, through looking at the first four years of the implementation process, we also find that \ medical autonomy seems to be negatively related to important ICT-related outcomes of integrated care. \ Our study implies that a focus only on how actors translate organizing visions may run the risk of underemphasizing \ context factors that affect the adoption of integrated care on the organizational level. To depict \ how such contexts influence the degree at which an organizing vision is performative, we introduce the \ concept of ‘performative cohesion’.