Digitalisation is usually about process innovation with the use of IT, i.e. automating or informating organisational processes. However, redesigned processes are often misaligned with the underlying digital infrastructure. For instance, improving patient logistics with the help of IT is a key aim for current e-health initiatives, but has proven to be quite challenging in practice, and is sparsely dealt with in the literature. Our research question is, how can a process innovation initiative successfully interact with an underlying digital infrastructure? Our empirical evidence is an in-depth case study at a new high-tech hospital in Norway. Building on a proposed framework of interaction between process innovation and digital infrastructure, we identify and analyse two governance and two architectural mechanisms. Theoretically, we contribute to the digital infrastructure research by proposing a configuration for successful process innovation, in a complex e-health context. For practitioners, we show that lightweight IT can serve as a mediating technology in the configuration.

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