Abstract
National Healthcare Transformation (NHT) initiatives are politically framed as digital reforms aimed at achieving integrated, efficient, and high-quality care. However, many struggle to achieve these goals, partly due to a gap between political visions and practical implementation. Using the sociotechnical imaginaries (STI) theory, we examine how an NHT imaginary evolves from its origins to its embedding in practice, through a longitudinal case study of a Norwegian NHT initiative. We identify four imaginaries of integrated care. We show how these imaginaries fail to acknowledge the installed base of the Norwegian community-based integrated care, instead privileging the vendor's imaginary. Ambiguity in public procurement and a top-down implementation process enabled the vendor's imaginary to define what integrated care meant in practice. We conceptualize what happened as displacement: a mechanism within the embedding phase of a sociotechnical imaginary in which a materially consolidated vendor imaginary occupies the institutional and technical space, claimed but not materialized, by aspirational policy imaginaries. The displaced installed base persisted through resistance, surfacing where the embedded architecture failed to accommodate existing care practices. By bringing the installed base concept into dialogue with STI theory, we contribute a more differentiated account of how NHT initiatives unfold and what they leave behind.
Recommended Citation
Hussain, Syed Sajid and Farshchian, Babak A., "Whose Integrated Care? How a Vendor Imaginary Displaced Political Visions in National Healthcare Transformation" (2026). 17th Scandinavian Conference on Information Systems. 18.
https://aisel.aisnet.org/scis2026/18