Les effets du partage de connaissances sur la construction de la vision organisante du dossier patient informatise : le cas d’un projet en systeme d’information au sein d’un groupement hospitalier territorial

« While the journey begins with the firm's consideration of what others in the field are being said to accomplish with the innovation, it ends with its consideration of what it has itself achieved. » (Swanson et Ramiller, 2004). This quote from the creators of the organizing vision suggests the need for structures that are going through an innovation process to introspect on the assets they hold. Swanson and Ramiller's (1997) observation of the organizing vision (OV) around an innovation is defined as follows: "An organizing vision is a community focal idea for the application of information technology in organizations." In 2004, they state that an "organizational vision is usually recognizable by one or a few 'buzzwords' that serve as a thematic label for the discourse of the broader community.". It is therefore primarily a discourse to guide and outline the course of an innovation in an organization. It clarifies the reasons for its existence and gives it meaning in order to mobilize actors in its implementation. However, these discourses mainly analysed journal articles and case studies are fewer. Among them, none proposes to identify knowledge sharing, in the sense of information for coordinating activities and practices, as a founding element of the OV discourse and its "authorized discourse". Our objective is to show the importance of knowledge sharing on the construction of an organizing vision within a health information system (IS) project and to identify it as a source of convergence between actors. It seems interesting to us to extend the exploratory study by Swanson and Ramiller (2003) in order to give concrete organizational keys to IS project managers and to bring the concept of knowledge sharing closer to that of the organizing vision. We believe that there is a practical interest in this. Indeed, we hypothesize that knowledge sharing has an influence on the organizing vision because it is a lever for action to encourage inter-organizational interaction that will allow a better understanding of the practices and expectations of each of the actors in order to achieve the success of a project. Our research was conducted within a Groupement Hospitalier Territorial (GHT) composed of a dozen health establishments, which found itself obliged to change the IT publisher for its Electronic Patient Record (EPR) because the current provider was leaving the French market. This opportunity was seen as a chance to reconcile inter-organizational practices and facilitate the sharing of patient information between institutions. The healthcare sector is particularly interesting for its complexity and technical knowledge with high operational stakes. We will see that in 2010, Morr and Subercaze identified several particularities specific to the healthcare domain for managing knowledge in the context of an information system project. The organizing vision (OV) is composed of 3 elements (interpretation, mobilization and legitimization) that will serve as objects for classifying the discourse. The 4 stratums of the OV (Carton et al., 2016), in turn, will determine the framework of our observation. Our methodology is based on the work of Swanson and Ramiller (2003), and will consist of a qualitative study of the process used to analyse what was said during semi-structured interviews and project scoping meetings by the actors. The main purpose of these scoping meetings is to share knowledge and data between the different institutions. They are also necessary for the work of the external service provider. Thus, after creating a matrix made up of the feelings of the different stakeholders and of the three elements of the organizing vision, we will analyse the discourse of each group of project stakeholders. This classification should make it possible to highlight the predominance of the language elements used and the feelings to which they are attached during the knowledge sharing phase, and then to compare them with the 4 stratums of the organizing vision. Our initial analyses of the project leaders' comments on the referents allow us to draw some initial results in this start-up period of the project. On the aspects of mobilization, the decision-makers are voluntarily positive to encourage the participation of a maximum number of people. However, the legitimization of the service provider is struck by comments that inspire mistrust and this can be explained by the classic mistrust of the client towards his service provider. Finally, the comments about the information system itself are neutral until we see the first tests in situation. Once our study is completed, we would like to extend the work of Swanson and Ramiller to further associate the notion of knowledge sharing with that of the organizing vision. Indeed, their 2003 article mentions knowledge transfer problems in the case studied and the usefulness for information system managers to have certain organizational bases. Also, the study of the actors' feelings during knowledge sharing is a new element in this type of analysis because it can have an influence on the development of the project.