Performance improvement in hospitals: leveraging on knowledge asset dynamics through the introduction of an electronic medical record

Purpose – This study seeks to further the current debate about how to systematically improve hospital performance by enhancing and balancing knowledge exploration and knowledge exploitation capabilities through the development of an electronic medical record (EMR). Design/methodology/approach – The study has an interpretative, inductive perspective, based on multiple and embedded case studies. Three large size Italian hospitals that have introduced an EMR were considered. Evidence was gathered by triangulating multiple sources of evidence. Findings – Three emergent strategies of EMR development are identified. Pros and cons of each strategy are stated and a set of propositions to be tested in further research are formulated. These results provide hospital managers and professionals with clearer guidelines about how to improve performance by implementing a tailored strategy to balance knowledge exploration and knowledge exploitation through the development of an EMR. Originality/value – Most of the literature on EMRs is focused on the benefits, the barriers and the enablers of their adoption. Little is understood about how hospital managers and professionals might leverage on the EMR to ambidextrously combine knowledge exploration and knowledge exploitation, and thus increase hospital performance. The study addresses this gap and offers original insights to advance both theory and practice.