Abstract: This study integrates tenets of the behavioraltheory of the firm and neo-institutional theory to identify four recurringsearch mechanisms that are expected to influence hospital managers' informationsystems investment decisions. To account for the critical role of regulation inhealthcare, senior managers' reliance on each of these four search mechanismsis hypothesized to be contingent upon their hospital's regulative legitimacy.Analyses of panel data from all 153 public nonspecialist hospital organizationsin England reveal that hospital managers invest in IS not only to findsolutions to performance shortfalls (problemistic search), but also to achievecontinuity and predictability in resource allocation (institutionalized search)and signal conformity with external norms and expectations (mimetic search). Wefind that the desire to make adequate use of uncommitted financial resources(slack search) is salient only among hospitals with low levels of regulativelegitimacy. These new insights into the motives that trigger-andconstrain-senior managers' IS investment decisions will help IS managers tostrengthen their case for IS investment and guide policy makers in how best toallocate resources to IS in healthcare and possibly beyond.
