How Do Meta-Organizations Reach Collective Action? A Comparative Study of Digital Transformation in Healthcare

Objective: To investigate how meta-organizations and traditional hierarchical organizations differ in their approaches to facilitating collective action in digital transformation initiatives within healthcare settings. Design: A comparative case study utilizing primary data collection for the meta-organization case and secondary data analysis for the traditional organization case. Setting: Comparing Abc Dental Group (a meta-organization of 12 dental clinics in Taiwan) and Princess Alexandra Hospital (a traditional hierarchical public hospital in Australia). Main outcome measures: Decision-making processes, implementation strategies, knowledge sharing mechanisms, and alignment approaches for digital transformation initiatives. Results: Meta-organizations rely on collaborative decision-making, voluntary implementation, peer learning networks, and identity-based alignment. Traditional organizations employ centralized decision-making, structured implementation, formal training, and authority-based alignment. Conclusions: Organizational structure fundamentally shapes collective action approaches in digital transformation. Meta-organizational distributed approaches particularly suit contexts requiring clinical autonomy and adaptation to diverse environments, while traditional centralized approaches promote consistency in critical systems. These findings extend meta-organization theory by identifying specific mechanisms that overcome limited formal authority challenges.