Exploring value creation mechanisms in enterprise architecture: a realist evaluation of healthcare organisations evidenced in the UK

There is a preponderance of evidence for the impact of Enterprise Architecture (EA) mechanisms onprogramme outcomes. However, little research has explored the context sensitivity of thesemechanisms in a socio-technological context in digital transformations in healthcare organisations.The study explains EA outcomes' critical failure and success factors through the lens of mechanismcontextinteraction to create outcomes. The study proposes a socio-technological initial programmetheory for eliciting Context-Mechanisms-Outcome (CMO) configurations concerning the strategicalignment of the organisation’s strategic objectives and goals; on the one hand, its InformationTechnology (IT) from an EA perspective. It proposes the Culture, Relations, Agency, Funding,Technology, Structure (CRAFTS) context model as a significant trigger for EA mechanisms.Twelve key informants and experts informed a large UK Healthcare Organisation's initial programmetheory or conceptual Framework through semi-structured qualitative data collection and retroductivetheorisation. Next, the CMO configurations were elicited, refined, and consolidated into criticalfailure and critical success factors of EA outcomes.The research found that the organisation's culture, the effectiveness of human agency and theirattitude towards technology are critical to the success of the EA implementation, one that aligns theorganisation's vision, objectives, and goals with IT. The findings suggest that the mechanisms of EAare context-sensitive. Applying mechanisms for EA development without due regard to contextcreates uncertain outcomes. Social interactions are complex, and EA outcomes are emergent on sociotechnologicalconsideration because of the unpredictability of agency and social systems. Therelationships between stakeholders are also a determining factor in EA outcomes. Where relationshipshave not been favourable, EA tended to be perceived as unsuccessful. Funding of technologyprogrammes is critical to EA's failure or success. With funding constraints, EA outcomes tend to beassessed as unfavourable.Where the organisation’s affinity for technology has been poor due to cultural aversion, or lack offunding, EA outcomes have been perceived not to be successful. Digital non-native may also slowthe pace of adoption. The study has identified preliminary support for context-sensitive EAmechanisms and outcomes in Enterprise Architecture. A new socio-technological model has beenidentified with culture, relations, agency, funding, technology, and structure playing critical roles indetermining alignment in EA outcomes. A significant contribution to EA is supporting contextmechanism-outcome configurations as enablers and barriers to EA outcomes.