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Knowledge creation practices at organizational boundaries: the role of ICT in sickle-cell care for tribal communities

Vinayak Ram Tripathi (Strategy, Innovation, and Entrepreneurship Area at the Institute of Management Technology, Ghaziabad, India)
Manish Popli (Strategic Management Area at the Indian Institute of Management, Indore, India)
Swati Ghulyani (Amrut Mody School of Management, Ahmedabad University, Ahmedabad, Gujarat, India)
Shrey Desai (SEWA Rural. Jhagadia, Gujarat, India)
Ajai Gaur (Department of Management and Global Business, Rutgers University, Newark, New Jersey, USA)

Journal of Knowledge Management

ISSN: 1367-3270

Article publication date: 17 August 2020

Issue publication date: 3 May 2021




This paper aims to examine the role of information and communication technology (ICT) in the knowledge creation practices adopted by a health care organization. The organization is delivering care to patients of a genetic disorder, called the sickle cell, in tribal communities. The paper identifies how ICT intermediates knowledge creation practices across the organizational boundaries wherein tribal patients, front-line counselors and expert physicians interact, which then produces context-specific, evidence-based medicine (EBM).


The knowledge-in-practice approach is adopted to conduct an ethnographic study of sickle cell care practices in a non-profit health care organization in Western India. The analysis focuses on ICT-mediated interactional practices among the physicians, front-line counselors, tribal patients and their families, for more than a year-long observation. These are supplemented with informal and formal interviews, archival records and vignettes based on several episodes to explicate the key knowledge creation practices.


Technology-mediated informative interactions at organizational boundaries can bridge socio-linguistic and interpretive barriers between actors, while also providing a generative structure that leads to the creation of longitudinal clinical evidence about a rare genetic disorder. Three specific ICT-entwined knowledge creation practices emerge, namely, knowing the community, increasing interactional engagement and constructing gradients of socio-clinical history. These practices generate organization-wide knowledge about the social and clinical dimensions of the genetic disorder. The findings are presented through vignettes and a novel conceptual framework.

Research limitations/implications

This study identifies various useful knowledge creation practices in health care delivery for resource-constrained emerging economy contexts. Further, the study suggests that the involvement of local front-line actors and ICT can become important resources in the delivery of health care in these settings.


A novel framework is developed which demonstrates knowledge creation at organizational boundaries wherein the actors use ICT-based practices for effective delivery of health care. The proposed framework may be used by health care organizations in similar contexts providing care to marginalized communities.



First author thanks Late Dr Anil Desai, Dr Lata Desai, Prof Omkar Desai, Prof Srinath Jagannathan, Dr Pankaj Shah and Dr Gayatri Desai for their unflinching support, encouragement and guidance during his field work. He is also thankful to Indian Institute of Management Indore, Indore for the fellowship during his ethnographic study.


Tripathi, V.R., Popli, M., Ghulyani, S., Desai, S. and Gaur, A. (2021), "Knowledge creation practices at organizational boundaries: the role of ICT in sickle-cell care for tribal communities", Journal of Knowledge Management, Vol. 25 No. 3, pp. 595-617.



Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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