DescriptionThis study examined messages representing three institutional orders – institutional order of the State, Profession and Corporation – to understand the process of institutional change surrounding the implementation of Electronic Health Records (EHR). An institutional change influences a host of stakeholders within an organizational field. These stakeholders include organizations representing different institutional orders, with multiple logics emerging from these orders. Institutional changes typically require modifying or replacing these existing institutional logics. Communication plays an integral role in how institutional logics are transformed, legitimized or delegitimized within an organizational field during change. Accordingly, this study used a discursive approach to understand institutional change. It analyzed institutional messages and identified organizing visions within an organizational field. Analysis of institutional messages enabled identification of institutional logics that are established and contested by institutional orders of the State, Profession and Corporation, whereas organizing visions located change discourse within the larger inter-institutional context. This was accomplished by asking the following research questions: What are the institutional logics advanced by institutional orders of State, Profession and Corporation? What are the discursive strategies used by institutional orders to (de)legitimize institutional logics and promote their version of change? What are the dominant organizing visions arising out of the messages within the organizational field? Institutional orders of the State and Corporation attempted to legitimize EHR-related change through logic of healthsystem efficacy, logic of operational efficacy and logic of collaboration. Institutional order of the Profession delegitimized the assertions made by the State and the Corporation by challenging their claims and advocating the logic of healthcare crises. The study found that all the institutional orders primarily used intertextual references that would aid them in establishment of their logics. At the same time, they also used intertextuality to minimize or exclude certain discourses or problematize discourses to delegitimize certain logics. Further, use of intertextuality enabled institutional orders to gain wider reach and increase the establishment of their messages. This, in turn, facilitated creation of two organizing visions – EHR technology as an impediment and EHR technology as progress. The study found that institutional change and discourse are mutually implicated, and highlighted the significance of discourse transmission and consumption to understand the dynamics of power and resistance within an organizational field.