Abstract. How are large scale ICT systems related to organizational development and management? We introduce digitalism as a new institutional logic compared to managerialism and professionalism. To develop our argument, we combine organisational and institutional logic theory with information systems research. We illustrate our arguments with a case study of a process of organisational development before and after the implementation of centralised large-scale ICT systems at a large Norwegian hospital in 2015. The understanding of digitalism offers insight in how large-scale technology and organisations are tied together and can contribute to effective healthcare management.