“…Since the implementation of managerial reforms, the majority of clinicians considered managerial activities as timeconsuming, bureaucratic procedures focused on costs and far from being clinically oriented and useful to clinicians' primary role of care delivery (Bourn & Ezzamel, 1986b;Kralewski, Dowd, & Kaissi, 2005;Lawrence, 1999). Due to the perceived low benefits in terms of clinical performance, clinicians frequently carried out their managerial duties with little attention, and did not integrate the use of AISs in their decision-making processes (Börner & Verstegen, 2013;Kurunmaki et al, 2003;Lapsley, 2007;Nyland & Pettersen, 2004). They also struggled against the introduction of control and the implementation of AISs in HCOs and reduced the impact of changes in the healthcare sector (Bourn & Ezzamel, 1986a, 1986bGuven Uslu & Conrad, 2008;Jacobs, 1995;Jones, 2002;Kurunmaki, 1999aKurunmaki, , 1999bKurunmaki et al, 2003;Notman et al, 1987).…”