The Duality of Digitalization: Evaluating Accounting Information System Implementation for Financial Flexibility (A Case Study at Community Health Center)

Abstract

Community Health Centers face challenges in delivering excellent service and managing operations—particularly finances—due to budget constraints and bureaucratic mechanisms for fund disbursement. The Regional Public Service Agency management model has addressed these administrative hurdles; however, adopting the model entails specific obligations for the centers regarding financial management accountability. This study evaluates the implementation of the e-BLUD accounting information system as an organizational mechanism to enhance financial governance and accountability at the community health center. Using an interpretive qualitative case study design, the study collected primary data through on-site observations and semi-structured interviews with eight purposively selected informants from the community health center and the Regional Health Office. Data analysis followed Creswell’s six-stage framework, grounded in institutional theory (organizational isomorphism) integrated with a performance feedback lens. The empirical results reveal that management model adoption remains confined to a symbolic compliance layer, characterized as "used but not utilized." Daily penurious bookkeeping, quarterly authorization statement preparation, and final financial reporting continue to rely heavily on parallel manual spreadsheets. System utilization is driven by coercive regulatory pressures (coercive isomorphism), localized mimicking of benchmarked health centers (mimetic isomorphism), and professional beliefs regarding administrative optimization (normative isomorphism). Structural impediments include non-accounting staff backgrounds, severe task duplication, lack of formal standard operating procedures (SOPs), and absent internal penalties. In short, successful digital transformation requires bridging the decoupling gap between regulatory adoption and active operational utilization.