The interplay between organizational structure, the decisions made by agents within the structure, and the technology supporting those agents is an important and complex, but not well understood, phenomenon in modern organizational studies. In this paper the authors describe how simulating key aspects of an organization’s structure, in this case a hospital, can yield insights into the design of information systems and their performance. In particular, they report on a project that simulates alternative distributed decision-making approaches for patient scheduling tasks. The results indicate that there are important and complicated interactions between the alternative organizational structures simulated, the form of the information systems supporting those structures, and the task environment. This suggests that current, universal, a priori assumptions about the interplay between technology and organizational structure are questionable. Furthermore, organization-specific simulation is seen as a potentially useful method of explicating the important tradeoffs in alternative design possibilities.
