| Summary: | This study employs a structuration view to examine how the use of mobile phones by healthcare staff affected, changed, or modified the existing patient referral system in rural Thailand. Findings from the interviews (n = 31) indicate that healthcare staff used their personal mobile phones for patient referral because they could quickly reach specific personal contacts in the hospitals and provide nuanced contextual information that was not possible to communicate via the formal paper-based communication system. The practices capture the nascent quasi-institutionalization of mobile-assisted referrals, and provide insights into how existing organizational rules, cultural, norms, resources, and social relationships shape, and are likely to be shaped by mobile communication.
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