Various mobile phone applications (hereafter apps) challenge instituted ways of working in healthcare. This study explores the institutional breaches arising from the use of apps in doctor-patient interactions. This paper argues that institutional breaches, however small, are important occasions for observing the contextual intersections between healthcare, regulation and technology in a hospital setting. Based on healthcare professionals’ normative judgements, the paper offers an empirically grounded understanding of institutional legitimacy-claiming; safeguarding responses deployed by the instituted regime, and the case-building responses deployed by the instituting persuaders. Institutional breach persistence arises from the moral dimension of legitimacy and is grounded in asymmetrical dynamics between two virtuous healthcare narratives. The paper concludes with a discussion of the contextual intersections between healthcare, regulation and technology, paying particular attention to institutional breaches as experimentation, the contestation of normativity and patterns of technology indulgency in healthcare work.

各种手机应用程序（以下简称应用程序）挑战了医疗保健领域的工作方式。本研究探讨了因在医患互动中使用应用程序而引起的机构违规行为。本文认为，无论多么小，机构违规行为都是观察医院环境中医疗保健、监管和技术之间背景交叉点的重要场合。基于医疗保健专业人士的规范判断，本文提供了对机构合法性主张的实证理解；保护所建立的制度部署的反应，以及案例建设由发起说服者部署的回应。制度违规的持续性源于合法性的道德维度，并植根于两种良性医疗保健叙述之间的不对称动态。本文最后讨论了医疗保健、监管和技术之间的上下文交叉点，特别关注作为实验的制度违规、规范性的争论和医疗保健工作中的技术纵容模式。