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This study intends to reveal how to manage the dynamic process of information technology business (IT-business) strategic alignment; managing this alignment is an unknown yet critical issue that must be addressed by any firm trying to unleash the business value of their IT investments.

This study presents our case study of a healthcare organization after healthcare information systems (HIS) implementation and investigates the strategic alignment between the implemented HIS and the organizational strategy from a dynamic perspective.

Two different patterns of alignment (i.e. an IT-strategy–driven pattern and a business-strategy–driven pattern) are identified, and a process model of the IT-business strategic alignment is developed. Moreover, this study focuses on the social dimension of strategic alignment and examines the role of this dimension, which is critical and fundamental with respect to other dimensions, in achieving strategic alignment.

This paper makes important theoretical contributions to the understanding of strategic alignment by taking a dynamic view of alignment, identifying different patterns of alignment, emphasizing the role of social alignment and developing a comprehensive process model.

From a managerial perspective, managers should periodically scrutinize the IT-business alignment patterns of their organizations and develop dynamic capabilities for strategic alignment.

While most of the literature on the dynamics of strategic alignment have focused on confirming the dynamics of strategic alignment and identifying the factors that create dynamics in alignment, this study examines IT-business alignment as a continuous process over time, thus providing a novel perspective. Moreover, while the role of social alignment and its impact on downstream performance remain unclear in the current literature, this study incorporates the social dimension of alignment to investigate the role of this dimension in achieving IT-business strategic alignment.