The concept of technological frames of reference (TFR) has been used to uncover people’s sense making of information and communication technologies (ICT), in order to deepen the understanding of ICT deployment. However, the role of the organization’s institutional context in the development of TFR has been overlooked. The aim of the paper is to analyse how the institutional logics shape the development of TFR over time. The aim will be pursued by the analysis of a case study of telemedicine deployment in a Swedish county during a 12 years period. It is concluded that actors draw on elements in the institutional logic when use is developed, and when use is rejected because it might imply a personal discomfort. But the institutional logic can also be neglected when use imply that a perceived dis-comfort for a group is removed.