Strategies for addressing customers’ adaptation problems in the healthcare ecosystem

This study investigates how an innovating firm can address adaptation problems encountered within an existing ecosystem without a central orchestrator. Lacking control over key interdependencies between customers and other actors, such firms must make strategic choices about how to address adaptation problems. Drawing on an in-depth qualitative study of the commercialization process of three innovations within an incumbent healthcare firm, we find that customer adoption was particularly hampered by existing interdependencies between customers and IT system providers and insurers. We identify three strategies—delegating, attuning, and facilitating—that firms use to tackle customer adaptation problems. Each strategy involves distinct trade-offs between control, learning, and cost, and their selection depends on both internal resource fit and external conditions. We discuss implications of our findings for the governance and problem-focused capabilities of firms innovating within established ecosystems.