Configurational pathways to professional service innovation: a fuzzy set analysis of provider adoption decisions

Purpose This study investigates how healthcare professionals make complex adoption decisions that transform service encounters and value co-creation processes. While most research has focused on patient-side technology adoption, this study advances the understanding of the configurational conditions that drive provider-side adoption of digital service innovations. Design/methodology/approach Employing fuzzy-set qualitative comparative analysis (fsQCA), this study analyzes data from 315 self-employed otolaryngologists (ENTs) who interacted with a virtual-reality-based healthcare service. The configurational approach reveals how combinations of technological, professional, and contextual factors jointly shape professionals' intentions to adopt service innovations. Findings Four conditions are necessary for adoption: performance expectancy, hedonic motivation, price value, and social influence (consistency = 0.90). When combined with effort expectancy, facilitating conditions and low Anxiety, they form a sufficient configuration explaining 63% of high adoption cases (consistency = 0.97). This pattern shows professional service innovation adoption needs cognitive evaluation, intrinsic motivation, economic viability and social legitimacy, unlike consumer technology adoption where single factors may suffice. Originality/value Beyond methodological innovation through fsQCA application, this study advances professional service theory by revealing how adoption requires multiple psychological mechanisms: expectancy-value calculations, intrinsic motivation, social validation and emotional regulation. The necessity of these conditions distinguishes professional service innovation from consumer technology adoption and IT implementation. These insights extend professional service firm theory by showing how knowledge intensity, low capital intensity and workforce shape digital transformation patterns. The study provides guidance for designing provider-centered digital healthcare services in post-pandemic ecosystems.