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For some time now, successive generations of more sophisticated information and communication technologies (ICTs) have been adopted by organisations to enhance or replace more traditional methods of accessing, recording and communicating information used in problem-solving activities. Professionals in most industries have had some experience of the impact of ICT innovation and might be expected to resist innovations which they perceive to have the potential to disrupt crucial processes. This appears particularly likely to occur where there is a substantial tacit knowledge component. In this paper, we report the perceptions of key groups of healthcare professionals of the barriers to adoption of videoconferencing into knowledge-intensive processes mediating high-level problem-solving. While there was some shared perception of the critical problems, the interpretations of the underlying issues differed. The findings give some insight into the conceptualisation issues surrounding innovation management within complex systems which are emerging in the adoption of ICTs. The nature of their impact on pre-existing core communication routines involving high level expertise and tacit knowledge is considered.

Incumbents’ inertia in the face of disruptive innovations has been emphasised in prior literature. The relevance of inertia is particularly topical in the context of digital transformation. However, incumbents may be able to invest in disruptive digital innovations appropriately if they possess the motivation and ability to do so. In this paper, I use three streams of research in order to investigate contextual, organisational, and individual antecedents of incumbents’ motivation and ability to adopt and use potentially disruptive digital innovations in health care: institutional theory, the resource-based view, and technology acceptance literature. I employ factor analyses and logistic regressions to test the impact on the adoption and usage of telemedicine applications using a dataset of 9,196 European general practitioners. I examine B2B as well as B2C applications in order to determine the effect of the antecedents on different business models. My findings suggest that only isomorphic pressure, complementary assets, and perceived output quality significantly influence both adoption and usage as well as B2B and B2C business models in the same way. Formal institutions and individual factors yield ambiguous results. These findings provide important implications for the understanding of incumbents’ response to potentially disruptive digital innovations in regulated contexts.