Users' search mechanisms and risks of inappropriateness in healthcare innovations: The role of literacy and trust in professional contexts

- Users' search mechanisms introduce risks of inappropriateness.
- Professionals orient users' search mechanisms toward logics of appropriateness.
- Professional tactics are shaped by behaviors of lead-users and laggards.
- Professionals invest on user literacy to create shared cognitive framework.
- Professionals invest on trust to generate positive affective framework.

In the context of professional service organizations, user engagement with knowledge search might generate significant risks of inappropriateness to innovation processes. Previous research suggests that professionals would then keep users at arms' length, controlling the design and implementation of innovations internally. This study overcomes this view investigating how professional service organizations can enable users' knowledge search while controlling for the risks of inappropriateness. Combining a qualitative research on 5 innovation processes in healthcare organizations with quantitative research on 110 service users, our findings highlight that professional providers, such as senior clinicians, shaped their tactics according to the 'threats' of laggards, i.e. users searching knowledge outside of professional logics of appropriateness; more than to the opportunities of lead-user communities. Professional providers sought to “activate” users' engagement with knowledge search by investing on their literacy, i.e. showing the basics of the logic of appropriateness informing their decision; and on trust relationships, i.e. becoming transparent on the criteria of knowledge selection during the innovation processes.