Organizational Path Constitution in Technological Innovation: Evidence from Rural Telehealth1

Path constitution theory has emerged as a promising combination of two contrasting perspectives on technological innovation: path dependence, which focuses on historically embedded, contingent processes that are more or less beyond the control of actors, and path creation, which emphasizes mindful contributions from powerful actors. However, the current path constitution literature focuses on macro-and multi-level inquiry without addressing the specific processes, opportunities, and challenges related to organizational (micro-level) technological innovation. Against this backdrop, we draw on the innovation and path literature as well as a case study of telehealth innovation in a public health organization to theorize how technological innovation paths constitute in organizational contexts. The proposed theory distinguishes between innovation path status and innovation path trajectory to help researchers understand and explain how organizations transform and reinforce path constitution patterns, how innovation paths may merge with or separate from other paths, and how organizations may arrive at a lock-in that challenges them to break out from dominant and seemingly irreversible action patterns.