Service science is concerned with the question of how systems can
co-create value in an optimal way. In essence, innovations aim at enabling
better value co-creation; but at the same time, cause disruption and tensions
in the service ecosystem by challenging prevailing practices. This chapter
examines the development and diffusion of a broad scale heath care service
innovation – the Electronic Prescription system (eRX) – as a process of
institutionalization within a service ecosystem. This case represents an
innovation process that attempts to solve a major societal challenge,
rationalization of medication and reduction of medication errors and abuse. This
change requires commitment and adaptation by diverse actors in multiple service
systems affected by the eRX, but is nearly disabled by these actors’ competing
and even conflicting institutional logics. We examine how diverse stakeholders
slowly move towards a convergent institutional logic as the innovation is
gradually institutionalized in the broader service ecosystem, and discuss the
major challenges along this process. This chapter highlights the dilemma of
change in service ecosystems and highlights the role of institutions therein.