We present an ethnographic study of a healthcare innovation ecosystem in Australia and how actors in this ecosystem coordinate for establishing a new national skin cancer diagnostic imaging infrastructure. Taking a sensemaking perspective, we uncover that actors assume concurrent roles in the ecosystem while maintaining parallel channels of communication for interdependent threads of development to unravel during a gradually unfolding distributed innovation process. Furthermore, actors cope with on-going yet inevitably fragmented coordinating by sustaining sensemaking with epistemic things as incomplete parts of an unfolding “whole” (i.e., the innovation process inside the ecosystem). Our paper contributes to management research and practice by, firstly, explicating coordinating challenges inherent to distributed innovation in innovation ecosystems, which have become an increasingly prevalent inter-organizational context for innovation. Secondly, we provide crucial knowledge of how actors enact their agency and unpack what underpins actors’ continuous coordinating for distributed innovation that is often taken for granted in theory and practice.
