Organizations must continuously allocate and reallocate limited resources, including IT resources, to competing innovation and operational concerns. While the ambidexterity literature provides some guidance regarding resource allocation approaches, studies typically assume that such tensions can be balanced without taking contextual and trade-off issues into account. Further, many studies examine ambidexterity approaches individually without considering how different approaches may be combined. To address these shortcomings, we pragmatically examine how a U.S. health delivery organization responded to technological, regulatory, and demand changes over a 15-year period and the effects of its actions. To manage the consequential tensions between innovation and operation of its IT-enabled services, we retrospectively observe that the organization applied a portfolio of sequential, structural, and contextual ambidexterity approaches. As a contribution to the IT governance and health IT literatures, the study offers theoretical and practical knowledge on how organizations can pragmatically apply ambidexterity in highly dynamic contexts to mindfully orchestrate and coordinate between innovation and operation of their IT-enabled services.

组织必须不断分配和重新分配有限的资源，包括IT资源，以应对竞争的创新和运营问题。尽管歧义性文献提供了有关资源分配方法的一些指导，但研究通常认为，可以在不考虑上下文和权衡问题的情况下平衡这种紧张关系。此外，许多研究单独检查歧义性方法，而没有考虑如何将不同的方法组合在一起。为了解决这些缺点，我们务实地研究了美国卫生保健机构如何在15年内对技术，法规和需求变化做出反应以及其行动的效果。为了解决创新和IT支持服务运营之间的紧张关系，我们回顾性地观察到该组织采用了顺序，结构和上下文歧义方法的组合。作为对IT治理和健康IT文献的贡献，该研究提供了有关组织如何在高度动态的环境中务实地应用歧义性以精打细算地在其IT支持的服务的创新和运营之间进行协调的理论和实践知识。