Dialectics of resilience: a multi-level analysis of a telehealth innovation

Resilience is commonly portrayed as a positive capability that allows individuals, groups, and organizations to thrive in dynamic contexts. This paper questions this oversimplified view based on a dialectical analysis of a telehealth innovation within a network of collaborating hospitals. We analyze the major contradictions that characterize the adoption of the innovation. First, we analyze contradictions between individuals and groups within each adopting organization. Second, we analyze contradictions between the adopting organizations. This multi-level analysis leads to a deeper understanding of resilience as a dialectical process. The analysis of the case shows that, although the participating individuals, groups, and organizations demonstrated apparent resilience in adopting the telehealth innovation, the innovation remained in a fragile state, where it was unclear whether it would continue to diffuse, stabilize as-is, or slowly deteriorate. Hence, while resilience facilitated swift and successful adoption, it also created tensions that endangered further diffusion and the long-term sustainability of the telehealth innovation. We suggest that understanding the future success of the innovation would be facilitated to a large extent by a dialectical analysis of the involved contradictions.