1 Managing ICT to Solve the Exploration-Exploitation Paradox in Healthcare Luca Gastaldi * , Mariano Corso Department of Management, Economics and Industrial Engineering Politecnico di Milano Via Lambruschini 4b, Building 26b — 20156 Milan (Italy) * Corresponding author: luca.gastaldi@polimi.it Structured Abstract Purpose – Hospitals struggle to achieve and maintain a paradoxical balance between their exploratory and exploitatory activities in order to improve the quality of their services while reducing their costs. Although Information and Communication Technology (ICT) can play a strategic role from this viewpoint, literature has only marginally analysed if and how ICT can be adopted—within and among hospitals—in order to manage the exploration- exploitation paradox and increase hospital performance. This paper addresses this gap. Design/methodology/approach – This study has an interpretative, inductive perspective, based on multiple and embedded case studies. 14 hospitals in North Italy have been con- sidered on the basis of the activities characterising, and the users involved in the adoption, the usage and the improvement of a set of different ICT-based solutions. The primary data source is 107 semi-structured interviews conducted over three years (from January 2009 to December 2011) with the C-levels and other knowledgeable informants of the hospitals. Originality/value – ICT can effectively solve the exploration-exploitation paradox and in- crease hospital performance through three complementary paths: (i) the digitalisation of the assets utilised within hospitals; (ii) the ICT-based integration among healthcare stakeholders; (iii) the disruption of clinical and administrative decision-making through the use of analytics. The complementarity of the paths allows the construction of the dynamic capabilities neces- sary to continuously cope with the conflicting demands characterising the healthcare industry. Practical implications – The cross-analysis of the cases provides healthcare practitioners with useful information to prevent energies from dissipating during the management of ICT-driven innovation. More specifically the paper (i) proposes a prioritisation of the dif- ferent ICT-based paths to solve the exploration-exploitation paradox that allows for the evaluation of possible “next steps” that could prove beneficial, and (ii) provides potential elements that deserve particular attention. Keywords – Exploration; Exploitation; Paradox; ICT; Healthcare Paper type – Academic Research Paper