In this study, we examine three types of second-order effects stemming from ICT innovation: subversive, adaptive, and generative. In order to theorize about the precursors of generative second-order effects, we use Galbraith’s organizational information processing theory to the highlight variables that moderate the relationships between the diffusion of ICT innovations and the variety of local adaptations that might enable or inhibit innovation. Future research will focus on second-order effects of Healthcare Information Technology (HIT) innovation.