In this paper we address the challenges faced when new e-health components are introduced within an existing infrastructural arrangement by focusing on the delicate balance between immediate usefulness and forward-looking preparedness. While e-health solutions are currently seen as a core element of on-going health sector reforms in most European countries, much of the challenges related to their design, development and implementation remain understudied. Based on an interpretive case study of technology innovation in the Norwegian healthcare context, we study the practices of building and putting to use a novel web-based platform for communication between users and providers of healthcare services. In particular, we analyse the conceptual design, the association with the installed base, and the relationship with users as core enacting practices of the project team members. We make use of the concepts of generativity and robustness to bring into focus and articulate possible approaches for change anticipation.