Explaining success and failure of IT initiatives is a subject with long
tradition in the information system field. However, users’ drivers and motivation
of the adoption of voluntary open-ended technology have been understudied.
It is not clear why users would choose to adopt a new voluntary technology and
how and why its use options and possibility unfold. In this paper these questions
are examined through the analysis of a longitudinal case study (1994-
2012) of telemedicine adoption in a northern Swedish county. The findings
reveal that it is not sufficient to make an open voluntary technology available
for its users, or passively demand them to use the technology. Successful use
would occur through a continuous interplay between users’ technology mental
models and their organisational setting and work practices. When in contradiction
with the latter, users would not consider the system and hence its use could
fade away. Institutional entrepreneurs who have the ability to imagine new and
different possibilities and encourage organisational members to experiment and
explore possible use and benefit from the technology could influence the initial
mental model.