Based on the lead user concept, Dominique-Pascal Gross examines the specifics of the homecare industry and the relationships between innovative users, intermediaries such as medical supply stores, providers or associations, and the manufacturers of homecare products. Through an analysis of the complex web of relationships, he illustrates the various pathways through which the diverse user needs, ideas, and innovations reach the manufacturers. Barriers to the implementation of innovations are evident in all three areas considered. The origins of these barriers among users, intermediaries, and manufacturers are as varied as the actual impact manifested in each area. These are highlighted, analyzed, and potential strategies for overcoming them are presented.