Health Care Innovation Diffusion Explored in Two CHCF Studies

New reports provide practical advice and view of adoption in California organizations


Two new iHealth Reports from the California HealthCare Foundation provide insights into how and why health care technology succeeds or fails to be adopted.

Diffusion of Innovation in Health Care offers practical advice on how new medical and information technologies are adopted by the health care industry. Prepared by the Institute for the Future, the report explains how diffusion tends to happen and how the pace and style of diffusion can be influenced in organizations.

“The report explains why getting new ideas and technologies put to good use continues to be both frustrating and rewarding for innovators and users alike,” according to Sam Karp, who directs CHCF’s Internet Health and Technology program.

The report is intended to assist practitioners and executives involved in medical and information technology adoption decisions. Authors Mary Cain and Robert Mittman explore ten critical dynamics of health care innovation diffusion. For each dynamic they provide real life examples of successes and failures and the lessons learned.

The ten critical dynamics include:

  1. Relative advantage: The more added value or benefit anticipated from adoption of the innovation relative to current practice, the more rapidly it will diffuse.
  2. Triability: The ability to try out an innovation without total commitment and with minimal investment improves the prospects for diffusion.
  3. Observability: The extent to which potential adopters can witness the adoption of an innovation by others improves its prospects for diffusion.
  4. Communications channels: The paths through which opinion leaders and others communicate about an innovation affect the pace and pattern of diffusion.
  5. Homophilous groups: Innovations spread faster among homophilous groups (those with similar characteristics) than among heterophilous groups (those that differ in important ways).
  6. Pace of innovation/reinvention: Some innovations are relatively stable and do not evolve much while they diffuse. Others evolve much more rapidly and are altered by users along the way.
  7. Norms, roles, and social networks: Innovations are shaped by the rules, formal hierarchies, and informal mechanisms of communication operative in the social systems in which they diffuse.
  8. Opinion leaders: Individuals whose opinions are respected (or at least listened to) by others in a population affect the pace of diffusion.
  9. Compatibility: The ability of an innovation to coexist with technologies and social patterns already in place improves the prospects for adoption/diffusion.
  10. Infrastructure: The adoption of many innovations depends on the presence of some form of infrastructure or of other technologies that cluster with the innovation.

Study of Technology Adoption in California Medical Groups, IPAs, and Community Clinics, conducted by the Healthcare Change Institute, surveyed health care organizations throughout the state to determine the status of technology adoption, what organizations view as barriers, and how they make investment and adoption decisions, among other issues.

The study found systems for administrative functions were far more prevalent than clinical systems, although improving quality of care and service were the highest priority information technology objectives. Financial factors were rated as the most significant obstacle to adoption of technology by 85 percent of survey respondents. Lack of leadership support was rated next (39 percent), followed by insufficient internal resources (33 percent), and lack of reliable/fitting products (26 percent).

Both reports are available for download through the links below.

About the Institute for the Future

The Institute for the Future is a nonprofit research and consulting firm that helps public and private organizations think systematically about the future by evaluating long-term trends and their implications, identifying potential markets, and analyzing policy options.

About the Healthcare Change Institute

The Healthcare Change Institute is a nonprofit organization dedicated to assisting health care organizations to more effectively anticipate, implement, and achieve the intended results of major change initiatives.


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About the California Health Care Foundation

The California Health Care Foundation is dedicated to advancing meaningful, measurable improvements in the way the health care delivery system provides care to the people of California, particularly those with low incomes and those whose needs are not well served by the status quo. We work to ensure that people have access to the care they need, when they need it, at a price they can afford.