Diffusion and privacy of health technological innovations
TECHNOLOGY → products made by humans that make our lives easier, not just digital
technology
Specific features of technology
● Hard technology: tangible products, can be seen and touched
● Soft technology: intangible, knowledge on how hard technology works
● Social construct: people, private organisations and public institutions interact and
jointly construct technology to meet their goals and needs
● Technology determinism: once it has started it may not be easy to reverse it
Effects of technology
Health technology: the application of organised knowledge and skills in the form of
devices, medicines, vaccines, procedures and systems developed to solve a health
problem and improve quality of lives
Roles of health technology
● Emerging and recurring health threats: HT helps detect and track diseases
● Social, economic, and physical conditions and environments which significantly
impact the health and wellbeing: HT collects and analyses data to understand
health inequalities and help target support to vulnerable groups
● Complexity of population health issues which increasingly emphasis the
importance of working together: HT enables data sharing and collaboration
INNOVATION
- New, better, more effective ways of solving problems (idea, device, method)
- The act or process of introducing new ideas, devices, or methods
Why innovate
● Improve services and products
● React to change (our societal problems change, need new innovation to address)
● Use resource wisely (time, money)
● React to competition
● Enlarge customers/market
Innovation characteristics (longer time)
● New idea (novel): new product, process, service, business
● Exploitable (value): implementable and valuable idea
● Successful (adopted): adopted by targeted audience
Types of innovations
● Social innovation: new approaches to tackle social issues
● Health innovation (falls under social innovation): new mechanisms to improve
population health
● Product innovation: new goods and services within the market
● Process innovation: new way to produce a good/service
Health innovations → health innovation improves the efficiency, effectiveness, quality,
sustainability, safety, and/or affordability of healthcare
, - It includes new or improved health policies, practices, systems, products and
technologies, services and delivery methods that result in improved healthcare
- The goal: to improve our ability to meet public and personal healthcare needs and
demands by optimising the performance of the health system
- In order for a solution to be an innovation, it must introduce something that is
new or significantly different from other solutions in the field and result in a
benefit of improvement → not all innovations are solutions and not all solutions
are innovations
DIFFUSION & ADOPTION
Diffusion: a social process that occurs among people in response to learning about a
new innovation
Starting points of diffusion
● People don’t always follow the evidence: just because something is proven to
work doesn’t mean everyone will start using it
● New ideas are sometimes used before they are officially tested
● Innovations often start with individuals experimenting
● Ideas spread through social and work networks: people are more likely to adopt
something if others in their group or workplace are using it too
Diffusion curve: the rate of diffusion can be
visualised as an S-shaped curve over time
- Slow start as few adopt
- Rapid growth as more people follow
- Slowing as most people have adopted
(discontinuance)
Dark blue: S-shape, if S curve isn’t reached it’s
not diffused
Light blue: other innovations that impact
Factors that affect diffusion (in general)
1. Attributes of the innovation
● Cost: the perceived monetary, time or
other resource expense of adopting and implementing an innovation
● Effectiveness: the extent to which the innovation works better than the current
way
● Simplicity: how easy the innovation is to understand and use
● Observability: the degree to which the results of an innovation are visible
● Trialability: the degree to which an innovation may be experimented
● Compatibility: how well the innovation fits with existing practices and values
2. Characteristics of adopters: how the innovation is perceived by individual adopters,
how much they are influenced by others (e.g. political leaders)
3. Larger social and political context: external factors (timing of introduction, framing of
the innovation, etc)
Diffusion vs dissemination vs adoption
Diffusion: a natural, social process of spread, may or may not occur after the
dissemination of information
Dissemination: an intentional, organised effort to spread information about the
innovation
, Adoption: decision and process by which individuals, organisations, or health systems
start to actively use a new health technology (part of difussion, more individuals adopt →
contributes to diffusion)
Driving factors of adoption & diffusion of HTI
1. Perceptions of the innovation: how people perceive the new technology affects
whether they’ll adopt it or not
● Perceived benefit: does it improve care, save time, reduce costs?
● Ease of use: is it user-friendly for doctors and patients?
● Evidence: are there clinical studies showing it works
● Cost: is it affordable for hospitals or patients?
● Compatibility: does it fit with existing systems (e.g. EHRs)?
2. Nature of decision-making: who makes the decision
● Individual: a person decides on their own to use the innovation (doctor, patient)
● Collective: a group or team makes the decision together
● Authoritative: a leader or manager makes the decision for others (e.g. health
ministry)
3. Complexity of healthcare innovations → Barlow argues that the complexity of
healthcare innovations makes their adoption and diffusion harder and may not follow a
neat S-shaped curve
● Many people and organisations are involved, the end-users (consumers/patients)
of the innovation may be far removed from the decision process
● The innovation itself can be complicated, combining multiple objectives which
makes the innovations harder to define and assess
● Wider impact on many stakeholders: the innovation might affect more than just
the main adopting organisation and these stakeholders (hospitals, GPs) may have
the power to approve or block adoption decisions
● Different views on evidence: people making the decision often come from
different sectors, may result in disagreement on what counts as good evidence
4. Attributes of the innovation itself, including its complexity
5. The prevailing cultural norms, beliefs and values of actors and institutions
6. The role of peer and expert opinion leaders
Difference between health interventions/policies and product marketing
Health interventions are harder to promote than commercial products
● Type of the product
○ More abstract and complex than purchasing products
○ No immediate gratification (reward)
○ Collective instead of individual benefits
● Target group: most relevant target group may be hard to reach
● Context
○ Against predominant social norm
○ Political dimension
● Available budget
ROGER’S DIFFUSION OF INNOVATION MODEL
- To accelerate the adoption of important PH programs that typically aim to change
the behaviour of a social system by understanding the target population and the
factors influencing the rate of adoption
TECHNOLOGY → products made by humans that make our lives easier, not just digital
technology
Specific features of technology
● Hard technology: tangible products, can be seen and touched
● Soft technology: intangible, knowledge on how hard technology works
● Social construct: people, private organisations and public institutions interact and
jointly construct technology to meet their goals and needs
● Technology determinism: once it has started it may not be easy to reverse it
Effects of technology
Health technology: the application of organised knowledge and skills in the form of
devices, medicines, vaccines, procedures and systems developed to solve a health
problem and improve quality of lives
Roles of health technology
● Emerging and recurring health threats: HT helps detect and track diseases
● Social, economic, and physical conditions and environments which significantly
impact the health and wellbeing: HT collects and analyses data to understand
health inequalities and help target support to vulnerable groups
● Complexity of population health issues which increasingly emphasis the
importance of working together: HT enables data sharing and collaboration
INNOVATION
- New, better, more effective ways of solving problems (idea, device, method)
- The act or process of introducing new ideas, devices, or methods
Why innovate
● Improve services and products
● React to change (our societal problems change, need new innovation to address)
● Use resource wisely (time, money)
● React to competition
● Enlarge customers/market
Innovation characteristics (longer time)
● New idea (novel): new product, process, service, business
● Exploitable (value): implementable and valuable idea
● Successful (adopted): adopted by targeted audience
Types of innovations
● Social innovation: new approaches to tackle social issues
● Health innovation (falls under social innovation): new mechanisms to improve
population health
● Product innovation: new goods and services within the market
● Process innovation: new way to produce a good/service
Health innovations → health innovation improves the efficiency, effectiveness, quality,
sustainability, safety, and/or affordability of healthcare
, - It includes new or improved health policies, practices, systems, products and
technologies, services and delivery methods that result in improved healthcare
- The goal: to improve our ability to meet public and personal healthcare needs and
demands by optimising the performance of the health system
- In order for a solution to be an innovation, it must introduce something that is
new or significantly different from other solutions in the field and result in a
benefit of improvement → not all innovations are solutions and not all solutions
are innovations
DIFFUSION & ADOPTION
Diffusion: a social process that occurs among people in response to learning about a
new innovation
Starting points of diffusion
● People don’t always follow the evidence: just because something is proven to
work doesn’t mean everyone will start using it
● New ideas are sometimes used before they are officially tested
● Innovations often start with individuals experimenting
● Ideas spread through social and work networks: people are more likely to adopt
something if others in their group or workplace are using it too
Diffusion curve: the rate of diffusion can be
visualised as an S-shaped curve over time
- Slow start as few adopt
- Rapid growth as more people follow
- Slowing as most people have adopted
(discontinuance)
Dark blue: S-shape, if S curve isn’t reached it’s
not diffused
Light blue: other innovations that impact
Factors that affect diffusion (in general)
1. Attributes of the innovation
● Cost: the perceived monetary, time or
other resource expense of adopting and implementing an innovation
● Effectiveness: the extent to which the innovation works better than the current
way
● Simplicity: how easy the innovation is to understand and use
● Observability: the degree to which the results of an innovation are visible
● Trialability: the degree to which an innovation may be experimented
● Compatibility: how well the innovation fits with existing practices and values
2. Characteristics of adopters: how the innovation is perceived by individual adopters,
how much they are influenced by others (e.g. political leaders)
3. Larger social and political context: external factors (timing of introduction, framing of
the innovation, etc)
Diffusion vs dissemination vs adoption
Diffusion: a natural, social process of spread, may or may not occur after the
dissemination of information
Dissemination: an intentional, organised effort to spread information about the
innovation
, Adoption: decision and process by which individuals, organisations, or health systems
start to actively use a new health technology (part of difussion, more individuals adopt →
contributes to diffusion)
Driving factors of adoption & diffusion of HTI
1. Perceptions of the innovation: how people perceive the new technology affects
whether they’ll adopt it or not
● Perceived benefit: does it improve care, save time, reduce costs?
● Ease of use: is it user-friendly for doctors and patients?
● Evidence: are there clinical studies showing it works
● Cost: is it affordable for hospitals or patients?
● Compatibility: does it fit with existing systems (e.g. EHRs)?
2. Nature of decision-making: who makes the decision
● Individual: a person decides on their own to use the innovation (doctor, patient)
● Collective: a group or team makes the decision together
● Authoritative: a leader or manager makes the decision for others (e.g. health
ministry)
3. Complexity of healthcare innovations → Barlow argues that the complexity of
healthcare innovations makes their adoption and diffusion harder and may not follow a
neat S-shaped curve
● Many people and organisations are involved, the end-users (consumers/patients)
of the innovation may be far removed from the decision process
● The innovation itself can be complicated, combining multiple objectives which
makes the innovations harder to define and assess
● Wider impact on many stakeholders: the innovation might affect more than just
the main adopting organisation and these stakeholders (hospitals, GPs) may have
the power to approve or block adoption decisions
● Different views on evidence: people making the decision often come from
different sectors, may result in disagreement on what counts as good evidence
4. Attributes of the innovation itself, including its complexity
5. The prevailing cultural norms, beliefs and values of actors and institutions
6. The role of peer and expert opinion leaders
Difference between health interventions/policies and product marketing
Health interventions are harder to promote than commercial products
● Type of the product
○ More abstract and complex than purchasing products
○ No immediate gratification (reward)
○ Collective instead of individual benefits
● Target group: most relevant target group may be hard to reach
● Context
○ Against predominant social norm
○ Political dimension
● Available budget
ROGER’S DIFFUSION OF INNOVATION MODEL
- To accelerate the adoption of important PH programs that typically aim to change
the behaviour of a social system by understanding the target population and the
factors influencing the rate of adoption
