Achieving Clinician Buy-in to Technology

Bryan Bergeron, MD

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In This Article

Group Behavior

Groups of clinicians change slowly, even when a change is obviously the best course of action. The Technology Adoption Curve,[3] illustrated in Figure 2, models the time required to achieve group buy-in for a technology, whether it's a stethoscope or an EMR. The shape of the Technology Adoption Curve -- an elongated "s" -- can be explained by the statistical quality of variance about the mean of any measure. Many physical characteristics and psychological phenomena are distributed according to a bell-shaped curve, illustrated on the lower half of Figure 2. Moving from left to right along the bell-shaped distribution, and counting the total number of adopters along the way, results in the s-shaped Technology Adoption Curve that extends to the top half of the figure. At the right edge of the adoption curve, virtually every clinician in the population of potential adopters has made the change to the new technology.

The Technology Adoption Curve.

Marketers in the high-tech industry typically slice the s-shaped adoption curve into 5 specific areas that describe the characteristics of those in each time slice: Innovators, Early Adopters, Early Majority, Late Majority, and Laggards. The first group to adopt a new technology are the Innovators, who characteristically have an infatuation with the technology, for technology's sake. Innovators must have the latest technology, regardless of whether it's practical or provides a solution for a particular problem. That said, Innovators don't necessarily live in the clouds; they may be habitually drawn to new technologies so that they can build on them or apply them in new, nonrelated areas. Often these areas are in an industry that never occurred to the original technology designers. For example, the innovators who chose to use their Palm Pilots to transfer patient data from one resident to the next probably used their PDAs in an application area that never occurred to the original Palm development team.

Next along the Technology Adoption Curve are the Early Adopters. Like the Innovators, these clinicians are also technology-focused, but they are motivated to use the technology to achieve meaningful results in a specific area. Early Adopters don't necessarily mind that the solution isn't plug-and-play, and often enjoy the challenge of developing a technology that isn't quite ready for mass-consumption work as advertised. Early Adopters are important because they work out the kinks in a technology solution -- that is, they take the arrows in the back so that other clinicians can benefit from the technology.

A technology is clinically successful or mainstream when it is accepted by the Early Majority. This group of clinicians comprises nontechnical solution-oriented users of the technology. Adopters in this group aren't interested in the nuances of the underlying technology but in what it can do to solve their problem, whether that thrust is to make their lives easier, save time, increase profits, or provide enhanced clinical care.

The Late Majority represents the next most important group of clinicians. Like the Early Majority, this group is characterized by a need for a solution that will help them achieve increased efficiency, cost savings, or other practical gains. They differ from the Early Majority in that they may have greater risk aversion, insufficient capital to invest in the technology soon after it is introduced, or greater need for change and correspondingly greater inertia. They may also be traditionally conservative and resistant to change. For these and other reasons, technology adopters in the Late Majority tend to wait for others to make the first move before committing to change. For their delay, and wish for security, they trade a loss in efficiency, cost savings, and other benefits of the technology. There is very little risk in relying on a technology that is used in hospitals throughout the country.

The final group, the Laggards, represent the clinicians who change only when they have no other choice. Clinicians averse to computers or nearing retirement are likely candidates for membership into this category, from the perspective of embracing an EMR, for example.

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