1. 1. Much of the diffusion literature directly references or can be traced back to general
principles articulated, originated and developed, by Everett M. Rogers. Begin by
looking at the background synthesis for an overview Rogers’ diffusion of innovations
and then read the following:
1.1What forces determine how quickly and when innovations / technologies diffuse?
The key to distinguishing some of the forces determining the diffusion of
innovations/technologies lies in the definition of the term diffusion. In his complex
behemoth of a book ‘Diffusion of Innovations’, Rogers offers this definition: “Diffusion is
the process by which an innovation is communicated through certain channels over time
among the members of a social system” (Rogers, 1962). From here spring the four main
elements that, together, lead to diffusion: an innovation, communication channels, time
and social systems.
Communication
Social systems
channels
Innovation Time
Diffusion
Image 1: Overview of the four main elements of diffusion
Innovation can be anything from and idea to a practice to an object and its rate of
adoption is determined by five attributes:
1. Relative advantages which deal mostly with financial payback;
2. Compatibility which is determined by how much in alignment the innovation and
the individual’s existing values;
3. Complexity concerns the level of difficulty the innovation poses to the user;
4. Trialabilitymeans that an innovation is tested and represents less uncertainty to
potential adopters, allowing them to learn by doing;
5. Observation, which means the result of an innovation is visible to others;

2. “In general, innovations that are perceived by receivers as having greater relative
advantages, compatibility, trialability, observations and less complexity will be adopted
more rapidly than other innovations” (Rogers, 1962)
Communication channels involve an informed party connecting with an
unknowledgeable one and, through creating a connection, there is a transfer of
knowledge.
These channels are divided into two parts, the mass media channel,which is most useful
in the beginning stage, and the individual channel, which more persuasive for it involves
word of mouth as a key factor in accelerating the adoption of innovation through
persuasion. More so, word of mouth is seen as more important than media coverage as
it involves the building of trust.
The time element encompasses the innovation-decision process, the term
“innovativeness” and the adopter categories.
1. Knowledge
Individual gains first
knowledge of the innovation.
2. Persuasion 3. Decision
Individual begins to form an Two posibilities: adopt or reject
opinion towards it. innovation.
4. Implementation
of the new idea.
5. Confirmation of the
decision.
Image 2: Visualization of Rogers’ (1962) innovation-decision process.
Innovativeness, or someone’s propensity to adopt an innovation, is found, in varying
degrees, throughout the 5 “adopter categories” identified by Rogers (1962). It is high in
innovators and early adopters and declines steadily from early majority to late majority
to laggards.
Lastly, the social systems which embody the norms and structures that govern us and
which, to some degree, assist or impede the diffusion of innovation.

3. On a more general level, we must state that diffusion comes about at different rates in
different countries, marking geographic proximity to the innovation as an important
factor in its possible diffusion because innovations are not appear everywhere at the
same time. As Brown (1981) states “Some groups of people and some places have
immediate access to the innovation, some gain access later and some never do.” This
can also be linked to economic and cultural (compatibility) factors,which also vary
greatly from country to country and may favor diffusion in wealthy, progressive ones.
Lastly, and most importantly, the diffusion of innovation has human behavior and trust
at its core. Though a large group of people can be influenced by their economic, social,
locational or demographic characteristics, humans are by nature sociable creatures who
value trust and human interaction above most things. Trust can be seen as an incredible
catalyzer to the diffusion of innovation because consumers “[…] buy products not only
for what they can do, but also for what they mean” (Levy, 1959) both to them as well as
to the person recommending it.
More so, building trust with their current and possible customers is also an option for
companies/innovators, which will greatly help in the diffusion of their offering as good
press means a good reputation, which leads to appreciation and word of mouth.
1.2Rogers says that the existence or knowledge of a technology does not guarantee its
absorption. What barriers prevent the diffusion of innovation?
In his ‘Diffusion of Innovation Theory’ Rogers (1995) identifies five characteristics of an
innovation that must be considered when examining its absorption. We looked at the
potential barriers to diffusion within these five stages.
Relative Advantage - If the innovation is perceived as having superior attributes than its
competitors it said to have strong or high relative advantage (Bessant & Tidd, 2011). The
lower the perceived advantage of the product, the slower the rate of adoption (if it ever
adopts). When talking about the attributes of an innovation it is useful to distinguish
between primary and secondary attributes. The primary attribute is the cost and size,
which remains for the most part constant. The secondary attribute is the relative
advantage and compatibility, which will vary from person to person, culture to culture
(Karahana et al, 2000). In most cases an “attribute gap” exists, this gap is the
discrepancy between a user’s perception of the attributes and what they would like that
attribute to be. The greater the gaps are, the bigger the barriers to adoption. For
example, if it is cheaper to make/buy, does the job better, or has new, desirable
functions, is easier to use, or is safe and reliable, the more likely it Is to be absorbed and
vice -versa.
Compatibility - People are at the heart of whether an innovation is absorbed or not. If an
innovation is perceived to be inconsistent with existing social norms, cultural (religious)

4. values, and experiences, it is much less likely to diffuse (Barton, Sinha, 1993).
Suggesting that an innovation, which isn’t adaptable, isn’t very likely to be absorbed.
Rogers (2003) says this is when a company is too innovation orientated rather than
client orientated (e.g. trying to sell packaged Ice to an eskimo). The extent to which an
innovation fits the existing skills, equipment, procedures, and performance of the
adopter is also critical. If the innovation is misaligned in those early stages to an
organization’s existing practices, it could be fatal to the diffusion of that innovation, as
the early adopters will not make contact with early majority (Rogers, 1995). On an
individual level, the main barrier to diffusion is resistance, more so, “resistance levels
differ from one individual to another” (Brown, 1981). Resistance is the complete
opposite of innovativeness, high in laggards and declining steadily up to the innovators,
which show little to no trace of it.
Complexity - Other functional barriers include complexity, the more an innovation is
seen as being too difficult to learn by the potential adopter, the less likely it will be
adopted. However resistance from the adopter isn’t always a conscious process. Often
we get into the habit of doing the same thing over and over, building routines over long
periods of time, which leads to natural resistance to current innovations. Sheth (1981)
terms this “the single most powerful determinant in generating resistance” and notes
that “perceptual and cognitive mechanisms are likely to be tuned in to preserve the habit
because the typical human tendency is to strive for consistency and status quo rather
than to continuously search for, and embrace new behaviours”.
Trialability - This is to the degree, which an innovation can be tested before its
permanent adoption. By giving people the option to trial the innovation, lowers the
perceived risk and uncertainty in the potential adopters mind. Innovations that do not
have this option generally take longer to diffuse than those that do (Bessant & Tidd,
2011).
Observability - This is concerned with how visible the benefits of the innovation are to
the potential adopters. The less visible the benefits of an innovation are, the less likely it
will be absorbed. The main premise behind the simple epidemic model of diffusion is
that innovation spreads as potential adopters make contact with existing users of an
innovation.

5. Image 3: The Model of Diffusion
Interestingly a study by Fattini (2008) suggested that this was the most powerful
indicator of diffusion. If you can gain the positive acceptance of early adopters, then
target the main market through their positive word of mouth and networks then your
innovation is much more likely to be absorbed. If the innovation is misaligned in this
early stage, its diffusion may stagnate as the early adopters are not coming into contact
with the potential adopters.
Wolpert (2002) has conducted a lot of research into the adoption of innovation
within organizations. He suggests that many organizations are internally focused and as
such seek to source most of their ideas and innovations from their own employees.
Image 4: “A Cartoon” by Mr. Fish posted in Harper’s Magazine (August 2005)

6. The consequence of this method is usually small incremental innovations and
dissatisfied Executives who were expecting radical new ideas and implementations of
technology, which would vastly improve the company’s productivity and accounts.
However always drawing from the same resource is going to give you stale results.
Wolpert goes on to say that when the economy is tough, these unimpressed executives
tend to severely reduce or cut off funding for innovative research, and focus more on
short-term defensive business strategies, putting their money into other departments. A
claim which has found recent support from a study by Nesta that examined 1,200 UK
businesses where:
- Innovation investment fell by 7 per cent, or £7.4bn, between 2008 and 2009.
- A further fall of 14 per cent, or £17bn, from 2009 to 2011
Image 5: Effects of recession in innovation investment
Getting the funding for innovations will often mean taking money away from an
established program. Since most companies work on annual funding cycles, they are
unable to grasp an innovation when the opportunity arises. Therefore timing can also be
a barrier, in fact a study by Hadjimanolis (1997) found that 500 companies rated time, as
the biggest internal barrier to innovation.
Wolpert argues that in a lot of cases, in order for technological innovations to transfer
or diffuse effectively between organizations they need to collaborate on ideas and look

7. beyond themselves to other sectors. The best example we could think of was Edward De
Bono’s (1976) famous true story explaining lateral thinking. A group of physiologists
were stumped on the purpose of the kidney tubules, years went by and they were still
no wiser for determining their use. Eventually they discussed their problem with an
engineer and allowed him to look at the tubules. He instantly recognized them as being
a counter-current multiplier, a common engineering device for changing the
concentration of solutions. It is this outside perspective that Wolpert believes to be of
great importance for the adoption of new innovations within a firm. When
communication between companies and different sectors breaks down, barriers to
innovation start to build up. Rogers (2003) argues that is because no new information
can be exchanged.
Mantel and Rosegger (1987) take this one step further. They identified that by looking
to third parties to help package or tailor a technology to your firm, to locate suppliers to
make components for your technology, inspire confidence through success stories, and
to help secure deals between firms can be of massive consequence for the diffusion of
technological innovation within organizations. Without it, tasks often seem too
overwhelming, time consuming, and by not sharing information and sourcing third party
help you may not have the necessary skills available to fully adopt the innovation into
your company.
1.3What does Gladwell mean by ‘the tipping point’ and can it be used to explain the
diffusion of innovation?
In his introduction, Gladwell (2000) defines ‘the tipping point’ as “the name given to
that one dramatic moment in an epidemic when everything can change all at once”
(Gladwell, 2000). In his opinion, epidemics should be applied to all fields, not just the
medical. Everything from ideas to products to behaviours can and have spread like
viruses.
In his introduction, the author emphasizes three main notions with which the reader
must fully accept so as to understand the logic behind ‘the tipping point’; firstly, that,
due to the nature of epidemics and viruses, people can infect others, which means their
behavior is contagious. Secondly, like the butterfly effect, little, seemingly unimportant
changes can have dramatic effects and, lastly, that this entire process happens
incredibly fast.
For this tipping point to be reached, the idea/object/etc… needs to be “widely
disseminated, "sticky" enough to be retained by each new recipient [and] operating in a
context that nurtures it” (Cattey, 2005). More so, the number of people needed to
spread such an epidemic is quite low, however, there are three particular roles that
must exist:

8. A •an individual who knows a
Connector large number of people
•an individual who manages to
condense the innovation
A Maven down to its simplest, most
relevant version (giving it a
new appeal)
•an individual who can
A Salesman convince others to take in the
new version
Image 6: The three relevant roles in creating epidemics as specified by Gladwell (2000)
Concerning the second part of the question, if the tipping point can explain the diffusion
of innovation, we cannot readily acknowledge or deny the effect it would have on the
process as it is not a stable recipe; in his own introduction, Gladwell used the example of
Hush Puppies which showed the brand flourish after hitting rock-bottom but its rise
back to popularity wasn’t due to strategy, it was due to a small number of kids who
wore the shoes because nobody else was and it escalated and grew in proportion from
there.
Should we choose to use the idea behind ‘The Tipping Point’ to speed up diffusion, then
we must also take“the potential impact of technologies still under development[under
consideration] as we develop strategies to speed the diffusion of beneficial innovations”
(Coye, 2003).Both potentially beneficial and disruptive innovation should be prepared
for before attempting to speed up the diffusion of any innovation. Gladwell’s (2000)
idea offers great importance to the act of word of mouth,which can be helped along,
but not staged as reaching every individual is nay impossible.
However, we feel that, if filled correctly, the three roles (connector, maven, salesman)
could very well help the diffusion process along. This is not by far an exact science
though, as epidemics are unstructured, almost chaotic and usually unpredictable, so we
consider ‘the tipping point’ more of a last resort when all else fails rather than the
integral missing part to Rogers’ theory.

9. 2. Within your groups, please do the following and prepare to present your findings to
another group in workshop. This needs to be completed by the entire group so that
you compare findings within the group;
2.1 Identify a product or service which is either being diffused or has been diffused
and plot this across Roger’s adopter categories.
Smart Phones.
Smartphones are mobile phones built on mobile operating systems; these systems have
a much more advanced computing capability than a regular feature phone. The first
smartphones combined the functions of a personal digital assistant (PDA) with a mobile
phone. Later, functions such as the Internet, multimedia and various software
applications were also added. In the UK, 27% of adults and 47% of teenagers are using
smartphones, interestingly 59% of those have only begun using them in past year
(Ofcom, 2011)
The Iphone is one of the most popular contemporary smartphones. One of it’s most
interesting qualities when it entered the market was its touch screen capability, most
notably how responsive it was compared to it’s competitors.
Another feature which really helped propel it’s diffusion was it’s ability to both write
and download software for reasonable prices. The user interface of the Iphone is a
variant of the same system core used in Mac OS X, which is used in Macintosh
comptuers.
Below is the diffusion of the iPhone plotted along Roger’s model of diffusion.
Image 7. The iPhones diffusion along Rogers (1995) Diffusion Model.
1) The iPhone gets released on June 29, 2007 (Macworld 2007) and received a lot
of publicity from the press, it was also named Invention of year in 2007 (Time,
2007). All helping (along with the companies brand strength) to propel the
iPhone into the early adopters.

10. 2) Apple had interesting strategy for speeding up diffusion. It made agreements of
country levels with operators for iPhone to be sold only with tying deals,
excluding the operators competition from selling iPhones.
3) Lowers the price and increases usability through fixing bugs and increasing the
responsibility of the touchscreen.
4) After a couple of years, iPhone released to other operators, increasing their
exposure.
5) Apple focuses on simplicity, applications (Siri, Whatsapp) available to assist the
elderly, and those not familiar with smartphones with functions such as emailing
and texting - pushing the iphone into the late adopters.
2.2 How have people (individuals or society as a whole) been important to this
product or service along the diffusion process?
People are at the heart of the absorption and diffusion of innovation. The iPhone is now
part of mainstream culture and society has played a significant role in getting it there.
The iPhone is a highly conspicuous product and as such it is expected that consumers
will influence their networks in the adoption of such a handset. A study back in 2007 on
the iPhones early release showed that 42% of iPhone users communicated with another
iPhone user, which echoes the social nature of technology (Choi, 2010)
The user friendly Operating system for the phone, keeping things simple , customer
service and in-store experience were the key points for Apple from the customer's point
of view for its success.It’s ease of use meant that the early adopters/majority could
easily promote apple’s functions to those who were not “tech savvy”. Similarly some
iPhone functions (iMesenger) only work iPhone to iPhone so in order to get the most
out of the product the adopter has an invested interested in promoting the iPhone to
their networks.
2.3. Think about some of the innovations that you have adopted – which category
would you put yourself in and are you always in the same category?
Smart Phones.
Ivy - In terms of smart phone, I categorize myself as being laggard in this sort of
innovation. The pace of smart phone technology is quite fast, and this kind of innovation
gives us some very handy and convenient applications. However, there still have some
barriers for me. The cost of smart phone is quite high and the operations are a bit
complicated, which sometimes are hard to setup it for a normal person. Some function
on smart phone overlap with another kind of 3C products, such as laptop and i-pad.
Therefore, I tend to change my mobile phone when the product become the dominant
trend in the society in case I become old-fashioned. With regards to technology I am
almost always in the laggard stage, as adoption for me largely depends on price.

11. Simon – I was definitely an early majority as I’m far too much of a skeptic of new
technology to be an early adopter. The main reason I picked it up sooner rather than
later was because my girlfriend lived in America so it’s internet based applications
(skype, whatsapp etc) really sold the device to me. Otherwise I might have been a late
majority. For the most part I’m a late majority as I like a finished product rather than a
work in progress, but if something really impresses, I’ll get it early.
Emma - I brought the iPhone soon after it’s initial release in China, mostly because I
really like listening music. It’s design (including operation) is really simple, meanwhile it
was an affordable price. But I do not always follow the trends. I would class myself as an
early majority when it comes to technology, but for other things I might be a late
majority.
Shannie - I think the smart phone is an excellent technological innovation, because I see
the way it changes people’s life. Nowadays, people always rely on it to communicate
others and search many things. For example, we could chat or send texts to friends as
well as find the route of destination. In terms of the fast change in high-technology
marketing, companies create smart phone frequently and separate different levels of
price or function to consumers. It makes the phones so much more convenient, having
many functions in one place. I will put myself in category of late majority, because I
usually am afraid of trying the newest production unless other people have users it.
However, sometimes I might become an early majority since I prefer to get opinions
from other users, and I will curious about the popular and new one which discuss the
most, then I might buy it, such as iPhone.
Jay – In India the Smartphone penetration and its users are significantly less as
compared to Singapore, Canada, US, Denmark , China. This is because peoples adaption
of technology is very slow though its improving. As far as Smartphones are concerned, I
bought a smartphone (Sony Xperia SL) lately as I was coming to UK for MSc. Here the
smartphone is very much useful to run application by using Wifi and helpful for the
flexible accessibility of different software and make productive use of it. But in India the
wireless connection and GPRS is very limited and slow due to poor Internet service in
some remote areas though the numbers of services providers and their improving
services are increasing.
I would categories myself in the "early majority" on Roger's Adaption Curve for adoption
of this innovation as I was slow in adapting this product because of lack in services in
India for the use of Smartphone.
Flavia - I am usually very interested in new developments in technology, however, the
dawn of the smartphone left me cold. I was very attached to my Sony Ericsson phone

12. and found the iPhone useless and not worth the money as I'd heard, through word of
mouth, that it wasn't very resistant.
My first choice after my phone had stopped working was the HTC desire, followed
shortly by the iPhone 4. My choice however wasn't dictated by a wish to have it, but
rather by the smaller selection of phones on the romanian market. Therefore, as far as
smartphones are concerned, I could be considered a laggard as it took me quite some
time and a lot of information to adopt smartphones. Curiously, I am usually within the
early majority group for other innovation, for example gaming stations or laptops,
however, the smartphone innovation didn't initially impress me in the least.
3.VIDEO - Frank Davidoff, M.D., "Innovation and Diffusion: The Informationist
Program"
This video is just over 35 minutes long and offers an excellent overview of
Roger’s Diffusion of innovation applying it to medical innovations.
3.1 What is the role Davidoff’s “Informationists” in the diffusion process and how does
he suggest they are implemented as an innovation?
Davidoff (2000) suggested that the best resources for medical knowledge are found
within a medical library. The problem however, is that the medical information is not
getting into the hands of those who need them within a clinical setting. Davidoff argues
that this is a common perception with clinical practitioners; the resources are available
but are unfortunately inaccessible.
This is where Davidoff’s informationists come into play, increasing information flow to
those that need it. They can work with information within a particular business, analytic
or scientific context to encourage decisions based on evidence, analysis, and prediction.
We examined the role of the “informationist” within Rogers model of diffusion (2003).

13. Image 8. source: Rogers’ (2003) Diffusion of Innovation Model
1. The informationist seeks to find relevant knowledge about an existing problem and
tries to find innovative solutions for it. It is largely evidence-based on medical
literature. Sometimes people who need the innovation are not even aware of them.
2. Persuasion and decision stages：At this stage the informationist presents their
findings to the relevant audience (the early adopter), and makes a case for it’s
adoption/diffusion based on their empirical findings.
3. Implementation stage: In this stage, the informationist can help remove problems
that are occurring because of the implementation, and provide encouragement to
the early adopters.
4. Confirmation stage: Here the informationist seeks to refine and improve the
innovation based of feedback from the early adopters and tries to spread the
innovation to the early majority.

14. 3.2. What are the barriers to diffusing medical innovations? Can you draw upon
Wilkins and Rogers barriers to draw on this?
The diffusion of medical innovations can be placed in the same context as other types of
innovation, but only in a broad manner. The diffusion of medical innovations has both
catalyzers as well as barriers which are specific in this field due to the medical, health-
oriented nature.
One obstacle that emerges in the beginning stages is funding, or, lack thereof. The
National Institute of Health (NIH) in America has been facing this problem throughout
the past years and even though they understand that most medical innovations stem
from the work of talented individuals who lack the funds, their budget makes them
unable to support the number of projects they consider worthwhile. “NIH Director
Francis Collins recently testified before a Senate subcommittee that in FY 2011 only 17 to
18% of grant applications would be funded, the lowest level on record”(Rosbash, 2011)
and regardless of the, albeit small, number of NIH programs and awards which
recognize outstanding, innovative projects there is still “the absence of stimulus funds
and the building momentum for cutting federal discretionary spending.”(Rosbash, 2011).
Mesman (2008) argues that al new medical technologies work on the concept of
promise and that all of them create new questions and dilemmas in the mind of the
patients. Here we find one of the first barriers to diffusion, the perceived risk. This is by
far not a barrier distinct to medical innovation; however, the perceived risk is higher and
constant in that it is present for any new medical innovation. People are far more likely
to overthink possible detriments to their health (medical innovation) than to waste
sleepless nights wondering if the new iPhone 5 is going to delete all their contacts
without notice.
“Technology diffusion in medicine is a complex, non-linear and dynamic process.”(World
Health Organization, 2010). Obstacles are a dime a dozen in this particular case, some
distinct to developing countries and others for developed ones. Common barriers are
limited staff training, because of the costs such training incurs, hostility and reluctance
toward new technology and, a barrier which has emerged gradually alongside the
evolution of medical technology, maintenance, which hit poorer countries worse “due
to lack of financial resources, but also other factors, such as a dearth of educational
opportunities and emigration of trained professionals from developing to.”(World Health
Organization, 2010)
There are also certain barriers to the diffusion of innovation that are exclusive to
developing countries;
COST - a single MRI scanner can cost more than 1 million dollars to purchase and
that does not take into account all the hidden costs that a single medical device
embodies [service contracts, test equipment, downtime, space, licenses,

15. upgrades, supplies, installation, accessories, product management, utilities,
training, etc…]
SPARE PARTS – the parts aren’t being produced anymore/ the cost is perceived
as too high/ staff doesn’t act due to corruption or frustration
CONSUMABLES – or accessories (such as IV sets) are a necessity for some
machines but might not even be available in a particular country
EXPERTISE AND TRAINING – complex machines need up-to-date training and the
lack of it in developing countries constitutes a distinct barrier to diffusion
INFRASTRUCTURE – “The lack of reliable electricity and water supplies in many
developing countries acts as a barrier to medical devices, particularly in view of
the fact that most equipment comes from economically advanced nations with
well-developed infrastructure and is designed to function in an environment
provided with basic conditions.” (World Health Organization, 2010)
CULTURAL AND SOCIAL INCOMPATIBILITIES – medical devices exist in a context
and cannot function unless said context is accepted by adopters; more so, some
cultures prohibit use of medical technology because they do not believe in it
Further barriers are summarized in the following table.
Lack of sufficient local research and research tradition
New ideas cannot be developed using solely local resources, also due to the lack of
technical knowledge
Low investment in innovation
Most medical devices are imported => little to no incentive to carry out clinical trials
before purchase
Inadequate post-marketing observation and feedback mechanisms
Lack of a direct link between clinical needs (locally) and design of devices (abroad)
Following Rogers (1962) definition of diffusion, we notice that medical innovations face
mostly similar problems to other types of innovation, therefore please see the answer
to question 1.2 for a more detailed analysis of barriers imposed on the diffusion of
innovation found through Rogers’ definition.

16. A general overview of the previously listed barriers to the diffusion of medical
innovations.
3.3 How does Davidoff use Rogers’ diffusion of innovation?
Davidoff uses Rogers’ model to demonstrate the diffusion of medical innovation and to
demonstrate why published scientific evidence is not diffused faster and applied in
medical practice. Helabeled his‘informationist’ concept to an innovation that has not
caught on despite the fact that the clinical librarian and pharmacist concepts have been
around since the 1970s. He used Rogers' framework to outline why this has come to
pass.
Firstly, the supposed perceived benefit of the ‘informationist’ is not as obvious as it
could be and so fails to fully convince medical practitioners and organizations of its
worth. Next, compatibility is also vague; It’s an approach compatible with the values,
the tradition, and the needs of the potential adopters(i.e.: medical community, the
patient and the families). This is clear, but,in many ways, it doesn’t come across as
Davidoff clearly thinks it should.

17. More so, its complexity is quite high, just by the sheer amount of training that will need
to be undertaken before someone could possibly become certified.That aside, this
‘innovation’ is highly trialable as a small number of ‘informationists’ may be but in the
preferred environment and their abilities and usefulness can be tested.
The observability is modest, but could gain speed fast as the new position is integrated
across medical institutions.
Davidoff names Gertrude Lamb as the primary innovator in this instance and larger
libraries, library services, a small part of the academic service community and the
pharmacy community as early adopters. There is currently no early majority as the
innovation has not reached that stage yet.
The contextual factors remain the same; communication (between departments,
branches of the health care service, individual practitioners), incentives (offered to
supposed adopters in the form benefits arising from the use/implementation of said
innovation), leadership (or opinion leaders, which may be the hospital higher-ups or
high-ranking and respected doctors who show their support of this new profession) and
management (of the different actions and routines that need to be changed and
managed for this innovation to diffuse).
3.4 What is Davidoff’s criticism of Roger’s theory and what does he do to overcome
this?
Whilst Davidoff praised Roger’s model for having clear and distinct stages of diffusion he
also criticized it for being too complex, feeling that there is a lot of overlap between the
5 attributes. He states that for some innovations the model is not appropriate (Getrude
Lamb – there was no early/late majority or laggard), so he instead suggests three stages
which are applicable to all types of innovation regardless of which point in Rogers model
they failed.
These factors were:
• Factors
• Barriers
• Time Course.

18. References:
Brown, L.A. (1981) Innovation Diffusion, Methuen & Co., pp. 1 – 20
De Bono, E. (1976). Teaching Thinking. London: Temple Smith.
Cattey, W.D. (2005) The Tipping Point – Book review,
http://web.mit.edu/wdc/www/tipping-point.html, last accessed 22th October 2012
Coye, M.J., Aubry, W.M., Yu, W.(2003), The “Tipping Point” and Health Care Innovations:
Advancing the Adoption of Beneficial Technologies, A conference held in Washington,
D.C., The Health Technology Center
Davidoff, F. (2002), Innovations and Diffusion: The Informationist Program, [online],
available at: <http://www.mlanet.org/research/informationist/pdf/davidoff.pdf >,
[accessed 20th October].
Frattini, E. (2008) the commercialization of innovation in high-the markets, PhD thesis,
Politecnico di Milano, Italy
Gladwell, M. (2000) The Tipping Point: How Little things can make a big difference, Little,
Brown and Company, pp. 3 - 14.
Hadjimanolis, A., 1997. The management of technological innovation in small and
medium size firms in Cyprus. Unpublished Ph.D. thesis, Brunel University, UK.
Hanool Choi, Sang-Hoon Kim, Jeho Lee, “Role of network structure and network effects
in diffusion of innovations”, Industrial Marketing Management 39 (2010) 170-177
Hansen J et al. (2010), A stepwise approach to identify gaps in medical devices
[Background Paper 1 of the Priority Medical Devices project], Geneva, World Health
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