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Workshop 3


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Workshop 3

  1. 1. 1. Much of the diffusion literature directly references or can be traced back to generalprinciples articulated, originated and developed, by Everett M. Rogers. Begin bylooking at the background synthesis for an overview Rogers’ diffusion of innovationsand 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 ofinnovations/technologies lies in the definition of the term diffusion. In his complexbehemoth of a book ‘Diffusion of Innovations’, Rogers offers this definition: “Diffusion isthe process by which an innovation is communicated through certain channels over timeamong the members of a social system” (Rogers, 1962). From here spring the four mainelements that, together, lead to diffusion: an innovation, communication channels, timeand social systems. Communication Social systems channels Innovation Time Diffusion Image 1: Overview of the four main elements of diffusionInnovation can be anything from and idea to a practice to an object and its rate ofadoption 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. 2. “In general, innovations that are perceived by receivers as having greater relativeadvantages, compatibility, trialability, observations and less complexity will be adoptedmore rapidly than other innovations” (Rogers, 1962)Communication channels involve an informed party connecting with anunknowledgeable one and, through creating a connection, there is a transfer ofknowledge.These channels are divided into two parts, the mass media channel,which is most usefulin the beginning stage, and the individual channel, which more persuasive for it involvesword of mouth as a key factor in accelerating the adoption of innovation throughpersuasion. More so, word of mouth is seen as more important than media coverage asit 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 varyingdegrees, throughout the 5 “adopter categories” identified by Rogers (1962). It is high ininnovators and early adopters and declines steadily from early majority to late majorityto laggards.Lastly, the social systems which embody the norms and structures that govern us andwhich, to some degree, assist or impede the diffusion of innovation.
  3. 3. On a more general level, we must state that diffusion comes about at different rates indifferent countries, marking geographic proximity to the innovation as an importantfactor in its possible diffusion because innovations are not appear everywhere at thesame time. As Brown (1981) states “Some groups of people and some places haveimmediate access to the innovation, some gain access later and some never do.” Thiscan also be linked to economic and cultural (compatibility) factors,which also varygreatly from country to country and may favor diffusion in wealthy, progressive ones.Lastly, and most importantly, the diffusion of innovation has human behavior and trustat 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 whovalue trust and human interaction above most things. Trust can be seen as an incrediblecatalyzer to the diffusion of innovation because consumers “[…] buy products not onlyfor what they can do, but also for what they mean” (Levy, 1959) both to them as well asto the person recommending it.More so, building trust with their current and possible customers is also an option forcompanies/innovators, which will greatly help in the diffusion of their offering as goodpress 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 itsabsorption. What barriers prevent the diffusion of innovation?In his ‘Diffusion of Innovation Theory’ Rogers (1995) identifies five characteristics of aninnovation that must be considered when examining its absorption. We looked at thepotential barriers to diffusion within these five stages.Relative Advantage - If the innovation is perceived as having superior attributes than itscompetitors it said to have strong or high relative advantage (Bessant & Tidd, 2011). Thelower the perceived advantage of the product, the slower the rate of adoption (if it everadopts). When talking about the attributes of an innovation it is useful to distinguishbetween primary and secondary attributes. The primary attribute is the cost and size,which remains for the most part constant. The secondary attribute is the relativeadvantage 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 thediscrepancy between a user’s perception of the attributes and what they would like thatattribute to be. The greater the gaps are, the bigger the barriers to adoption. Forexample, if it is cheaper to make/buy, does the job better, or has new, desirablefunctions, is easier to use, or is safe and reliable, the more likely it Is to be absorbed andvice -versa.Compatibility - People are at the heart of whether an innovation is absorbed or not. If aninnovation is perceived to be inconsistent with existing social norms, cultural (religious)
  4. 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 thanclient orientated (e.g. trying to sell packaged Ice to an eskimo). The extent to which aninnovation fits the existing skills, equipment, procedures, and performance of theadopter is also critical. If the innovation is misaligned in those early stages to anorganization’s existing practices, it could be fatal to the diffusion of that innovation, asthe early adopters will not make contact with early majority (Rogers, 1995). On anindividual level, the main barrier to diffusion is resistance, more so, “resistance levelsdiffer from one individual to another” (Brown, 1981). Resistance is the completeopposite 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 isseen as being too difficult to learn by the potential adopter, the less likely it will beadopted. However resistance from the adopter isn’t always a conscious process. Oftenwe get into the habit of doing the same thing over and over, building routines over longperiods of time, which leads to natural resistance to current innovations. Sheth (1981)terms this “the single most powerful determinant in generating resistance” and notesthat “perceptual and cognitive mechanisms are likely to be tuned in to preserve the habitbecause the typical human tendency is to strive for consistency and status quo ratherthan to continuously search for, and embrace new behaviours”.Trialability - This is to the degree, which an innovation can be tested before itspermanent adoption. By giving people the option to trial the innovation, lowers theperceived risk and uncertainty in the potential adopters mind. Innovations that do nothave 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 tothe potential adopters. The less visible the benefits of an innovation are, the less likely itwill be absorbed. The main premise behind the simple epidemic model of diffusion isthat innovation spreads as potential adopters make contact with existing users of aninnovation.
  5. 5. Image 3: The Model of DiffusionInterestingly a study by Fattini (2008) suggested that this was the most powerfulindicator of diffusion. If you can gain the positive acceptance of early adopters, thentarget the main market through their positive word of mouth and networks then yourinnovation is much more likely to be absorbed. If the innovation is misaligned in thisearly stage, its diffusion may stagnate as the early adopters are not coming into contactwith the potential adopters. Wolpert (2002) has conducted a lot of research into the adoption of innovationwithin organizations. He suggests that many organizations are internally focused and assuch 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. 6. The consequence of this method is usually small incremental innovations anddissatisfied Executives who were expecting radical new ideas and implementations oftechnology, 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 executivestend to severely reduce or cut off funding for innovative research, and focus more onshort-term defensive business strategies, putting their money into other departments. Aclaim which has found recent support from a study by Nesta that examined 1,200 UKbusinesses 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 investmentGetting the funding for innovations will often mean taking money away from anestablished program. Since most companies work on annual funding cycles, they areunable to grasp an innovation when the opportunity arises. Therefore timing can also bea barrier, in fact a study by Hadjimanolis (1997) found that 500 companies rated time, asthe biggest internal barrier to innovation.Wolpert argues that in a lot of cases, in order for technological innovations to transferor diffuse effectively between organizations they need to collaborate on ideas and look
  7. 7. beyond themselves to other sectors. The best example we could think of was Edward DeBono’s (1976) famous true story explaining lateral thinking. A group of physiologistswere stumped on the purpose of the kidney tubules, years went by and they were stillno wiser for determining their use. Eventually they discussed their problem with anengineer and allowed him to look at the tubules. He instantly recognized them as beinga counter-current multiplier, a common engineering device for changing theconcentration of solutions. It is this outside perspective that Wolpert believes to be ofgreat importance for the adoption of new innovations within a firm. Whencommunication between companies and different sectors breaks down, barriers toinnovation start to build up. Rogers (2003) argues that is because no new informationcan be exchanged.Mantel and Rosegger (1987) take this one step further. They identified that by lookingto third parties to help package or tailor a technology to your firm, to locate suppliers tomake components for your technology, inspire confidence through success stories, andto help secure deals between firms can be of massive consequence for the diffusion oftechnological innovation within organizations. Without it, tasks often seem toooverwhelming, time consuming, and by not sharing information and sourcing third partyhelp you may not have the necessary skills available to fully adopt the innovation intoyour company.1.3What does Gladwell mean by ‘the tipping point’ and can it be used to explain thediffusion of innovation?In his introduction, Gladwell (2000) defines ‘the tipping point’ as “the name given tothat 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 themedical. Everything from ideas to products to behaviours can and have spread likeviruses.In his introduction, the author emphasizes three main notions with which the readermust 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 theirbehavior is contagious. Secondly, like the butterfly effect, little, seemingly unimportantchanges can have dramatic effects and, lastly, that this entire process happensincredibly fast.For this tipping point to be reached, the idea/object/etc… needs to be “widelydisseminated, "sticky" enough to be retained by each new recipient [and] operating in acontext that nurtures it” (Cattey, 2005). More so, the number of people needed tospread such an epidemic is quite low, however, there are three particular roles thatmust exist:
  8. 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 diffusionof innovation, we cannot readily acknowledge or deny the effect it would have on theprocess as it is not a stable recipe; in his own introduction, Gladwell used the example ofHush Puppies which showed the brand flourish after hitting rock-bottom but its riseback to popularity wasn’t due to strategy, it was due to a small number of kids whowore the shoes because nobody else was and it escalated and grew in proportion fromthere.Should we choose to use the idea behind ‘The Tipping Point’ to speed up diffusion, thenwe must also take“the potential impact of technologies still under development[underconsideration] as we develop strategies to speed the diffusion of beneficial innovations”(Coye, 2003).Both potentially beneficial and disruptive innovation should be preparedfor 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 sciencethough, as epidemics are unstructured, almost chaotic and usually unpredictable, so weconsider ‘the tipping point’ more of a last resort when all else fails rather than theintegral missing part to Rogers’ theory.
  9. 9. 2. Within your groups, please do the following and prepare to present your findings toanother group in workshop. This needs to be completed by the entire group so thatyou 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 havea much more advanced computing capability than a regular feature phone. The firstsmartphones combined the functions of a personal digital assistant (PDA) with a mobilephone. Later, functions such as the Internet, multimedia and various softwareapplications were also added. In the UK, 27% of adults and 47% of teenagers are usingsmartphones, 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 mostinteresting qualities when it entered the market was its touch screen capability, mostnotably how responsive it was compared to it’s competitors.Another feature which really helped propel it’s diffusion was it’s ability to both writeand download software for reasonable prices. The user interface of the Iphone is avariant of the same system core used in Mac OS X, which is used in Macintoshcomptuers.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. 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 thisproduct or service along the diffusion process?People are at the heart of the absorption and diffusion of innovation. The iPhone is nowpart 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 consumerswill influence their networks in the adoption of such a handset. A study back in 2007 onthe iPhones early release showed that 42% of iPhone users communicated with anotheriPhone user, which echoes the social nature of technology (Choi, 2010)The user friendly Operating system for the phone, keeping things simple , customerservice and in-store experience were the key points for Apple from the customers pointof view for its success.It’s ease of use meant that the early adopters/majority couldeasily promote apple’s functions to those who were not “tech savvy”. Similarly someiPhone functions (iMesenger) only work iPhone to iPhone so in order to get the mostout of the product the adopter has an invested interested in promoting the iPhone totheir networks.2.3. Think about some of the innovations that you have adopted – which categorywould 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 ofinnovation. The pace of smart phone technology is quite fast, and this kind of innovationgives us some very handy and convenient applications. However, there still have somebarriers for me. The cost of smart phone is quite high and the operations are a bitcomplicated, which sometimes are hard to setup it for a normal person. Some functionon 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 dominanttrend in the society in case I become old-fashioned. With regards to technology I amalmost always in the laggard stage, as adoption for me largely depends on price.
  11. 11. Simon – I was definitely an early majority as I’m far too much of a skeptic of newtechnology to be an early adopter. The main reason I picked it up sooner rather thanlater 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 latemajority. For the most part I’m a late majority as I like a finished product rather than awork 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 Ireally like listening music. It’s design (including operation) is really simple, meanwhile itwas an affordable price. But I do not always follow the trends. I would class myself as anearly majority when it comes to technology, but for other things I might be a latemajority.Shannie - I think the smart phone is an excellent technological innovation, because I seethe way it changes people’s life. Nowadays, people always rely on it to communicateothers and search many things. For example, we could chat or send texts to friends aswell as find the route of destination. In terms of the fast change in high-technologymarketing, companies create smart phone frequently and separate different levels ofprice or function to consumers. It makes the phones so much more convenient, havingmany functions in one place. I will put myself in category of late majority, because Iusually 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 opinionsfrom other users, and I will curious about the popular and new one which discuss themost, then I might buy it, such as iPhone.Jay – In India the Smartphone penetration and its users are significantly less ascompared to Singapore, Canada, US, Denmark , China. This is because peoples adaptionof technology is very slow though its improving. As far as Smartphones are concerned, Ibought a smartphone (Sony Xperia SL) lately as I was coming to UK for MSc. Here thesmartphone is very much useful to run application by using Wifi and helpful for theflexible accessibility of different software and make productive use of it. But in India thewireless connection and GPRS is very limited and slow due to poor Internet service insome remote areas though the numbers of services providers and their improvingservices are increasing.I would categories myself in the "early majority" on Rogers Adaption Curve for adoptionof this innovation as I was slow in adapting this product because of lack in services inIndia for the use of Smartphone.Flavia - I am usually very interested in new developments in technology, however, thedawn of the smartphone left me cold. I was very attached to my Sony Ericsson phone
  12. 12. and found the iPhone useless and not worth the money as Id heard, through word ofmouth, that it wasnt very resistant.My first choice after my phone had stopped working was the HTC desire, followedshortly by the iPhone 4. My choice however wasnt dictated by a wish to have it, butrather by the smaller selection of phones on the romanian market. Therefore, as far assmartphones are concerned, I could be considered a laggard as it took me quite sometime and a lot of information to adopt smartphones. Curiously, I am usually within theearly majority group for other innovation, for example gaming stations or laptops,however, the smartphone innovation didnt initially impress me in the least.3.VIDEO - Frank Davidoff, M.D., "Innovation and Diffusion: The InformationistProgram"This video is just over 35 minutes long and offers an excellent overview ofRoger’s Diffusion of innovation applying it to medical innovations.3.1 What is the role Davidoff’s “Informationists” in the diffusion process and how doeshe suggest they are implemented as an innovation?Davidoff (2000) suggested that the best resources for medical knowledge are foundwithin a medical library. The problem however, is that the medical information is notgetting into the hands of those who need them within a clinical setting. Davidoff arguesthat this is a common perception with clinical practitioners; the resources are availablebut are unfortunately inaccessible.This is where Davidoff’s informationists come into play, increasing information flow tothose that need it. They can work with information within a particular business, analyticor 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. 13. Image 8. source: Rogers’ (2003) Diffusion of Innovation Model1. 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. 14. 3.2. What are the barriers to diffusing medical innovations? Can you draw uponWilkins and Rogers barriers to draw on this?The diffusion of medical innovations can be placed in the same context as other types ofinnovation, but only in a broad manner. The diffusion of medical innovations has bothcatalyzers 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. TheNational Institute of Health (NIH) in America has been facing this problem throughoutthe past years and even though they understand that most medical innovations stemfrom the work of talented individuals who lack the funds, their budget makes themunable to support the number of projects they consider worthwhile. “NIH DirectorFrancis Collins recently testified before a Senate subcommittee that in FY 2011 only 17 to18% 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 whichrecognize outstanding, innovative projects there is still “the absence of stimulus fundsand the building momentum for cutting federal discretionary spending.”(Rosbash, 2011).Mesman (2008) argues that al new medical technologies work on the concept ofpromise and that all of them create new questions and dilemmas in the mind of thepatients. Here we find one of the first barriers to diffusion, the perceived risk. This is byfar not a barrier distinct to medical innovation; however, the perceived risk is higher andconstant in that it is present for any new medical innovation. People are far more likelyto overthink possible detriments to their health (medical innovation) than to wastesleepless nights wondering if the new iPhone 5 is going to delete all their contactswithout notice.“Technology diffusion in medicine is a complex, non-linear and dynamic process.”(WorldHealth Organization, 2010). Obstacles are a dime a dozen in this particular case, somedistinct to developing countries and others for developed ones. Common barriers arelimited staff training, because of the costs such training incurs, hostility and reluctancetoward new technology and, a barrier which has emerged gradually alongside theevolution of medical technology, maintenance, which hit poorer countries worse “dueto lack of financial resources, but also other factors, such as a dearth of educationalopportunities and emigration of trained professionals from developing to.”(World HealthOrganization, 2010)There are also certain barriers to the diffusion of innovation that are exclusive todeveloping 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. 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 itFurther barriers are summarized in the following table.Lack of sufficient local research and research traditionNew ideas cannot be developed using solely local resources, also due to the lack oftechnical knowledgeLow investment in innovationMost medical devices are imported => little to no incentive to carry out clinical trialsbefore purchaseInadequate post-marketing observation and feedback mechanismsLack of a direct link between clinical needs (locally) and design of devices (abroad)Following Rogers (1962) definition of diffusion, we notice that medical innovations facemostly similar problems to other types of innovation, therefore please see the answerto question 1.2 for a more detailed analysis of barriers imposed on the diffusion ofinnovation found through Rogers’ definition.
  16. 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 todemonstrate why published scientific evidence is not diffused faster and applied inmedical practice. Helabeled his‘informationist’ concept to an innovation that has notcaught on despite the fact that the clinical librarian and pharmacist concepts have beenaround since the 1970s. He used Rogers framework to outline why this has come topass.Firstly, the supposed perceived benefit of the ‘informationist’ is not as obvious as itcould be and so fails to fully convince medical practitioners and organizations of itsworth. 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, thepatient and the families). This is clear, but,in many ways, it doesn’t come across asDavidoff clearly thinks it should.
  17. 17. More so, its complexity is quite high, just by the sheer amount of training that will needto 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 thepreferred environment and their abilities and usefulness can be tested.The observability is modest, but could gain speed fast as the new position is integratedacross medical institutions.Davidoff names Gertrude Lamb as the primary innovator in this instance and largerlibraries, library services, a small part of the academic service community and thepharmacy community as early adopters. There is currently no early majority as theinnovation 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 tosupposed adopters in the form benefits arising from the use/implementation of saidinnovation), leadership (or opinion leaders, which may be the hospital higher-ups orhigh-ranking and respected doctors who show their support of this new profession) andmanagement (of the different actions and routines that need to be changed andmanaged for this innovation to diffuse).3.4 What is Davidoff’s criticism of Roger’s theory and what does he do to overcomethis?Whilst Davidoff praised Roger’s model for having clear and distinct stages of diffusion healso criticized it for being too complex, feeling that there is a lot of overlap between the5 attributes. He states that for some innovations the model is not appropriate (GetrudeLamb – there was no early/late majority or laggard), so he instead suggests three stageswhich are applicable to all types of innovation regardless of which point in Rogers modelthey failed.These factors were:• Factors• Barriers• Time Course.
  18. 18. References:Brown, L.A. (1981) Innovation Diffusion, Methuen & Co., pp. 1 – 20De Bono, E. (1976). Teaching Thinking. London: Temple Smith.Cattey, W.D. (2005) The Tipping Point – Book review,, last accessed 22th October 2012Coye, 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 CenterDavidoff, F. (2002), Innovations and Diffusion: The Informationist Program, [online],available at: < >,[accessed 20th October].Frattini, E. (2008) the commercialization of innovation in high-the markets, PhD thesis,Politecnico di Milano, ItalyGladwell, 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 andmedium size firms in Cyprus. Unpublished Ph.D. thesis, Brunel University, UK.Hanool Choi, Sang-Hoon Kim, Jeho Lee, “Role of network structure and network effectsin diffusion of innovations”, Industrial Marketing Management 39 (2010) 170-177Hansen J et al. (2010), A stepwise approach to identify gaps in medical devices[Background Paper 1 of the Priority Medical Devices project], Geneva, World HealthOrganizationKarahanna, E., Ahuja, M., Srite, M., Galvin, J. (2002). Individual differences and relativeadvantage: the case of GSS. Decision Support Systems. 32 (1), 327-341.Leonard-Barton, D. and D.K. Sinha (1993) Developer-user interaction and usersatisfaction in internal technology transfer. Academy of Management Journal, 36 (5),1125-39.Levy, S.J. (1959) Symbols for Sale, Harvard Business Review, 37 (July-August), pp. 118
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