Beyond individual characteristics such as, early adopters or laggards, what else might be important for the Diffusion of Innovations? Let me now examine some of these issues in more detail. Everett Rogers explained that there are several important factors relating to an innovation which will influence whether or not it will be used in practice. These all relate to the features of the innovation itself. First, it needs to have relative advantage. It needs to be better at what it does than the current best alternative. Second, it needs to be compatible with the context where it will be used. You can't be too different from what people are already using. Third, it helps if it's simple, a very complex innovation might put people off, it'll take training to use and be time-consuming. Fourth, it needs to be trailable, in other words people need to be able to test it out. Finally, the effect of the innovation must be observable, people need to see the benefits. In addition to all these things, the price must be reasonable, the innovation must be affordable. It must be able to be procured, the systems for selling and purchasing must be in place, and yet there's still much more to it than that. These are just the characteristics of the innovation itself. Trisha Greenhalgh and colleagues' Systematic Review in 2004 is still one of the most comprehensive reviews in the literature on Innovation Diffusion in health care. They've identified a plethora of different factors that influence the adoption, scaling, and diffusion of innovations, all from a variety of different literatures including, management research and cognitive psychology. They identified that in addition to the features of the innovation that I've already discussed and the characteristics of people in terms of how open they are to change, both the context and the process of adoption is important. Context means the features of the place where the innovation will be used. The use of any new technology or process requires change, and so that context needs to be receptive to change and have capacity to change. The people using the innovation need to have the requisite skills and capacity to learn new techniques, and this requires time, resources, and motivation. There needs to be a perceived need for the innovation. The people that will use it need to feel that it will solve a problem they have. They need to be motivated to change their current practice, and this can take time and effort to do. Greenhalgh and colleagues also noted that adoption of innovation is a process, and this process needs careful managing. Attention needs to be paid to how to manage people and their time. Frequently, innovations do not manage to get into practice because the time, energy, and resources that it takes to manage people in this process has been ignored. The good news, this can be supported by champions, people who are willing and motivated to lead the changes that are necessary to use the new innovation. All these are important issues to consider when getting an innovation out into practice, but there isn't a single one-size-fits-all strategy for doing this. Each innovation will pose different issues, and each context will pose different challenges. It's useful to look at Trisha Greenhalgh and colleagues' article on the NASSS framework. This is a theory-driven pragmatic framework created to work through the features of an innovation, and identify if against each domain, the innovation is simple, complicated, or complex. You look at features of the condition the innovation is addressing, the technology that it uses, the value proposition, the features of the adopters, the organization that will use it, and the wider system in which it's located. This then helps you work out what strategies you might need to get your innovation out and into practice. By looking carefully where the simple, complicated or complex issues are, you can focus your attention on these and develop strategies to address them. You've considered some of the important challenges in getting innovations into practice, you've learnt that there are issues to do with the innovation itself, to do with the adopter context, and also to do with the process of change. Paying special attention to the challenge of adoption is as important as developing the innovation itself.
