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n this week's reflection report I will discuss technology diffusion, S-Curves and innovation 
decision process. I will use the healthcare industry as an example. Our healthcare system is ever 
evolving - new technologies, insurance models, and information systems are shaping the system 
on a daily basis. Despites these changes and the huge healthcare expenditures (16of GDP in 
America compared to 8 in United Kingdom), Americans are comparatively not any healthier 
than citizens in most other developed nations (Merson, Black, &Mills, 2012). The disconnect 
between investments in technology and health outcomes is a concern of us all. It makes as 
question technology diffusion within the healthcare system: are investments in health system 
being spent efficiently? Are consumers really resistant to changes that benefit their health? Or 
are there issues with technology diffusion as a practice.

Diffusion is the process by which an innovation is spread through a population. Ironically, 
people and institutions, generally, do not like change. Change isviewed as painful, difficult and 
times creating uncertainties. Because of this, and for the healthcare industry, huge amounts of 
resources are devoted either to promoting innovations (for example, selling the latest drug, 
imaging system, medical device etc.) or to preventing innovations from disrupting the status quo. 
Although many successful healthcare innovations are aimed at making people healthier, at 
relatively smaller increases in costs, IT usage in healthcare hasalways lagged other industries - 
ERH are a good example. Adoption of ERH was slow. Literature on technology diffusion states 
that successful implementation is influenced by the compatibilityand complexity of the 
innovation, organizational context, and the characteristics of the implementation strategy (Cain 
M, & Mittman, 2002; Rogers, 1995). People respond to these factors differently resulting in an 
S-shaped curve illustration of the adoption process.

The S-curve model shows that any innovation is first adopted by a few people/organizations and 
as more use it, and confidence is built around the technology, other will begin to use it. Because 
of the inherent uncertainty to new innovations, the decision to adopt an innovation takes time. 
However, "once the diffusion reaches a level of critical mass, it proceeds rapidly. Eventually a 
point is reached where the population is less likely to adopt theinnovation, and spread slows 
down. The S-curve implies a hierarchy of adopters, starting with innovators, early adopters, early 
majority, late majority and laggards (Rogers, 1995). In other words the S-curve explains the 
innovation-decision process: the process through which an individual/organization passes 
through from when they gain knowledge of an innovation, to forming an attitude, to the decision 
to accept or reject the innovation, to implementation, up to the confirmation of the decision.

Thus it is important for innovators to understand the factors that influence this decision process 
and design information and adoption messages that reduce thelevel of uncertainty about the 
innovation.

Cain M, & Mittman, R. (2002). Diffusion of Innovation in Healthcare. California HealthCare 
Foundation.

Merson, M.H.; Black, R.E.; & Mills, A. 1. (2012) GlobalHealth: Disease, Programs, Systems and 
Policies. Sudbury, MA: Jones and Bartlett Publishers.

Rogers, E. (1995). Diffusion of Innovations. The Free Press, New York