Adoption of Incremental Innovation by Physicians: Exploratory Study

Abstract

New advances in healthcare service are characterised by the occasional introductions of radical innovations, followed by a series of incremental innovations. These incremental technologies improve on the quality of care by refining the raw attributes of the radical innovations, such as eliminating side effects or increasing efficacy. They are also important to the manufacturer in maintaining their market share. One field of medicine that illustrates this phenomenon clearly is hospital-acquired infection (HAI), which is currently dominated by incremental innovations. Despite the recognised importance of incremental innovations by the industry, there has been little empirical research investigating the adoption process for incremental innovations by physicians. The aim of this study is therefore to explore the decision-making process for adopting incremental innovations, and to identify factors that influence this decision. To achieve this aim, a qualitative grounded theory approach was chosen, using semi-structured interviews as the primary method of data collection. The context of this study was established to be within specific subtypes of HAI, namely ventilator-associated pneumonia (VAP) and central line-associated blood stream infection (CLABSI) The finding of this study showed that the adoption of incremental innovations occurred through two distinct pathways, and were influenced by a number of factors related to the adopter, the innovation, and the context. Specifically, the findings suggest that the adoption of incremental innovations depends on the physicians’ perceived need, risk orientation, and research interest. Furthermore, their degree of influence was moderated by the type of patients, the national regulatory requirements, and the degree of centralisation in the hospital decision-making. This study also found that the perceived safety, efficacy, and cost of the innovation had a greater influence during the first stages of the adoption-decision process, and were replaced by the ease of use and safety concerns in the later stages. Overall, the most important factor identified in this process was the presence of perceived need. The finding of this study can be generalised to other HAI-related innovations, and future research opportunity could be to test the model in other areas of adoption.