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The Technology Adoption Life Cycle
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Ophthalmology has been viewed as one of the more technologically advanced medical and surgical specialties. But not all of us have the same technology-adoption habits. How do you convince colleagues that some technologies could increase efficiencies, lower costs and ultimately raise revenues for your practice?

The decision to purchase a new technology is multifactorial, but understanding where our partners/colleagues are coming from will help us fine-tune the decision-making process to reach a well-thought-out solution. By identifying where you fall under the technology adoption curve and where your partners/residents are along the curve, you can use those insights to find ways to work with your colleagues to make informed tech-related decisions for your practice/department. 

undefinedThe Technology Adoption Curve
When evaluating new technology options for your practice or department, first ask yourself, “Why do we want or need this new product?” To facilitate the decision-making process, compare the new technology with what you are currently doing.

Start by answering these questions:

  1. Will this new technology increase patient safety?
  2. Will this new technology improve patient outcomes?
  3. Will this new technology increase efficiency?
  4. Do the economics of adding this new technology make sense for me and my practice?

Next, consider your mindset and that of your colleagues. Are you or your partners happy with your current technology? Do you or they refuse to explore newer technologies? Are you or they reluctant to pursue the new technology for cost reasons or because of a dislike for “change”?

For example, ask yourself which of your colleagues purchased a new iPad when they were first released and what this says about them. Which ones waited to purchase the iPad 2 or another tablet? Who in your practice is resistant to converting to electronic health records (EHRs)? Why?

Believe it or not, these behaviors — choosing to purchase an iPad or an EHR system during the early launch of the product or waiting until later — likely forecast your colleagues’ future decision-making processes regarding new technologies in your practice.

If you are a member of an established practice involved in assessing potential hires, then consider asking these tech-related questions of them as well. This is especially important if you are counting on a younger new hire to help you understand the new technologies.

In his marketing book Crossing the Chasm, Geoffrey Moore describes how people decide when to purchase a new technology. He also groups tech purchasers into five distinct categories along what he calls “the technology adoption life cycle. In order to help you identify where people (including yourself) fall along the tech adoption curve, I will describe Moore’s five groups in more detail, then look at how they apply to ophthalmology practices. 

Innovators
Members of this group, often described as techies, are interested in trying new technologies, but never want to pay for them. Rather, they prefer to be paid to use these innovations.

This group is well known for pursuing new technology products aggressively. Their endorsement inspires other people to purchase the product. They also tend to be the gatekeepers for new technology. They usually want just the facts — without the marketing gloss. They also want easy access to technologists with whom they can discuss problems with the new product.

Which of your colleagues fall into this category? Do you yourself? For example, whom do you know who is using the femtosecond laser for cataract surgery in 2011? Remember, innovators will typically choose to use a new technology earlier because they are receiving it for free to conduct research and/or at a discounted rate.

Presently, it is cost prohibitive for some practices to incorporate femtosecond laser technology. When a user has to pay for the technology, the decision is much more complex.

  • Pros of being an innovator: You can help members of your practice or colleagues gain experience with the new technology. You become a leader in this area of technology and a leading voice in discussions.
  • Cons of being an innovator: If you push the new technology too soon, when others are not yet ready to engage, you may be viewed as a maverick or out of touch with your colleagues. Identifying your tendencies and those of your partners/colleagues will help everyone make a well-informed decision.

Early Adopters
Also known as visionaries, these users are ahead of the curve and willing to try new technologies. They have the insight to match an emerging technology with a strategic opportunity to achieve a fundamental breakthrough to accomplish a business goal. Put another way, early adopters are looking for a high return on their investment.

This group might, for example, strategize on how to increase efficiencies in patient flow for intravitreal injections of Avastin or Lucentis. They might also choose the femtosecond laser for cataract surgery as a way to create a competitive advantage. As it stands now, femtosecond cataract surgery makes efficient surgeons less efficient, but the touted increased revenue from adding this technology may offset this decrease in efficiency.

Moore says early adopters are the least price sensitive of the five segments. They are willing to pay nearly any amount just to get the new technology. This group is easy to sell to but hard to please. They are also an outgoing and ambitious group. This group understands that there are three constants in life: death, taxes and change. This group embraces change and tries to get ahead of it.

Early Majority
This group, also referred to as the pragmatists, sticks with the herd and will rarely be the first to try out a new technology. This market segment generally focuses on making a certain percentage improvement in their existing technology.

Members of this group are hard to win over initially, but are very loyal once they have been convinced. This segment cares about standardization and the support infrastructure for a new technology. They focus especially on the reliability of the product and the service associated with it. This group generally won’t buy a product until it has become established.

Late Majority
The fourth group, also referred to as the conservatives, typically raises a lot of questions, slowing the decision-making process. As its name implies, this group is late to adopt technology, and it is fairly large in number.

By listening to this group, to gather the pros and cons of purchasing new technologies for your practice or surgery center, you can gain more information and make a better-informed decision.

Laggards
Also referred to as the skeptics, this last group will likely never obtain a new technology unless someone else in the practice makes the decision to purchase it. Laggards tend to be naysayers who try to block purchases. They continually point out the discrepancies between the sales claims and the delivered product, but eventually will come around to using the technology when it is imposed upon them and/or the only option.

For example, can you think of someone who refused to use PowerPoint on their laptop and insisted on using the slide projectors? Today, it is unheard of in our ophthalmic meetings for a physician to use a slide projector.

Moore’s Categories in Practice
Are there people in your practice who refuse to convert to EHRs? This does not make them bad partners, but it should make you ask yourself why they are not interested in using the new technology. For example, we have heard many arguments about new technologies being too expensive or, in the case of EHRs, the government’s way of invading our privacy.

Let’s say you are part of the late majority and your partners want to implement a new EHR system, The differences among you could create some tension. However, it is important to have all types of individuals on a team. Change is difficult for all of us, but the transition is easier when an experienced colleague can train you to use the new technology and explain its clear benefits. The important issue here is to remain open to new ways of doing your daily tasks that may be more time efficient and cost saving.

There are advantages to being a laggard too. This group can buy a product after it has stabilized, and leave it to the innovators and early adopters to work out the bugs in the beta version. Typically, by the time the laggards purchase the product, there will be more competition in the marketplace, lowering the cost of entry.

This group also has the advantage of choosing from several product lines in the later stages of development. For example, think of the cataract surgeons who implanted the first multifocal lenses. Individuals who choose to wait another five to 10 years for additional products to reach the market will have the luxury of choosing from many types of intraocular lenses.

Where Do YOU Fit In?
What type of surgeon are you? What type of doctor? What type of business partner? Are you the first to try out new techniques or technologies? Do you have the latest phaco machine, femtosecond laser or other cutting-edge equipment? Have you implemented EHRs in your practice? Do you take business courses to improve your practice?

It’s said that you can’t teach an old dog new tricks. So, how do you avoid becoming an old dog? Learn new tricks.

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About the author: This article has been adapted from the original version, written by Robert F. Melendez, MD, MBA, which appeared in the fall 2011 AAOE News. Dr. Melendez is a partner at Eye Associates of New Mexico and assistant clinical professor at the University of New Mexico in Albuquerque. The editor-in-chief of the Academy’s Ophthalmic News and Education (ONE®) Network and 2012 YO Committee chairman, he is a former editor of YO Info and a graduate of the AAO Leadership Development Program.

 
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