title: Technology as system innovation: a key informant interview study of the application of the diffusion of innovation model to telecare.
abstract: OBJECTIVE
  To identify and explore factors that influence adoption, implementation and continued use of telecare technologies.
  
  
  METHODS
  As part of the Assistive Technologies for Healthy Living in Elders: Needs Assessment by Ethnography (ATHENE) project, 16 semi-structured interviews were conducted with key participants from organisations involved in developing and providing telecare technologies and services. Data were analysed thematically, using a conceptual model of diffusion of innovations.
  
  
  RESULTS
  Participants identified numerous interacting factors that facilitated or hindered adoption and use. As predicted by the model, these related variously to the technology, individual adopters, the process of social influence, the innovativeness and readiness of organisations, implementation and routinisation processes following initial adoption, and the nature and strength of linkages between these elements. Key issues included (i) the complexity and uniqueness of the "user system", (ii) the ongoing work needed to support telecare use beyond initial adoption, and (iii) the relatively weak links that typically exist between users of telecare technologies and the organisations who design and distribute them.
  
  
  CONCLUSIONS
  Telecare is not merely a technology but a complex innovation requiring input from, and coordination between, people and organisations. To promote adoption and use, these contextual factors must be specified, understood and addressed.
authors.affiliation: Newham University Hospital, Barts Health NHS Trust , London , UK .
authors.forename: Paul
authors.initials: P
authors.lastname: Sugarhood
authors.forename: Joseph
authors.initials: J
authors.lastname: Wherton
authors.forename: Rob
authors.initials: R
authors.lastname: Procter
authors.forename: Sue
authors.initials: S
authors.lastname: Hinder
authors.forename: Trisha
authors.initials: T
authors.lastname: Greenhalgh
mesh_terms: D004059:Diffusion of Innovation; D004867:Equipment Design; D006801:Humans; D020380:Needs Assessment; D012656:Self-Help Devices; D017216:Telemedicine / Q000379:methods*; D014584:User-Computer Interface