The UK National Health Service (NHS) has been slow at adopting seemingly well-evidenced innovation. A great deal of energy and resources have gone into understanding the issues behind the failure to adopt innovation in the NHS. In recent times Accelerated Access Review (AAR) identified new barriers to innovation and put forward solutions at both local and national levels (Department of Health and Department for Business, Energy and Industrial Strategy, 2017). Scholars and policy-makers have investigated the majority of the obstacles to adopting innovation in the NHS and results have appeared in multiple outlets over the last twenty years. Innovation within the NHS have mostly been judged on a least-cost basis or presumed to yield a positive return in the very first year. Some scholars also point to the fact that most perspectives on innovation deem it as a luxury rather than a routine part of the operational management.
The failure to successfully adopt innovations is costing taxpayers and despite so many obstacles well documented, the NHS is still struggling to overcome the scale of innovation. To this concern, my research is an attempt to better understand the process of innovation adoption in healthcare. Using a year-long field study at one of the largest UK-based University Hospitals, I have explored the process of adoption of electronic medicine chart (EMEDs) designed to replace traditional paper-based systems. Based on three groups of non-clinical and clinical stakeholders, I have developed a multi-view perspective of the adoption process.
Exploring the perspectives of both the clinical users (doctors, nurses, and pharmacists) and technology (clinical and non-clinical) implementer groups, I have developed a multi-view perspective of the adoption process. To address the struggles and complexity of the adoption process underpinning the implementation of innovation in hospitals, my research has advanced a socio-cognitive perspective through examining the groups of technology implementers and technology users. Currently, a body of research exists which has examined the adoption of innovation underpinning implementation in firms. The literature has tended to provide economic-based theories of rational action by focussing on channels through which technical or economic benefits are communicated as a means to propagate its adoption. An alternative to economic-based explanations, the institutional theory perspectives have identified forces triggering adoption, irrespective of the innovation’s technical, work-related, or economic benefits to the adopter. Contributing to the growing interest in socio-cognitive perspective, my research through interactive framing has examined the groups of technology implementers and technology users. This has been done to develop an understanding of how actors ‘make sense’ of the process unfolding through them (the implementers and users). Having used Gioia methodology, I have utilised data collected through rich in-depth interviews of the actors during the process of implementation and adoption. The data collected have been used to build a data structure leading onto an interactive grounded theory model of EMEDs adoption. The model is built on three core dynamic framing activities – intrinsic, frictional and transitioning. Collectively they represent a cognitive transformation of all the actors involved and offer insight into the negotiated state and challenges of adoption process faced by both users and implementers in a complex organisation.
