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The CPR market may also be uncertain because computer applications are generally not well understood by health care practitioners (Anderson and Jay, 1987). This lack of understanding limits the demand for such products and, as a result, reduces commercial interest in developing new products. Few sources exist to help practitioners learn what a computer technology can do for them, and there is little likelihood such help will be forthcoming in the near future, given the costs associated with producing such resources.
Barriers to Diffusion
Technological diffusion has been analyzed in greater depth than technological development. Rogers (1987) presents five characteristics of a technology that influence its adoption:
relative advantage over existing technologies (the degree to which an innovation is perceived as better than the practice it supersedes);
compatibility (the degree to which an innovation is perceived to be consistent with values, experiences, and needs of potential adopters, as well as with the structure of adopting organizations);
complexity (the degree to which an innovation is perceived as difficult to understand and use);
feasibility3 (the degree to which one can experiment with an innovation on a limited basis); and
observability (the degree to which the results of an innovation are observable to others).
Other factors also affect CPR adoption and use, including the environment of the health care system; leadership; user behavior, education, and training; costs; social and legal issues; and network needs. Major concerns in these areas are briefly noted below.
Environment of the Health Care System
The U.S. health care system has been characterized as comprising "thousands of relatively autonomous units, centering on large hospitals, which are themselves made up of relatively autonomous divisions and departments" (Lindberg, 1979:215). Maintaining CPRs, however, "imposes requirements for greater coordination among separate ancillary services, particularly with regard to terminology" (McDonald and Tierney, 1988:3438).
Rogers (1987) uses the term trialability to reflect the degree to which an innovation can be experimented with on a limited basis.