Explaining plateaued diffusion by combining the user-IT-success factors (USIT) and adopter categories: the case of electronic prescription systems for general practitioners

Although the diffusion of new IT in healthcare does not seem to have levelled off, successes are reported frequently. Many of these successful cases show enthusiastic use of an innovation by a limited group of physicians or other users. This paper explains plateaued diffusion by differentiating the match between user and IT to adopter categories (the User-IT-match or USIT model). This match is described by the (sub)-dimensions of affection/resistance, relevance, requirements and resources. Once the sub-dimensions are determined for all adopter groups, it should become clear that different sub-dimensions play a role for every adopter group, and thus in every successive stage of the diffusion process. The diffusion process plateaus if there is no match with the sub-dimensions that play a role in the adopter category which was to adopt the innovation at that stage. A total of 56 case studies on the diffusion of an Electronic Prescription System (EPS) for general practitioners in the Netherlands was used to test the explanatory power of these factors. We conclude that USIT is of high value in determining adopter category specific diffusion problems, and thus in understanding plateauing diffusion. The relevance-factor has the biggest impact within USIT. The paper includes discussion of the limits of the model and suggestions for elaboration. It also discusses diffusion problems that are specific to this EPS.