Diffusion of innovation in medicine to evaluate impact of new technology.

PURPOSE: Diffusion of Innovation (DOI) model, used in finance to evaluate technology adoption, was applied to medicine using robotic surgery adoption as a case study.

METHODS

National Cancer Database (2010-2021), facility level compound annual growth rate (CAGR) in colorectal surgical volume was calculated. Facilities were grouped by year of robotic adoption into DOI categories. Multivariable linear regression estimated associations between CAGR, DOI groups, initial surgical volume and robotic utilization.

RESULTS

There were 714,742 patients. DOI groups demonstrated a bell-shaped association with CAGR (Innovators β = 1.88; Early Majority β = 3.98; Late Majority: 2.57; Laggards: 2.07; all p < 0.01). Patients travelled further to Innovator/Early Adopters (β = 7.42 miles) and Early Majority hospitals (β: 8.25 miles, both p < 0.01).

CONCLUSION

DOI served as a useful model to evaluate the impact of technology adoption at various points of dissemination, demonstrating largest surgical volume growth in institutions who adopt the technology after a period of initial dissemination.