Innovation Diffusion Across 13 Specialties and Associated Clinician Characteristics.

Innovations in health care delivery have resulted in dramatic shifts in the experience of seeking and receiving health care services. Many of these innovations, like telehealth and patient portals, predated the COVID-19 pandemic, but the pandemic quickly spurred rapid changes in availability and use. It is important to understand how older adults view and experience these innovations and the opportunities and challenges these innovations present. Since its launch in 2017, the National Poll on Healthy Aging (NPHA) has surveyed a nationally representative sample of adults ages 50-80 to gauge their perspectives on health care and health policy-related topics, including health care innovations, and assess trends and changes in views and experiences over time. In addition, AARP regularly conducts surveys to offer additional timely insights on important related topics. This symposium will focus on lessons learned from the NPHA related to telehealth, patient portals, direct-to-consumer health care services, and use of alternative sites for health care, like urgent care and retail clinics. In addition, it will highlight key findings from recent AARP surveys related to views on innovations in health care delivery among adults and older adults and will share how these insights can inform policy and practice.

Summary Since its launch in late 2015, NEJM Catalyst has showcased practical innovations in health care delivery and created a dialogue among leaders and clinicians to better solve today’s complex problems. Now we take the next step. NEJM Catalyst has evolved to become a peer-reviewed subscription journal, NEJM Catalyst Innovations in Care Delivery. Six times each year, this new digital journal will publish the most important ideas and actionable innovations for care delivery that are grounded in research, real-world experience, and value for patients.

BackgroundDespite great medical advances and scientific progress over the past century, one billion people globally still lack access to basic health care services. In the context of the 2030 Agenda for Sustainable Development social innovation models aim to provide effective solutions that bridge the health care delivery gap, address equity and create social value. This commentary highlights the roles of multilateral organizations and governments in creating an enabling environment where social innovations can more effectively integrate into health systems to maximize their impact on beneficiaries.Main textThe integration of social innovations into health systems is essential to ensure their sustainability and the wide dissemination of their impact. Effective partnerships, strong engagement with and endorsement by governments and communities, regulations, trust and sometimes willingness are key factors to enhance system integration, replication and dissemination of the models. Three examples of social innovations selected by the Social Innovation in Health Initiative illustrate the importance of engaging with governments and communities in order to link, integrate and synergize their efforts. Key challenges that they encountered, and lessons learnt are highlighted. Multilateral organizations and governments increasingly engage in promoting and supporting the development, testing and dissemination of social innovations to address the health care delivery gap. They play an important role in creating an enabling environment. This includes promoting the concept of social innovation in health care delivery, spreading social innovation approach and lessons learnt, fostering partnerships and leveraging resources, convening communities, health system actors and various stakeholders to work together across disciplines and sectors, and nurturing capacity in countries.ConclusionsMultilateral organizations and local and national governments have a critical role to play in creating an enabling environment where social innovations can flourish. In supporting and disseminating social innovation approach, multilateral organizations and governments have a great opportunity to accelerate Universal Health Coverage and the achievement of the Sustainable Development Goals.

This research details efforts to analyze the adoption and diffusion of agricultural technology innovations through the Integrated Participatory Development Management of Irrigation Program (IPDMIP) Field School Program in Kedungreja District, Cilacap Regency. In the background, the urgency of agriculture as the primary sector in development is illustrated, with technology adoption being the key to increasing productivity and farmer welfare. The IPDMIP program emphasizes the involvement of farmers in irrigation management and implementing modern technology to optimize agricultural yields. However, there has not been much in-depth research on the factors that influence the successful adoption and diffusion of technological innovations in the context of this program. This research aims to identify the factors that influence the adoption and diffusion of agricultural technology innovations in the IPDMIP Field School while measuring the adoption and diffusion of these innovations in the Kedungreja District. The quantitative research method uses a survey approach and statistical data analysis. The research instrument includes variables such as cultivated area, farmer age, education level, innovation characteristics, characteristics of potential users, decision-making, communication channels, and instructor qualifications. Data was collected from 100 respondents who were members of farmer groups receiving IPDMIP Field School activities through questionnaires. Data analysis shows that the IPDMIP Field School Program effectively increases the adoption and diffusion of agricultural technology innovations in the Kedungreja District. Factors such as farmer age, characteristics of the innovation, characteristics of potential users, and communication channels play a significant role in the successful adoption and diffusion of the innovation. The research results provide an in-depth picture of the effectiveness of this program in bringing positive change among farmers. This conclusion can be a basis for formulating further policies to support sustainable agricultural development and improve farmer welfare.

The health care industry in a society plays a significant role for the welfare of people and the advance of medical engineering/bio-technology alike. However, increasing investment in acquiring the sophisticated instruments and world-patented drug prescription quells people's hope to afford the health care service, unless insurance policy allows the access. Concurred with Christensen's framework of disruptive innovation in health care delivery, we observe that the integration of traditional Chinese and Western medicine entitles itself to disrupt the incumbent health care system. Based on Roger's innovation diffusion model and Davies' technology adoption model we propose a framework to explore the influential factors and their interrelationship with customer's adoption intention towards the integration of traditional Chinese and Western Medicine. Hypotheses are made to conceptualize this theoretical framework and allow the methodology of structure equation modeling (SEM) to test the theory. The objective is to identify the causal links of customer perception and motivation towards the integration with construct such as customer's adoption attitude and intention. The outcome of this study makes a contribution in providing insights for the development of appropriate business model for health care service industry.

Factors driving or impeding the diffusion and adoption of innovation in mining: A systematic review of the literature

Health care organizations and systems seem to benefit for the adoption and implementation of innovation driven by new technologies for seeking legitimacy and building trust with patients as to proceed towards a sustainable development. New technologies lead to develop health care as a process innovation-driven and patient-centered by improving quality and efficiency of health care services. Policies tend to help for diffusion and dissemination of innovation as to support the implementation of new technologies in health care service delivery. Sustainable health care organizations tend to develop or follow innovation by new technologies conforming to policies driving the diffusion of innovation for continuous improvement within health care delivery and systems.

This preliminary quantitative research investigates preservice teachers’ (PSTs) perceptions of adopting ChatGPT, an artificial intelligence (AI) tool, focusing on the early stage of the diffusion of innovation (DOI) process. The study aims to understand PSTs’ innovation consciousness and how it influences their perceptions of integrating ChatGPT into their teaching and learning. Conducted at a teacher education campus through an online survey, the study explores correlations between innovation adoption and the use of AI-based technologies. The findings reveal positive correlations between attitudes towards innovation, technology use, and innovation consciousness, highlighting PSTs’ readiness to adopt new technologies, particularly for academic writing. Notably, 21% of the participants were identified as early adopters who used ChatGPT to write papers and expressed a strong belief in the potential of AI in teaching, contrasting with those who had not used it. By integrating the Technology Acceptance Model (TAM), Diffusion of Innovation (DOI) theory and a constructivist approach, this research offers a deeper understanding of how PSTs engage in a constructivist process of exploration and adaptation. This theoretical framework goes beyond traditional analyses of technology adoption, presenting insights into how future educators will navigate and integrate AI tools such as ChatGPT into their professional development and transformative learning practices.

Still Piecing It Together: Women's Primary Care

Perioperative education is crucial for optimizing outcomes in neuroendovascular procedures, where inadequate understanding can heighten patient anxiety and hinder care plan adherence. Current education models, reliant on traditional consultations and printed materials, often lack scalability and personalization. Artificial intelligence (AI)-powered chatbots have demonstrated efficacy in various health care contexts; however, their role in neuroendovascular perioperative support remains underexplored. Given the complexity of neuroendovascular procedures and the need for continuous, tailored patient education, AI chatbots have the potential to offer tailored perioperative guidance to improve patient education in this specialty. We aimed to develop, validate, and assess NeuroBot, an AI-driven system that uses large language models (LLMs) with retrieval-augmented generation to deliver timely, accurate, and evidence-based responses to patient inquiries in neurosurgery, ultimately improving the effectiveness of patient education. A mixed methods approach was used, consisting of 3 phases. In the first phase, internal validation, we compared the performance of Assistants API, ChatGPT, and Qwen by evaluating their responses to 306 bilingual neuroendovascular-related questions. The accuracy, relevance, and completeness of the responses were evaluated using a Likert scale; statistical analyses included ANOVA and paired t tests. In the second phase, external validation, 10 neurosurgical experts rated the responses generated by NeuroBot using the same evaluation metrics applied in the internal validation phase. The consistency of their ratings was measured using the intraclass correlation coefficient. Finally, in the third phase, a qualitative study was conducted through interviews with 18 health care providers, which helped identify key themes related to the NeuroBot's usability and perceived benefits. Thematic analysis was performed using NVivo and interrater reliability was confirmed through Cohen κ. The Assistants API outperformed both ChatGPT and Qwen, achieving a mean accuracy score of 5.28 out of 6 (95% CI 5.21-5.35), with a statistically significant result (P<.001). External expert ratings for NeuroBot demonstrated significant improvements, with scores of 5.70 out of 6 (95% CI 5.46-5.94) for accuracy, 5.58 out of 6 (95% CI 5.45-5.94) for relevance, and 2.70 out of 3 (95% CI 2.73-2.97) for completeness. Qualitative insights highlighted NeuroBot's potential to reduce staff workload, enhance patient education, and deliver evidence-based responses. NeuroBot, leveraging LLMs with the retrieval-augmented generation technique, demonstrates the potential of LLM-based chatbots in perioperative neuroendovascular care, offering scalable and continuous support. By integrating domain-specific knowledge, NeuroBot simplifies communication between professionals and patients while ensuring patients have 24-7 access to reliable, evidence-based information. Further refinement and research will enhance NeuroBot's ability to foster patient-centered communication, optimize clinical outcomes, and advance AI-driven innovations in health care delivery.

Agricultural production in the cotton basin of Banikoara in Benin depends on the variability of rainfall, which fluctuates between 800 and 1 200 mm per annum. The income of farm households and their food security are determined by the concomitant fluctuations in cotton and food production. Agricultural diversification based on a sound understanding of the process of adoption of technical innovations has the potential to provide a consistent income, improved agricultural productivity and, in the end, a substantial improvement in the well-being of the farmers. These technical and agricultural innovations are the subject of an economic analysis of the impact of technical progress on the technical and allocative efficiency of farmers in this region. The production of “white gold” in the Banikoara basin depends heavily on the use of chemicals, rather than on biological, agronomic and mechanical interventions. However, these four forms of agricultural innovations need to be combined. In some Asian countries, for example, a more judicious combination of different forms of innovations has resulted in better yields. As yields in Banikoara are low by global standards, technological development and the implementation of new technologies present a real opportunity for improving the well-being of these cotton farmers. However, although many cotton farmers in Banikoara understand that agricultural innovations could help to overcome the challenge of food security, the real question is how to give the cotton producers access to the right technical and agricultural innovations. To this end, this article attempts to describe the levels of adoption of technical and agricultural innovations by the farmers and then to explain the options available to them in order to clarify the mechanisms for sustainable management of cotton production in the Banikoara basin. In total, 1 000 cotton producers were interviewed during the harvest and post-harvest period from October 2010 to September 2012. Some 75% (750 farmers) of the collected responses were found to be reliable. The results show that farmers differ widely in their attitude to the adoption of innovations. A total of 64% of the cotton farmers were not sure about the impact of these innovations on their agricultural efforts, while 32% considered this impact as weak and insufficient. These results can be explained by a delay in decision making in the adoption of agricultural and technical innovations, the lack of information about the benefits of these, the non-reliability of previous results in other specific cases, and the conservative spirit of the endogenous cultural practices. Only 3,2% of farmers perceived these innovations to their right value, while the proportion of cotton producers who were totally in favour of the implementation of these innovations represents only 1,2% of all the farms. Generally speaking, the factors that prevent the adoption and diffusion of new innovations are sociodemographic, economic or institutional in nature. For example, on top of the real risks and uncertainties that threaten agricultural production in the basin there also is the ageing of the farmers and the weak level of education, which makes it difficult for them to adopt the technical innovations. This is reflected in the absence of modern technology. It also is essential that the government should implement specific programmes for the intensification of the technical training of farmers and that farmers should be grouped by means of cooperatives. These two factors would lead to a higher and better perception of the benefits of adopting technical and agricultural innovations not only for cotton, but also for other agricultural production.

Disruptive innovation has brought affordability and convenience to customers in a variety of industries. However, health care remains expensive and inaccessible to many because of the lack of business-model innovation. This paper explains the theory of disruptive innovation and describes how disruptive technologies must be matched with innovative business models. The authors present a framework for categorizing and developing business models in health care, followed by a discussion of some of the reasons why disruptive innovation in health care delivery has been slow.

As reimbursement transitions from a volume-based to a value-based system, innovation in health care delivery will be needed. The process of innovation begins with framing the problem that needs to be solved along with the strategic vision that has to be achieved. Similar to scientific testing, a hypothesis is generated for a new solution to a problem. Innovation requires conducting a disciplined form of experimentation and then learning from the process. This manuscript will discuss the different types of innovation, and the key steps necessary for successful innovation in the health care field.

The U.S. spends more of its total GNP on health services than any other nation, yet it has one of the highest infant mortality rates in the industrialized world. Young American children are immunized at rates that are one-half those of Western Europe, Canada, and Israel. In the mid-1980s, a consensus among policymakers on the need for federal action to improve child health services resulted in the expansion of Medicaid eligibility for pregnant women and young children and the separation of Medicaid eligibility from eligibility for AFDC. The current phase of child health policymaking includes discussion of much broader proposals for changes in health care financing and innovation in health care delivery. This examination of child health policy begins by reviewing the politics of maternal and child health services from the early twentieth century to the Reagan administration, including the role of feminist movements, the development of pediatrics, and the expansion of federal involvement during the 1960s. Next, the politics of Medicaid expansion as a strategy for addressing child health issues are discussed. Current critiques of child health services in the U.S. are examined, along with proposals to restructure health care financing and delivery. Central to the politics of child health policy during the 1980s and into the 1990s is the way in which child health has been defined. Infant mortality and childhood illness are presented as preventable problems. Investment in young children is discussed as a prudent as well as a compassionate policy, one which will reduce future health care costs and enhance our position in the international economy. Unlike other "disadvantaged groups," children are universally viewed as innocent and deserving of societal support. Framing child health issues in these terms helped to produce consensus on the expansion of Medicaid eligibility. Yet the issues beyond the expansion of Medicaid eligibility involve the restructuring of health care financing and delivery, and, on these issues, conflict is far more likely than consensus.

The innovation diffusion and adoption literature explores multiple topics including stages of innovation decision-making, diffusion networks, rate of innovation adoption, categories of adopters but there are still opportunities for continued theory building and research on diffusion and adoption within and across organizations. This paper will discuss the innovation diffusion and adoption literature focusing on diffusion models, adoption categories, the adoption process, and innovation adoption and diffusion in organizations.