Tuesday, September 25, 2007

The Science of Spread

Quote of the Day:
Resentment is like taking poison and hoping the other person dies.
--St. Augustine


Batten down the hatches....this post is going to be rather long, not a sound byte.  Thomas Bodenheimer  M.D.wrote for the California Health Care Foundation a treatise on this subject which bears reexamination at this juncture in the development of Health IT and the proposed NHIN. Dr Bodenheimer is on the faculty at UCSF.

He summarizes the literature on "spread theory" by Everett Rogers (1962), and Malcom Gladwell's "Tipping Point" . Paul Plesk cites Rogers and Gladwell "to argue that once 10-20% of the target population has adopted an innovation the tipping point has been reached."  Plesk than goes on to discuss "stages of change", "precontemplation", contemplation and action, followed by maintenance.

It can be said that EMRs and RHIOs, and NHIN are in all phases of Plesk's analysis of "Spreading Good Ideas for Better Health Care"

He offers several tools that might help improvement champions that analyze the systems and individuals that make up the spread target population....more later

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