Crossing the chasm
from adoption to diffusion of a telehealth innovation
pp. 361-378
in: Ana M Bernardos, Karlheinz Kautz (eds), Open it-based innovation: moving towards Cooperative it transfer and knowledge diffusion, Berlin, Springer, 2008Abstract
Telehealth innovations promise to provide extensive medical benefits by increasing access to healthcare services and lowering costs at the same time. However, many telehealth initiatives fail to go beyond the status of prototype applications despite being considered technically viable and medically relevant. Based on a longitudinal investigation of a successful telehealth program, we identify a chasm between the initial adoption mode of the innovation as a prototype within a network of hospitals and the subsequent diffusion mode of the innovation as a commercialized product. Subsequently, we analyze how key actors negotiated the chasm to successfully diffuse the innovation beyond the initial hospital setting. In terms of research, the paper presents a longitudinal, empirical investigation of a successful telehealth innovation. Drawing on the metaphor of "crossing the chasm," we explain why many telehealth initiatives fail to go beyond prototype application status. In terms of practice, the paper provides lessons on how key actors can negotiate the chasm to transition from adoption mode to diffusion mode.