What Are You Waiting For? Insight Into The Mind of a Second-Wave IT Adopter

We’re pretty familiar with the term early adopter – those people or organizations that are the first to start using new technology. By the nature of your profession and interest in health IT, it’s likely you are an early adopter yourself. If you have any doubt you can take this quiz to see how you rank as an adopter.

I have a good friend who I would classify as an early adopter. She’s always the one to buy the first generation of gadgets like the iPod, iPhone, iPad and some Nike+ iPod sensor thing to track her running mileage. If it’s new and techie, she’ll have it first.

I, however, am a bit different. Case-in-point: One day we were out shopping in the artsy, eclectic city of Evanston, Ill., which is home to Northwestern University. We were hitting the various boutiques and I noticed, to quote the show Portlandia, everything had “a bird on it.” Purses, journals, shirts, those birds (which looked suspiciously similar to that Twitter icon we all know) couldn’t be avoided. My annoyance with this excessive use of avian images maxed out when we walked into Barnes & Noble, the antitheses of a trendy boutique, and we were greeted by a giant display filled with a variety of bird merchandise.

“What is with these birds! I don’t want to see another ‘Twitter’ bird on one more tote bag,” I said.

“What do you want to see instead?” she asked.

“Owls,” I blurted out.

We headed up the escalator to the children’s section to buy some books for our friend’s new baby. As we stepped off, she pointed at a display and burst out laughing. Can you guess what the cup holders, bookends and pencil cases on that display were sporting? Owls.

“You might not be ahead of the curve,” she said, “but you are at least right on the curve.”

Her observation about me was spot on. I am generally, with birds or with technology, not an early adopter. But neither am I one who resists technology. I am what is described as a second-wave or middle adopter. We are the ones who get on board with technology after the early adopters have embraced it. Why don’t I want to be first on the band wagon when it comes to technology?

1. Expense

First generation devices aren’t cheap. You’ve no doubt heard second-wave friends say they’re waiting until a piece of technology comes down in price before they’ll purchase it. Plus, we all know there will be upgrades and changes (for better or for worse) in each subsequent edition. Why pay for something now when there will be a new, lighter one with enhanced color and HD released in nine months?

I guess we second-wave adopters are frugal. We want the most bang for our buck. My early-adopter friend has no qualms about buying each new generation of technology as they come out. Me, not so much.

How does the second-wave mindset translate to health IT adoption? After all, the clinicians aren’t shelling out their own money to buy the system.

Well, that depends on how you look at it. They know IT systems and implementation aren’t cheap. Unfortunately, in some places clinical staff hasn’t received pay raises for a few years or feel they aren’t adequately staffed to care for patients. They ask, “Why is the facility spending all this money on new technology when they won’t make an investment in their staff?”

If you want the middle adopters to get on board, show them how the technology will save money long term and help provide better patient care. Not just one time but monthly until you start hearing, “How did we ever live without this!”

2. Uncertainty

Not quite knowing how something works can be a little unnerving. We’ve lived in our house for almost seven years and a few months ago I rearranged my kitchen cabinets. I still can’t find stuff. And I’m the one who rearranged it. I’ve been through this with Twitter, Facebook, Microsoft Word and Mac OS.  Just when I know where the templates are and which box to check to enable “track changes,” they change it on me.I was confident and comfortable and self-sufficient.

When something is changed or I’m not quite sure how to use it in the first place, I feel nervous, incompetent and dependent on others. Sometimes by holding out on technology you can find a kindly early adopter, who’s already discovered the ins-and-outs of the technology, to take you under their wing and show you the ropes (or Windows).

We middle adopters really want to learn. We just don’t want to come across as inept by putting our lack of knowledge on display.

3. Annoyance

I was completely surprised when my mother bought me a Barnes & Noble Nook Tablet for Christmas. I was hemming and hawing over whether I should get one.

Did I really need a laptop, smartphone and an eReader? Should I get a tablet instead? Maybe I shouldn’t get either one.

For the most part, I love my Nook. My initial reason for being so excited about it is the option to borrow library books. It takes me eight minutes to walk to my local library but when it’s 3 degrees outside, I’m not making the trek. And it seems so lazy to get in the car and drive a quarter of a mile to borrow a book. If I’m going to be lazy, I might as well stay in the house and borrow the books electronically.

But here is where the eReader got demoted from gold to bronze—my library’s server keeps going down and I can’t borrow books. One time it even deleted me from their system so I kept getting an “this is not a valid library card number” error. It took five days and four emails to resolve that issue. Annoying! I was finally being modern and using technology and I kept running into glitches.

If you want second-wave adopters to get on board you have to have all the bugs worked out before you turn us loose on it. It seems likes early adopters are more forgiving of problems with new technology. Perhaps they have a better understanding of what it takes to fine tune a product.

Second-wave adopters want things to work correctly and consistently. If you don’t have the bugs worked out when you try to get us on board, it’s likely we will never adopt the technology.

4. Time

It takes time to learn something new and to become proficient in using it. I tried figuring out all the nuances of my Nook on my own, but I think I’m going to have to end up taking a class (most Barnes & Noble stores have them) on how to use it. I know I’m missing things and not using it to its full potential. But that takes time.

Now, when you are an early adopter, technology is very near and dear to your heart and spending time learning how to use software or a device can be fun for you, almost a hobby. I see the value in technology and even enjoy it at times, but I have other things that demand my attention and interest me more. I want to be able to know how to use something correctly in less than 30 minutes.

I hope this gives you early adopters some insight into how we middle adopters think and that you’ll be able to apply these ideas to help you get more of us on board earlier. We do come around eventually.

Can you guess what “theme” my daughter’s bedroom is decorated in? You’ve got it! Birds. ♦


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Jennifer Thew, RN, MSJ

Jennifer Thew, RN, MSJ, is a registered nurse and journalist who has covered healthcare issues and how they relate to the nursing profession. She began her nursing career as a neuroscience nurse at Rush University Medical Center in Chicago and then transitioned to journalism after receiving a degree from Roosevelt University in Chicago. She has edited and written numerous articles on a wide range of nursing and healthcare topics like Accountable Care Organizations, evidence-based practice and telehealth.

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  • http://twitter.com/techguy John Lynn

    Great article. We’re just starting to see many of the middle adopters join the healthcare IT wave and quite frankly it hasn’t been pretty for them for many of the reasons that you state. Most notably that many systems still have many bugs and take more than 30 minutes to learn.

    What I think also isn’t covered is that we may exhibit different characteristics in different situations. For example, you might be an early adopter of the iPhone, but not so in the EHR world. This is true for many doctors who are happy to be early adopters in their personal life, but not in their professional life.

  • http://twitter.com/jen_NurseEditor Jennifer Thew

    Thanks for commenting John. And I absolutely agree about variances in adoption depending on situation. I also didn’t mention that sometimes you end up being a second-wave adopter by default. When I was kid my dad worked for Zenith and he came home with this thing called a “modem.” One of the parents of the children at our school also had one but that was about it. So even though we had one quite early (this would have been mid-to-late 80s), few others did so we couldn’t use it to its full potential. The same thing happened to me when Facebook first started and not many people were using it. I ignored my account until more of my friends started using it.