Capabilities for incremental innovation: the adoption of electronic health records

The focus of his chapter is on the compatibility issues generated by a substantial diffuse innovation in a well-established sector with an existing carefully developed set of practices, and on the barriers to change that are generated as a result. The innovation is the introduction of Electronic Health Records (EHRs) and the sector is healthcare. Our argument is that the introduction of a national EHR system, although very substantial, requires incremental innovations that frequently must be adjusted so that they can be assimilated into existing arrays of equipment and established patterns of personal relationships. The technological knowledge required for the implementation of a national EHR system is extant, external to the individual implementers of EHRs. To achieve compatibility between old and new relationships and equipment, however, does require creative thinking to generate necessary adjustments and modifications. Although in some cases these may be undertaken within the innovating organisation, it is often necessary to draw on external knowledge in order to manage change efficiently.