Why are some less solidly supported health care innovations widely adopted while others with apparently stronger scientific support remain underused? Drawing on four case studies, the authors argue that the way in which the distribution of benefits and risks map onto the interests, values, and power distribution of the adopting system is critical to understanding how innovations diffuse.
Jean-Louis Denis, Ph.D., is CHSRF/CIHR Chair, Département d'administration de la santé, Université de Montréal, Montréal, Québec, Canada.
Yann Hébert is a Ph.D. candidate, Psychologie industrielle, Université du Québec à Montréal, Montréal, Québec, Canada.
Ann Langley, Ph.D., is Professor, École des Hautes Études Commerciales, Montréal, Québec, Canada.
Daniel Lozeau, Ph.D., is Associate Professor, École nationale d'administration publique, Montréal, Québec, Canada.
Louise-Hélène Trottier is a Ph.D. candidate, Département d'administration de la santé, Université de Montréal, Montréal, Québec, Canada.
We thank all the people who helped us with this research: members of our steering committee, individuals who agreed to be interviewed, and colleagues Raynald Pineault and Marie-Dominique Beaulieu who commented on our work. We also thank the Canadian Health Services Research Foundation, the Fonds de recherche en santé du Québec, the Conseil d'évaluation des technologies de la santé and Healnet for their financial support.