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To the Editor: In his article about desseminating innovations in health care, Dr Berwick¹ noted that many innovations in health care are slow to be adopted. Some medical innovations, however, are disseminated quite quickly. Coronary stents in angioplasty were widely adopted in just a few years, and drug-eluting stents are likely to be adopted even more quickly. Multidrug therapy for human immunodeficiency virus infection changed the course of that disease in industrialized countries in a matter of just a few years. Few hospitals now operate without a computerized tomography scanner; many now have multiple magnetic resonance imaging scanners and are purchasing positron emission scanners. What is the difference between innovation that is disseminated rapidly and that which languishes?

I believe that innovation is most rapid when the decision maker in the purchase of the innovation sees a short-term positive financial return on investment in adopting the innovation. Hospitals are able . . . [Full Text of this Article]

Jeffrey Levin-Scherz, MD, MBA
Reden & Anders, Ltd
Belmont, Mass

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