Telehealth Technologies: Expanding Access and Enhancing Treatment and Recovery ServicesNancy A. Roget, MS, MFT, LADC & Joyce A. Hartje, PhD

National Frontier & Rural Addiction Technology Transfer Center (NFAR ATTC) | University of Nevada, Reno

OBJECTIVES:• Recognize the basic tenets of diffusion of innovation theory and technology adoption research• Cite factors related to technology adoption and the provision of substance abuse treatment services

PURPOSE:Just because an organization integrates new technology to deliver services, there is no guarantee that staff will embrace using it. Research has examined the complexity of individuals’ relationships with technological innovation, identifying several paradoxes experienced when dealing with new technologies.1, 3 Several theories have been used to examine:

• choices individuals make to accept/reject a particular innovation and extent to which that innovation is integrated into the appropriate context (adoption);

• how an innovation spreads through a population (diffusion); and • beliefs and attitudes formed over time that may influence decisions about the innovations adopted/rejected

This study extends previous research on understanding of why one individual chooses to adopt a technology while another resists.

METHODS:• Web-based survey administered to substance abuse treatment professionals (n=171)• Examined propensity to adopt technology on 4 dimensions:

Contributing Factors* Optimism – technology makes life easier* Proficiency – learning to use technology is quick and easy

Inhibiting Factors* Dependence – overly reliant on technology* Vulnerability – increased chance of being targeted

CONCLUSIONS:• Early Adopters in the behavioral health workforce who use telehealth technologies may increase promotion, adoption, & implementation of its use. • Along with recognizing where individuals are on the adoption/dissemination continuum, it is important to understand that successfully facilitating

technology adoption needs to address cognitive, emotional, and contextual concerns. • Attitude about technology influences propensity to adopt• Facilitating technology implementation projects should be informed by knowledge of technology adoption research• Technology adoption is a complex, developmental process through which individuals construct unique (but malleable) perceptions of technology that

influence the adoption process. • Although results from the current study were explained on only two of those factors (Proficiency and Dependence), they do suggest positive

correlations between individuals’ attitudes and propensity to deliver substance abuse treatment services using technology-based interventions.

RESU

LTS: Reasons for implementing telehealth technologies

• Facilitate easier access to services for individuals living in remote areas• Ability to provide services to more individuals

* wait time to schedule appointments was too long * specialty services not available (e.g., psychiatric care for adolescents)

Characterist ics of Early Adopters in the Context of the Behavioral Health Workforce

• Believe most people in the organization think using telehealth technologies to deliver treatment and recovery services is a good thing

• Consider services delivered using telehealth technologies to be as effective as face-to-face

What helps innovations spread?• Relative advantage• Compatibility• Simplicity and ease of use• ‘Triability’ • Observable results

Formulat ing a Bel ief about Technology• How beneficial will this new technology be once I start using it?• How difficult will it be for me to learn to use it properly?

2.5%Innovators

13.5%Early

Adopters

34%

Early Majority34%

Late Majority16%

Laggards

Early M

arkets

Mainstream Market Late Market

Techies:‘Try it.’

Visionaries:‘Get ahead!’

Pragmatists:‘Stick with the herd!’

Skeptics: ‘No way!’

Conservatives:‘Hold on!”

Research posits that the population can be broken down into five different segments based on their propensity to adopt a specific innovation.

ROGERS’ ADOPTION OF INNOVATION CURVE

The diffusion curve represents how many individuals are using an innovation.

REFERENCES:1 Ratchford, M. & Barnhart, M. (2012). Development and validation of the technology adoption propensity (TAP) index. Journal of Business Research, 65, 1209-1215.2 Straub, E.T. (2009). Understanding technology adoption: Theory and future directions for informal learning. Review of Educational Research, 79 (2), 625-649.3 Rogers, E.M. (1995). Diffusion of innovations (5th ed). New York: Free Press.