21 January 2013

Rwanda: All This Push, Where Is the Pull?


WITH SO much talk about innovation in the techosphere these days, one has to wonder, when we will be as proactive about speed of adoption and diffusion of these innovations. It is a no-brainer that innovations must make sense to potential users - adoption is essentially driven by push and pull.

So what of this? A recent visit to one of Kigali's larger hospitals was an eye opener like no other. I had heard about how we have taken great strides adopting technology in Health sector: what with telemedicine and all those other technologies reserved for futuristic movies. I was disappointed when the person I accompanied had to write her name on a slip, wait for the clerk to sort through a gazillion files to find hers (I am afraid soon they will have to build a separate building just for files), right before sending us to the 'insurance queue'. All in all, it might have been a good half-hour before we were ready to wait in line outside the doctor's office.

What I originally had in mind was us waiting to be checked in by a clerk electronically: all her information such as insurance and past conditions would be in the system and all the clerk had to do was check her in, and send her file (not the manila one, but the one composed of 1's and 0's) to the doctor's computer. Et voila! Our time is saved, and so is that of the sweaty clerk who has to run between shelves of files.

I asked someone about this and was told the hospital actually has the required software to do the above (yet to be verified by a reliable source). If it is true, it is unfortunate; one of the great barriers to the adoption of technology is the perception that it is too hard to use. It is never guaranteed that if you throw technology at users, they will eat it up - user requirements have to co-evolve with technological trajectories.

I suspect it is a question of cultural readiness. We all know the hospital experience is not unique: paying the bill at the restaurant or at a clothes store, borrowing DVDs from a neighbourhood DVD rental, you name it. Before the hospital software was put in place, were the needs of hospital staff and patients clearly defined? Desired outcomes motivating proposed changes in technology listed? What about the work flow and processes - was the hospital deemed ready to adopt change?

I am in no place to answer but these questions apply to other situations. At any rate, the needs of the adopters of the technology need to be studied especially since if new technologies are not correctly implemented, they can negatively affect work flow. Customised training programmes are the safest bet to baseline adoption, smooth integration of technology to systems and will drive value out of the investment in technology; once the benefits of time-saving become evident, there will be no turning back (not the mention the fact that we would probably save a couple of thousand trees a year by eliminating all that paper).

I think another critical factor has to do with leadership no matter what institution; change has to be driven from above. For example, the clerks at the desk would be forced to use the software at hand if doctors set a precedent. In terms of mainstream adoption of technology, price elasticity is worth taking into account but I won't explore that here.

Not surprisingly, technological innovation and diffusion have been coupled to the economic development of the US - one just has to complement the other for us to reap the fruits. As we look for the next Rwandan innovator (Mark Zuckerberg), let's make sure that Rwandans actually appreciate and adopt his innovation (Facebook)!

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