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Jon Patrick

Hi Grant, form a HIT perspective I think this model doesn't give a ready role for technology incumbency which I envision as a shadow across the diagram. Can you suggest how it explains incumbency and/or how it can explain how to dislodge technological incumbency, especially given a lot of money has been spent on it and there is little administrative interest in change despite the need and value at the clinical level.

Grant Taylor

Thanks for your comment, Jon. I think I agree - and this is an important consideration that I did not address in this article.

Incumbency can generate 'policy'-type factors (information security and capital investment policies are a couple that spring to mind), 'intervention' factors (things that the incumbent technology can and can't do, for example) and behavioural factors (over-learned processes shaped by the incumbent technology, perhaps).

I still see utility in the Behaviour Change Wheel for unpacking the challenge presented by incumbency but it is very useful to explicitly consider incumbency as a source of resistance to change.

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Grant Taylor
Director, Taylor Health Design

With a professional background as a clinical psychologist and health psychologist, I have more than 30 years of experience in healthcare service delivery, intervention design, organisational development and leadership - most recently Director of the intervention design and R&D teams at a leading, multinational provider of medication adherence and patient support programmes. I believe strongly in the importance of patient behaviour as a determinant of healthcare outcomes.

How can we design health service systems and interventions that better match what patients are really like and thereby deliver better healthcare outcomes and better returns on investment?

This blog discusses some of what we already know can make a difference, some of what I think will help, and some of the obstacles to change that we need to deal with. Please join the discussion: add your comments, subscribe to the feed or email me directly.

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