Technology Diffusion Adoption
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TECHNOLOGY DIFFUSION & ADOPTION SG-2, LLC
Technology Diffusion Technology diffusion is modeled as a “logistic” function in which the following parameters define the shape of the curve. % of volume
Technology Diffusion
1.20000
Saturation 1.00000
0.80000
Accelerating diffusion "r" value - rate)
0.60000
"50%" mark
0.40000
Development lag 0.20000
0.00000 2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Years
Saturation level: A given technology can impact on 100% of disease prevalence or DRG utilization (where the saturation is “1”) or on a certain percentage of that prevalence or utilization (where the saturation can be set to less than “1”) “Take-off” point: The “take-off” point (or year at which 50% of relevant healthcare facilities are using the technology) can be identified. Development lag: Time related to development of the technology and regulatory approval (as appropriate). For technologies just recently approved, this development lag is “0” Acceleration rate or “r”: Related to how rapidly the technology diffuses (reaches saturation) once available. Pharmaceuticals (with low cost and low side-effects) typically have a rapid (or large) acceleration rate, while surgical devices (high expense and extensive training involved) would have a slow (small) acceleration rate. This value can be predefined for most technologies.
Technology Diffusion & Adoption (847) 733-9080 www.sg-2.com
SG-2, LLC 1560 Sherman Avenue Evanston, IL 60201
Technology Diffusion: noninvasive angiography example This example forecasts the utilization of non-invasive coronary angiography (CTA and/or MRA based). In the future, the vast majority of noninvasive angiographies will be screening angiographies. Screening noninvasive angiographies will outnumber diagnostic noninvasive angiographies by a factor of 10 and both will plateau by around 2009. We also see that invasive angiographies (even despite an increase in angioplasty volumes) will decrease yet not be completely replaced by noninvasive angiography. Projected coronary angiography volumes U.S. Population, 2001 - 2010 Total Invasive Angiography Total Noninvasive Angiography (Diagnostic & Screening) Noninvasive (diagnostic) angiography Noninvasive (screening) angiography
14,000,000 12,000,000
Volume
10,000,000 8,000,000 6,000,000 4,000,000 2,000,000
20 10
20 09
20 08
20 07
20 06
20 05
20 04
20 03
20 02
20 01
0
Year
Assumptions Baseline Population Data
CAD current technology utilization
Noninvasive angiography (timing and expected maximal utilization parameters)
Technology Diffusion & Adoption (847) 733-9080 www.sg-2.com
Symptomatic CAD Population Total U.S. Population (35+) Total U.S. Population Total diagnostic angiography Total endovascular procedures (stents/angioplasty) Total open procedures (CABG) Total screening (exercise & thallium) "stress" tests Year in which it is estimated that noninvasive angiography begins to achieve widespread adoption (e.g. at least 50% of all healthcare facilities) Factor (between 0 and 1) indicating to what extent noninvasive angiography (when the technology is fully available) will be applied to CAD screening. Factor (between 0 and 1) indicating to what extent noninvasive angiography (when the technology is fully available) will be applied to the symptomatic population undergoing nonendovascular treatment.
Growth Rate (average annual) 2001 12,282,452 2.0% 142,946,000 2.1% 281,000,000 0.9% 1,165,003 Variable 620,203 Variable 341,366 Variable 9,394,000
2%
2005
0.8
1.00
1
1.00
SG-2, LLC 1560 Sherman Avenue Evanston, IL 60201
Technology Adoption Different institutions will fall on different portions of a given technology diffusion curve. An institution’s adoption rate of each technology can be computed by comparing the current (volume-adjusted) utilization of that technology at the institution relative to the (volume-adjusted) national utilization rate for that technology. In the example below, Institution #1 is a rapidly adopting institution with a volumeadjusted utilization higher than the current (2002) utilization. Institution #2, on the other hand, is a slower adopting institution with a utilization that is lower than the national (volume-adjusted) utilization.
Technology Adoption 1.20000
1.00000
% of volume
0.80000
Utilization at a rapidly adopting institution #1
0.60000
Utilization at a slowly adopting institution #2 0.40000
∆U1: Difference between utilization at institution #1 relative to local volume adjusted national rate
Current average national utilization rate
0.20000 ∆U2:
0.00000 2001
2002
2003
Current time
Technology Diffusion & Adoption (847) 733-9080 www.sg-2.com
2004
2005
2006
2007
2008
2009
2010
Years
SG-2, LLC 1560 Sherman Avenue Evanston, IL 60201
Overall Technology Adoption Rating A complete technology adoption rate for an entire institution (or a department/service line) within an institution can thus be created which is simply the sum over all relevant technologies of the “differences” (positive or negative) described above.
∑ ∆U
i
techi
%
Adoption Rating
1.20000
Conservative 1.00000
Accelerators
0.80000
0.60000
"50%" mark Early Accelerators
0.40000
0.20000
Initiators 0.00000 2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
The overall rating (relative to a national rating) can then be used to assign the institution into one of four categories: Initiators: Utilize technology typically in the first 10% of overall utilization Early Accelerators: Are in the 10% to 50% group of first utilizers. Accelerators: Are in the 50% to 90% group of utilizers. Conservative: Are in the last 10% of utilizers
Technology Diffusion & Adoption (847) 733-9080 www.sg-2.com
SG-2, LLC 1560 Sherman Avenue Evanston, IL 60201
Technology Diffusion Technology diffusion is modeled as a “logistic” function in which the following parameters define the shape of the curve. % of volume
Technology Diffusion
1.20000
Saturation 1.00000
0.80000
Accelerating diffusion "r" value - rate)
0.60000
"50%" mark
0.40000
Development lag 0.20000
0.00000 2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Years
Saturation level: A given technology can impact on 100% of disease prevalence or DRG utilization (where the saturation is “1”) or on a certain percentage of that prevalence or utilization (where the saturation can be set to less than “1”) “Take-off” point: The “take-off” point (or year at which 50% of relevant healthcare facilities are using the technology) can be identified. Development lag: Time related to development of the technology and regulatory approval (as appropriate). For technologies just recently approved, this development lag is “0” Acceleration rate or “r”: Related to how rapidly the technology diffuses (reaches saturation) once available. Pharmaceuticals (with low cost and low side-effects) typically have a rapid (or large) acceleration rate, while surgical devices (high expense and extensive training involved) would have a slow (small) acceleration rate. This value can be predefined for most technologies.
Technology Diffusion & Adoption (847) 733-9080 www.sg-2.com
SG-2, LLC 1560 Sherman Avenue Evanston, IL 60201
Technology Diffusion: noninvasive angiography example This example forecasts the utilization of non-invasive coronary angiography (CTA and/or MRA based). In the future, the vast majority of noninvasive angiographies will be screening angiographies. Screening noninvasive angiographies will outnumber diagnostic noninvasive angiographies by a factor of 10 and both will plateau by around 2009. We also see that invasive angiographies (even despite an increase in angioplasty volumes) will decrease yet not be completely replaced by noninvasive angiography. Projected coronary angiography volumes U.S. Population, 2001 - 2010 Total Invasive Angiography Total Noninvasive Angiography (Diagnostic & Screening) Noninvasive (diagnostic) angiography Noninvasive (screening) angiography
14,000,000 12,000,000
Volume
10,000,000 8,000,000 6,000,000 4,000,000 2,000,000
20 10
20 09
20 08
20 07
20 06
20 05
20 04
20 03
20 02
20 01
0
Year
Assumptions Baseline Population Data
CAD current technology utilization
Noninvasive angiography (timing and expected maximal utilization parameters)
Technology Diffusion & Adoption (847) 733-9080 www.sg-2.com
Symptomatic CAD Population Total U.S. Population (35+) Total U.S. Population Total diagnostic angiography Total endovascular procedures (stents/angioplasty) Total open procedures (CABG) Total screening (exercise & thallium) "stress" tests Year in which it is estimated that noninvasive angiography begins to achieve widespread adoption (e.g. at least 50% of all healthcare facilities) Factor (between 0 and 1) indicating to what extent noninvasive angiography (when the technology is fully available) will be applied to CAD screening. Factor (between 0 and 1) indicating to what extent noninvasive angiography (when the technology is fully available) will be applied to the symptomatic population undergoing nonendovascular treatment.
Growth Rate (average annual) 2001 12,282,452 2.0% 142,946,000 2.1% 281,000,000 0.9% 1,165,003 Variable 620,203 Variable 341,366 Variable 9,394,000
2%
2005
0.8
1.00
1
1.00
SG-2, LLC 1560 Sherman Avenue Evanston, IL 60201
Technology Adoption Different institutions will fall on different portions of a given technology diffusion curve. An institution’s adoption rate of each technology can be computed by comparing the current (volume-adjusted) utilization of that technology at the institution relative to the (volume-adjusted) national utilization rate for that technology. In the example below, Institution #1 is a rapidly adopting institution with a volumeadjusted utilization higher than the current (2002) utilization. Institution #2, on the other hand, is a slower adopting institution with a utilization that is lower than the national (volume-adjusted) utilization.
Technology Adoption 1.20000
1.00000
% of volume
0.80000
Utilization at a rapidly adopting institution #1
0.60000
Utilization at a slowly adopting institution #2 0.40000
∆U1: Difference between utilization at institution #1 relative to local volume adjusted national rate
Current average national utilization rate
0.20000 ∆U2:
0.00000 2001
2002
2003
Current time
Technology Diffusion & Adoption (847) 733-9080 www.sg-2.com
2004
2005
2006
2007
2008
2009
2010
Years
SG-2, LLC 1560 Sherman Avenue Evanston, IL 60201
Overall Technology Adoption Rating A complete technology adoption rate for an entire institution (or a department/service line) within an institution can thus be created which is simply the sum over all relevant technologies of the “differences” (positive or negative) described above.
∑ ∆U
i
techi
%
Adoption Rating
1.20000
Conservative 1.00000
Accelerators
0.80000
0.60000
"50%" mark Early Accelerators
0.40000
0.20000
Initiators 0.00000 2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
The overall rating (relative to a national rating) can then be used to assign the institution into one of four categories: Initiators: Utilize technology typically in the first 10% of overall utilization Early Accelerators: Are in the 10% to 50% group of first utilizers. Accelerators: Are in the 50% to 90% group of utilizers. Conservative: Are in the last 10% of utilizers
Technology Diffusion & Adoption (847) 733-9080 www.sg-2.com
SG-2, LLC 1560 Sherman Avenue Evanston, IL 60201
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