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Purpose – The aim of this paper is to examine the diffusion of a new surgical procedure with lower per-case cost and how its diffusion path is affected by the simultaneous introduction of a new drug class that may be an effective treatment to prevent surgery. In particular, we examine whether a process of technology substitution exists that influences the diffusion process of the surgical technology. Given their different cost implications, the interaction of these two different technologies, surgery and drug intervention, is relevant from the perspective of health expenditure. This is of particular interest in health care as technology adoption and diffusion has been cited as a major driver of expenditure growth. Such expenditure growth has been increasingly targeted through the use of market-orientated policy tools aimed at increasing efficiency. Our research is thus addressing the question of how economic incentives influence the diffusion process and we discuss the impact of a set of incentives on hospital behavior.

Design/methodology – Hospital admission data for the financial years 1998/1999 to 2007/2008 in England are used to empirically test the contribution of prescription uptake and market-oriented reforms. Dynamic panel data models are used to capture any changes in technology preference during the period of study.

Findings – Our results suggest that the hospital sector exhibits a strong new technology preference, tempered by the interaction of competition for patients and the ability of the primary care sector to substitute treatments.

Value/originality – Given the current fast technological change, we examine the technological race occurring in the health care sector. We account simultaneously for the diffusion of different technologies not only within the same typology but also with technologies of a different class.

Information and communications technology (ICT) offers enormous opportunities for individuals, businesses and society. The application of ICT is equally important to economic and non-economic activities. Researchers have increasingly focused on the adoption and use of ICT by small and medium enterprises (SMEs) as the economic development of a country is largely dependent on them. Following the success of ICT utilisation in SMEs in developed countries, many developing countries are looking to utilise the potential of the technology to develop SMEs. Past studies have shown that the contribution of ICT to the performance of SMEs is not clear and certain. Thus, it is crucial to determine the effectiveness of ICT in generating firm performance since this has implications for SMEs’ expenditure on the technology. This research examines the diffusion of ICT among SMEs with respect to the typical stages from innovation adoption to post-adoption, by analysing the actual usage of ICT and value creation. The mediating effects of integration and utilisation on SME performance are also studied. Grounded in the innovation diffusion literature, institutional theory and resource-based theory, this study has developed a comprehensive integrated research model focused on the research objectives. Following a positivist research paradigm, this study employs a mixed-method research approach. A preliminary conceptual framework is developed through an extensive literature review and is refined by results from an in-depth field study. During the field study, a total of 11 SME owners or decision-makers were interviewed. The recorded interviews were transcribed and analysed using NVivo 10 to refine the model to develop the research hypotheses. The final research model is composed of 30 first-order and five higher-order constructs which involve both reflective and formative measures. Partial least squares-based structural equation modelling (PLS-SEM) is employed to test the theoretical model with a cross-sectional data set of 282 SMEs in Bangladesh. Survey data were collected using a structured questionnaire issued to SMEs selected by applying a stratified random sampling technique. The structural equation modelling utilises a two-step procedure of data analysis. Prior to estimating the structural model, the measurement model is examined for construct validity of the study variables (i.e. convergent and discriminant validity).

The estimates show cognitive evaluation as an important antecedent for expectation which is shaped primarily by the entrepreneurs’ beliefs (perception) and also influenced by the owners’ innovativeness and culture. Culture further influences expectation. The study finds that facilitating condition, environmental pressure and country readiness are important antecedents of expectation and ICT use. The results also reveal that integration and the degree of ICT utilisation significantly affect SMEs’ performance. Surprisingly, the findings do not reveal any significant impact of ICT usage on performance which apparently suggests the possibility of the ICT productivity paradox. However, the analysis finally proves the non-existence of the paradox by demonstrating the mediating role of ICT integration and degree of utilisation explain the influence of information technology (IT) usage on firm performance which is consistent with the resource-based theory. The results suggest that the use of ICT can enhance SMEs’ performance if the technology is integrated and properly utilised. SME owners or managers, interested stakeholders and policy makers may follow the study’s outcomes and focus on ICT integration and degree of utilisation with a view to attaining superior organisational performance.

This study urges concerned business enterprises and government to look at the environmental and cultural factors with a view to achieving ICT usage success in terms of enhanced firm performance. In particular, improving organisational practices and procedures by eliminating the traditional power distance inside organisations and implementing necessary rules and regulations are important actions for managing environmental and cultural uncertainties. The application of a Bengali user interface may help to ensure the productivity of ICT use by SMEs in Bangladesh. Establishing a favourable national technology infrastructure and legal environment may contribute positively to improving the overall situation. This study also suggests some changes and modifications in the country’s existing policies and strategies. The government and policy makers should undertake mass promotional programs to disseminate information about the various uses of computers and their contribution in developing better organisational performance. Organising specialised training programs for SME capacity building may succeed in attaining the motivation for SMEs to use ICT. Ensuring easy access to the technology by providing loans, grants and subsidies is important. Various stakeholders, partners and related organisations should come forward to support government policies and priorities in order to ensure the productive use of ICT among SMEs which finally will help to foster Bangladesh’s economic development.

Much attention has been given to adoption and diffusion, defined as the degree of market penetration, of Information and Communications Technologies (ICT) in recent years (Carter, Jambulingam, Gupta, & Melone, 2001; Kiiski & Pohjola, 2002; Milner, 2003; Benhabib & Spiegel, 2005). The theory of diffusion of innovations considers how a new idea spreads throughout the market over time. The ability to accurately predict new product diffusion is of concern to designers, marketers, managers, and researchers alike. However, although the diffusion process of new products is generally accepted as following an s-curve pattern, where diffusion starts slowly, grows exponentially, peaks, and then declines (as shown in Fig. 1), there is considerable disagreement about what factors affect diffusion and how to measure diffusion rates (Bagchi, Kirs, & Lopez, 2008).

The paper extends the organizational learning framework: Structural-Functional (SF)-single-loop or Conflictual-Radical (CR)-double-loop learning to the management accounting literature. The sociological approach of organizational learning is utilized to understand those contingent factors that can explain why management accounting innovations succeed or fail in organizations.

We view learning as enhancing an organization’s strategic competitive advantage by making it better able to adopt and diffuse innovation in respond to changes in its environment in order to manage improved performance. The success of management accounting innovations is contingent upon whether its learning process involves SF-single-loop or CR-double-loop learning to adopt and diffuse process innovation.

The paper suggests that the learning strategy that the organization chooses is the reason why some management accounting innovations are more successfully adopted than others and why some innovations are easily diffused in some organizations but not in others. We propose that the sociological approaches to learning provide an alternative framework with which to better understand the adoption and diffusion of process innovations in management accounting systems.

It has become evident that management accounting researchers need to pay particular attention to an organization’s approach to adoption and diffusion of innovation strategies, particularly when they are designing and implementing process innovation programs for an organization. According to Schulz (2001), there are two interrelated stages of the learning that can shape the outcome of the innovation process in an organization. The first stage is related to the acquisition/production (adoption) of knowledge that results in gathering information, codification, and exploration. This is followed by the second stage which is the distribution or dissemination (diffusion) processes. When these two stages – adoption and diffusion – are applied within an accounting context, they address issues that are commonly associated with the successes and/or failures of management accounting innovations.

Although innovation involves learning, the nature of the learning process does not completely describe the manner in which an innovation affects the organization. Accordingly, we suggest that the two interrelated organizational sociological dimensions of innovations processes, namely, (1) the adoption and diffusion theories of Rogers (1971 and 1995), to approach organizational learning, and (2) the SF (single loop) and CR (double loop) approaches to learning be used simultaneously to describe management accounting innovations.

When an innovation is implemented, it initially can be introduced as an incremental change, one that can be limited in both in its scope and its breadth of administrative changes. This means that situations which are most likely to benefit from its initiation can serve as the prototype for its adoption by the organization. If successful, this can be followed by systemic accounting innovations to instituting broader administrative changes within the existing accounting reporting and control systems.

This chapter considers the role of technology transfer intermediaries (TTIs) in the processes of innovation in networks involving universities, research and development centres, and business firms from an international perspective. A diversity of types of TTIs is recognised in terms of their particular interests in the operation of innovation processes and the conditions they impose in transactions involving intellectual property. It will identify the various objectives of sponsoring stakeholders as differentiating the missions and accountabilities and, in turn, determining the focus and roles of different types of TTIs and the interactions and networking between them, both formal and informal.

In discussion, the chapter will propose that the significance of systemic influence on the processes of technology transfer and innovation should be researched at two levels. At the micro-level of personal interactions, examining how systemic influences shape tacit knowledge transfer between and learning by individuals engaged in research and innovation processes. Second, at the level of national cultures, examining the ways in which the cultural context institutionalises patterns of innovation and technology transfer networking.

Smart card-based E-payment systems are receiving increasing attention as the number of implementations is witnessed on the rise globally. Understanding of user adoption behavior of E-payment systems that employ smart card technology becomes a research area that is of particular value and interest to both IS researchers and professionals. However, research interest focuses mostly on why a smart card-based E-payment system results in a failure or how the system could have grown into a success. This signals the fact that researchers have not had much opportunity to critically review a smart card-based E-payment system that has gained wide support and overcome the hurdle of critical mass adoption. The Octopus in Hong Kong has provided a rare opportunity for investigating smart card-based E-payment system because of its unprecedented success. This research seeks to thoroughly analyze the Octopus from technology adoption behavior perspectives.

Cultural impacts on adoption behavior are one of the key areas that this research posits to investigate. Since the present research is conducted in Hong Kong where a majority of population is Chinese ethnicity and yet is westernized in a number of aspects, assuming that users in Hong Kong are characterized by eastern or western culture is less useful. Explicit cultural characteristics at individual level are tapped into here instead of applying generalization of cultural beliefs to users to more accurately reflect cultural bias. In this vein, the technology acceptance model (TAM) is adapted, extended, and tested for its applicability cross-culturally in Hong Kong on the Octopus. Four cultural dimensions developed by Hofstede are included in this study, namely uncertainty avoidance, masculinity, individualism, and Confucian Dynamism (long-term orientation), to explore their influence on usage behavior through the mediation of perceived usefulness.

TAM is also integrated with the innovation diffusion theory (IDT) to borrow two constructs in relation to innovative characteristics, namely relative advantage and compatibility, in order to enhance the explanatory power of the proposed research model. Besides, the normative accountability of the research model is strengthened by embracing two social influences, namely subjective norm and image. As the last antecedent to perceived usefulness, prior experience serves to bring in the time variation factor to allow level of prior experience to exert both direct and moderating effects on perceived usefulness.

The resulting research model is analyzed by partial least squares (PLS)-based Structural Equation Modeling (SEM) approach. The research findings reveal that all cultural dimensions demonstrate direct effect on perceived usefulness though the influence of uncertainty avoidance is found marginally significant. Other constructs on innovative characteristics and social influences are validated to be significant as hypothesized. Prior experience does indeed significantly moderate the two influences that perceived usefulness receives from relative advantage and compatibility, respectively. The research model has demonstrated convincing explanatory power and so may be employed for further studies in other contexts. In particular, cultural effects play a key role in contributing to the uniqueness of the model, enabling it to be an effective tool to help critically understand increasingly internationalized IS system development and implementation efforts. This research also suggests several practical implications in view of the findings that could better inform managerial decisions for designing, implementing, or promoting smart card-based E-payment system.

Citizens are substantial stakeholders in every e-government system, thus their willingness to use and ability to access the system are critical. Unequal access and information and communication technology usage, which is known as digital divide, however has been identified as one of the major obstacles to the implementation of e-government system. As digital divide inhibits citizen’s acceptance to e-government, it should be overcome despite the lack of deep theoretical understanding on this issue. This research aimed to investigate the digital divide and its direct impact on e-government system success of local governments in Indonesia as well as indirect impact through the mediation role of trust. In order to get a comprehensive understanding of digital divide, this study introduced a new type of digital divide, the innovativeness divide.

The research problems were approached by applying two-stage sequential mixed method research approach comprising of both qualitative and quantitative studies. In the first phase, an initial research model was proposed based on a literature review. Semi-structured interview with 12 users of e-government systems was then conducted to explore and enhance this initial research model. Data collected in this phase were analyzed with a two-stage content analysis approach and the initial model was then amended based on the findings. As a result, a comprehensive research model with 16 hypotheses was proposed for examination in the second phase.

In the second phase, quantitative method was applied. A questionnaire was developed based on findings in the first phase. A pilot study was conducted to refine the questionnaire, which was then distributed in a national survey resulting in 237 useable responses. Data collected in this phase were analyzed using Partial Least Square based Structural Equation Modeling.

The results of quantitative analysis confirmed 13 hypotheses. All direct influences of the variables of digital divide on e-government system success were supported. The mediating effects of trust in e-government in the relationship between capability divide and e-government system success as well as in the relationship between innovativeness divide and e-government system success were supported, but was rejected in the relationship between access divide and e-government system success. Furthermore, the results supported the moderating effects of demographic variables of age, residential place, and education.

This research has both theoretical and practical contributions. The study contributes to the developments of literature on digital divide and e-government by providing a more comprehensive framework, and also to the implementation of e-government by local governments and the improvement of e-government Readiness Index of Indonesia.

Additive manufacturing (AM) has the potential to transform the organisation of all the activities carried out by firms. The growing diffusion of these technologies is increasingly challenging multinational enterprises to reinvent their businesses. Accordingly, many scholars argue that AM may reduce countries’ participation in global value chains (GVCs) or, at least, affect GVCs’ geography, length and further developments. However, so far, the lack of available data on the real worldwide diffusion of these technologies has precluded the possibility to study this phenomenon from an empirical standpoint.

This study investigates AM technologies, with a particular focus on their possible impact on GVCs, in the framework of the current debate in international business. In order to examine this relationship and overcome the lack of adoption data, the authors identify a potential proxy of AM diffusion – that is, patenting activity. Coherently, the authors employ this proxy and a country-level measure of GVC participation (i.e., the Share of Re-Exported Inputs on Total Imported Inputs) to empirically investigate the role of AM in influencing countries’ participation to GVCs. This country-level analysis is focussed on three specific industries and the aggregate economy in 58 countries for the period 2000–2014.

The results show that AM decreases a country’s participation in GVCs, both at the country level and, in particular, in the sectors which are more likely to be affected by AM technologies. This evidence suggests that this phenomenon might be induced by a decreasing reliance on intermediates processed abroad, hence an increasing importance of domestic goods, manufactured via AM.

The U.S. healthcare system is very complex and inundated with many challenges, ranging from escalating healthcare expenditure to increasing prevalence of medication errors. Emphasis on cost reduction and prevention of medication errors has given impetus to the development of computerized information technologies. Advanced technological innovation such as e-prescribing has the potential to improve quality of care, reduce costs and enhance patient satisfaction. Reaping these benefits is dependent on successful diffusion of innovation. This chapter summarizes the current literature covering diffusion of e-prescribing technology with an emphasis on the barriers and facilitators, and strategies to overcome these potential barriers.