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				 January 5, 2014  
I just received the above.   All of SETMA can be proud.   The note stated, “Larry, I always  enjoyed reading your articles.  We have launched an Innovation Zone in our  medical community and SETMA serves as a wonderful example for us."   The subject line on the e-mail stated, "thank you for  the  comprehensive information on SETMA's website." 
Todd Rowland MD 
  CEO 
  HealthLINC HIE 
  Bloomington, Indiana 47402 
http://healthinnovators.blogspot.com/2014/01/innovation-diffusion-of-ideas-and.html 
Innovation, Diffusion of Ideas, and the  Medical Home
“Early in my  medical school education, I heard about the “science to  service gap”, i.e. " it takes 13 years for  proven medical improvements to become mainstream." But after 20 years of  clinical practice and 17 years of work with informatics,  I consider it a truism. 
   
  During my medical informatics work, it has become more than a curiosity as to  why the “science to service gap” exists. About 5 years ago, I discovered a  series of books that explain the Diffusion of Innovations by Everett Rogers  who was a professor of communications. It helped me to understand that there is  a natural variation, a bell curve of sorts, for how any group adopts  innovation. Since negative news travels fastest, physicians often get a bad rap  when it comes to adopting health information technology (HIT) due to the  vocal nature of what Rogers called  "laggards." That is a complex topic for posts in the future. I would  encourage anyone interested in innovation to read Rogers 2003 5th edition of Diffusion of Innovations as it includes many lessons learned during the 40 year period following his 1st  edition in 1962. 
   
  I recently re-visited a web site which comprehensively documents the  19-year journey of a medical home practice that was  formed in 1995, called SETMA. The link to  the SETMA site is a great example of how diffusion of innovation can happen  within an organization with visionary leadership. I had the pleasure of meeting  Larry Holly, MD, the founder of SETMA and I would encourage anyone interested  in how to create a cultural framework for innovation to read his web site,  which is beyond comprehensive in its depth  and breadth of information shared. (emphasis added)  
   
  Believe it or not, in 2013,the medical home is still being questioned as  a valid approach.  So perhaps the “science to service gap” for team work,  process improvement, and user-centered design in health care is a bit longer  than 13 years. I am encouraged by the work being done in both my local medical  community as well as at the national level -- American health care really needs the medical home innovations more than  ever.” 
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