Table 4.

Mapping to the characteristics of an innovation likely to affect its adoption

Characteristic of the innovation (from Rogers (1995) The diffusion of innovations) [19]	Positive findings from this study	Negative findings from this study
Relative advantage (the perceived efficiencies gained by the innovation relative to current tools or procedures)	• Convenience • Empowerment • Confidence • Motivation • Better measurements • Could potentially reduce workloads	• Anxiety/dependence in small numbers of patients • Professional concerns about creating dependency • Concern about workloads
Complexity/ difficulty to learn	• Most patients found telemonitoring easy	• Professional interfaces complex • No clear signals for professionals in COPD data • Lack of intelligent decision support
Compatibility with the pre-existing system	• Preference for adoption within current system which influenced later implementations	• Lack of fit of professional system interfaces with workflows within practices • Concern about roles
Trialability or testability	• High –particularly for patients
Potential for reinvention (using the tool for initially unintended purposes)	• Patients used data to manage day to day activity
Observed effects	• Higher workloads – reduced with learning and external drivers such as pressure on the system. • Patients using data to support self management. • Increased responsibility for the patient in study 7 was acceptable	• Limitations and extra work created by system design • Empowered patients bypassing nurses or therapists, particularly with regard to prescribing