Deployment is just the first step – Adoption takes longer | Working Principles

A little personal story on the difference between deployment (getting something out there) and adoption (getting people to use and value it).

Last Friday morning I awoke feeling a bit strange, and aware of a raised heart rate. I’d only just woken up and being British decided that the best response was to wait a while. We don’t like to make a fuss about nothing, and this was bound to be nothing.

A short while into my wait I remembered that my new Apple Watch had an ECG App on it and wondered whether now was the time to give it a go. I clicked on the App and watched as it showed a trace of peeks and troughs which I assumed corresponded to what my heart was doing. Some 30 seconds later the App popped up to tell me that my heart wasn’t behaving quite as you might expect. Still being British I decided to sit a while longer because this still wasn’t worth making a fuss.

Having waited a little longer (well, an hour) everything settled down and it was time to get on with the rest of my day.

A couple of days later I decided that perhaps I should put my Britishness to one side and do as the ECG App had instructed me, which was to contact a doctor, or, more specifically I decided to contact the reception at my General Practitioner. I wasn’t sure quite how I was going to describe the events from the previous Friday, I still didn’t want a fuss, and I certainly didn’t want an ambulance needlessly turning up at my door. In the end I decided to start with what my Apple Watch had told me. I then described it again in a slightly different way because this was clearly something a bit unusual. The lovely, now confused, receptionist put me on hold while she went to speak to someone. A few minutes later she came back with a plan, she would send me a link where I could describe (again) what had happened and post some pictures from the App, they would then assess the information and get back to me.

I dutifully did as requested and awaited a phone call, which came a couple of hours later. The next phase of the plan was for me to go in to see a Nurse Practitioner, which I dutifully did.

The Nurse Practitioner was lovely, she asked me to describe the situation, again, which I did by showing here the ECG traces on my phone. She never really engaged with Apple Watch App data preferring instead, as I was expecting, to listen to my chest, take my pulse and check my blood oxygen. These were all normal, as I had expected they would be. The data on my phone was irrelevant to the conversation because, as the Nurse Practitioner said, she had no knowledge of whether the App was accurate or not. The deployment of the ECG App may have given me some value, but it wasn’t going to be able to give any value from this point on.

I have no idea what it takes for a diagnostic device to become adopted by the professionals of the NHS, but it was clear that this hadn’t happened for the Apple Watch ECG App, even though from what I can tell the data it produces is highly accurate – over 98%. I may have deployed a highly accurate piece of technology, but it hadn’t been adopted by the broader system. The broader system needed to carry on doing what it had always done. I’m sure this will change but it’s going to take time, it wasn’t that long ago that medical professionals didn’t trust the widely available electronic blood pressure machines, now they use them as their default tool.

The conclusion of the visit to the Nurse Practitioner was – more tests.

I little while ago I wrote about how long it was taking us to adopt our newly deployed kitchen – a similar challenge of deployment v adoption.

There are hundreds and thousands of technical solutions that have been deployed in businesses across the world with little or no adoption. There are plenty of piece of technology in our homes that sit dormant in cupboards awaiting their transition to the local recycling facility, eBay, Facebook Marketplace or equivalent. How many Apps sit unused on our smartphones? Most of these had a plan for deployment, but only a limited plan for adoption. One of the problems is that deployment is easy to measure, adoption is subtler less tangible, and often takes far longer than you think.

Businesses use a famous misquote from the 1989 film “Field of Dreams” – “If you build it, they will come.” You do need to build something for people to come, but even if they do come it doesn’t mean that they will hang around and enjoy the stay. Adoption isn’t the natural outcome of deployment.

As a maker of things, the objective isn’t to have the things deployed it’s to see them provide value, to see them used. We need to look beyond the first step of deployment and accept that the long journey of adoption is where the value is.

Header Image: This is York Minster on a lovely day of wandering around ancient streets filled with American tourists marvelling at a pub that was nearly 400 years old and spending vast amounts of money on Harry Potter merchandise.