JMIR Publications

ABSTRACT

Clinical technology adoption has been examined through technology-acceptance, diffusion, and implementation frameworks. However, less attention has focused on clinic-based clinicians who may simultaneously be technology users, clinical decision-makers, skilled operators, accountable professionals, and, in some settings, purchasers or owners. We propose the Technology Adoption by Clinic-based Clinicians (TACC) framework, in which adoption emerges from interactions among three domains: Clinician, Clinic, and Technology. TACC advances five propositions: clinicians make decisions as both human decision-makers and professionals; clinics structure decisions through economic, organizational, social, choice, and governance architectures; technology characteristics shape both potential and realized value; these determinants are perceived and valued through behavioral processes; and successful adoption should be judged by appropriate, competent, and sustainable use rather than uptake alone. TACC links these determinants to an adoption continuum, implementation quality, and patient, professional, and economic outcomes. It also supports mechanism-matched behavioral, educational, organizational, economic, and regulatory interventions. By distinguishing appropriate from maximal adoption, TACC recognizes that selective use, non-adoption, and discontinuation may sometimes be appropriate outcomes.