The CPR market may also be uncertain because computer applications are generally not well understood by health care practitioners (Anderson and Jay, 1987). This lack of understanding limits the demand for such products and, as a result, reduces commercial interest in developing new products. Few sources exist to help practitioners learn what a computer technology can do for them, and there is little likelihood such help will be forthcoming in the near future, given the costs associated with producing such resources.
Technological diffusion has been analyzed in greater depth than technological development. Rogers (1987) presents five characteristics of a technology that influence its adoption:
Other factors also affect CPR adoption and use, including the environment of the health care system; leadership; user behavior, education, and training; costs; social and legal issues; and network needs. Major concerns in these areas are briefly noted below.
The U.S. health care system has been characterized as comprising "thousands of relatively autonomous units, centering on large hospitals, which are themselves made up of relatively autonomous divisions and departments" (Lindberg, 1979:215). Maintaining CPRs, however, "imposes requirements for greater coordination among separate ancillary services, particularly with regard to terminology" (McDonald and Tierney, 1988:3438).