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Introduction 59Early Early LateInnovators Adopters Majority Majority Laggards2.5% 13.5% 34% 34% 16%Early INNOVATIVENESS Late(based on time of adoption)FIGURE III.1. Everett Rogers’ innovativeness/adopter categories. The relative earliness or latenessthat an individual adopts an innovation relative to other members of the social system.4. Make early adopter activity observable.5. Trust and enable reinvention (changes must be adapted locally to work).6. Create slack for change.7. Lead by example.What Does Success Mean for Healthcare IT Implementations?It is often not difficult to tell when an IT project has failed and even to assign one ormore causes that led to this failure. Failure may result for a number of reasons: technicalshortcomings; lack of specific technology competencies; vendor shortcomings;problems with so-called legacy systems; project management shortcomings; inappropriatescope, timeline, or budget; and organizational shortcomings. 10 However, it maybe much harder to understand when a project has succeeded and to understand thefactors that led to that success. Success can be viewed from a project management perspective:Was the project completed on time, within budget, and to technical specifications?Perhaps, more importantly, success can be viewed from a customer (or user)perspective. Lorenzi and Riley 10 have suggested that a project can be considered successfulif it meets the perceived needs of more than 90 percent of end users viewedrandomly. This definition reinforces principles introduced earlier in this introduction,namely, that perception of an innovation (how it meets needs) is integral to its adoptionand that a broad range of users, not just innovators and early adopters, mustsee benefit in the innovation for it to be considered successful. Ideally, from animplementation perspective, the project management and customer perspectives arecompatible and both have been taken into account. There are clearly defined responsibilitiesand accountability, realistic objectives, and significant emotional commitmentto or ownership of these objectives on the part of all significant parties, as well as specificrealistic definitions of project success and mechanisms for feedback and problemsolving. Thus, in analyzing the cases in this section, suggested questions for study anddiscussion are: What is the definition of success for this system? How will the projectteam be able to tell if they have succeeded?