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© 2019 The authors and IOS Press. Technologies are often viewed as the route to better, safer and more efficient care, but technology projects rarely deliver all the benefits expected of them. Based on a literature review and empirical case studies, we developed a framework (NASSS) for studying the non-adoption, abandonment and challenges to scale-up, spread and sustainability of technology-supported change efforts in health and social care. Such projects meet problems usually because they are too complex - and because the complexity is sub-optimally handled. NASSS consists of six domains - the illness or condition, the technology, the value proposition, the individuals intended to adopt the technology, the organisation(s) and the wider system - along with a seventh domain that considers how all these evolve over time. The NASSS framework incorporates a number of other theories and analytic approaches described elsewhere in this book. It is not intended to offer a predictive or formulaic solution to technology adoption. Rather, NASSS should be used to generate a rich and situated narrative of the multiple influences on a complex project; to identify parts of the project where complexity might be reduced; and to consider how individuals and organisations might be supported to handle the remaining complexities better.

Original publication




Journal article


Studies in Health Technology and Informatics

Publication Date





193 - 204