{"paper":{"title":"The partial adoption trap: Coordination failure, trust, and cultural lock-in in health AI adoption","license":"http://creativecommons.org/licenses/by/4.0/","headline":"Health AI adoption often stabilizes in a partial adoption trap rather than achieving full systemic transformation.","cross_cats":[],"primary_cat":"econ.TH","authors_text":"Ari Ercole","submitted_at":"2026-05-17T11:12:45Z","abstract_excerpt":"Health artificial intelligence (AI) adoption presents a paradox: point-solution tools diffuse readily through clinical populations, yet system-change AI, which carries the greatest potential for pathway-level transformation, consistently stalls at partial adoption. An evolutionary game theoretic model is developed to explain this pattern. Doctors choose among three strategies: genuine adoption, partial adoption, and rejection, where genuine adoption is required for systemic benefits to materialise above a population threshold. The system is shown to be generically bistable, with a stable parti"},"claims":{"count":4,"items":[{"kind":"strongest_claim","text":"The system is shown to be generically bistable, with a stable partial adoption equilibrium coexisting alongside full genuine adoption. The basin of attraction of the partial adoption trap is enlarged by three compounding failure modes: a threshold coordination failure arising from the non-appropriable nature of systemic benefits; a trust failure arising from the organisation's inability to credibly commit to sharing productivity gains; and a cultural failure arising from negative coordination norms among doctors.","source":"verdict.strongest_claim","status":"machine_extracted","claim_id":"C1","attestation":"unclaimed"},{"kind":"weakest_assumption","text":"Genuine adoption is required for systemic benefits to materialise above a population threshold, with doctors choosing among genuine adoption, partial adoption, and rejection under evolutionary dynamics that produce bistability.","source":"verdict.weakest_assumption","status":"machine_extracted","claim_id":"C2","attestation":"unclaimed"},{"kind":"one_line_summary","text":"Evolutionary game theoretic model demonstrates generic bistability in health AI adoption with a stable partial adoption equilibrium enlarged by coordination failure, trust erosion, and negative cultural norms, producing a Value-Adoption Paradox.","source":"verdict.one_line_summary","status":"machine_extracted","claim_id":"C3","attestation":"unclaimed"},{"kind":"headline","text":"Health AI adoption often stabilizes in a partial adoption trap rather than achieving full systemic transformation.","source":"verdict.pith_extraction.headline","status":"machine_extracted","claim_id":"C4","attestation":"unclaimed"}],"snapshot_sha256":"b706df6366a31da759de42b96d2c531fb4fd3a6534431078282bd26ce6dd6a90"},"source":{"id":"2605.17388","kind":"arxiv","version":1},"verdict":{"id":"575fa828-2467-403e-85fd-99eaff53e7e9","model_set":{"reader":"grok-4.3"},"created_at":"2026-05-19T22:37:01.994103Z","strongest_claim":"The system is shown to be generically bistable, with a stable partial adoption equilibrium coexisting alongside full genuine adoption. The basin of attraction of the partial adoption trap is enlarged by three compounding failure modes: a threshold coordination failure arising from the non-appropriable nature of systemic benefits; a trust failure arising from the organisation's inability to credibly commit to sharing productivity gains; and a cultural failure arising from negative coordination norms among doctors.","one_line_summary":"Evolutionary game theoretic model demonstrates generic bistability in health AI adoption with a stable partial adoption equilibrium enlarged by coordination failure, trust erosion, and negative cultural norms, producing a Value-Adoption Paradox.","pipeline_version":"pith-pipeline@v0.9.0","weakest_assumption":"Genuine adoption is required for systemic benefits to materialise above a population threshold, with doctors choosing among genuine adoption, partial adoption, and rejection under evolutionary dynamics that produce bistability.","pith_extraction_headline":"Health AI adoption often stabilizes in a partial adoption trap rather than achieving full systemic transformation."},"integrity":{"clean":true,"summary":{"advisory":0,"critical":0,"by_detector":{},"informational":0},"endpoint":"/pith/2605.17388/integrity.json","findings":[],"available":true,"detectors_run":[{"name":"doi_title_agreement","ran_at":"2026-05-19T23:01:19.660757Z","status":"completed","version":"1.0.0","findings_count":0},{"name":"doi_compliance","ran_at":"2026-05-19T22:42:11.467495Z","status":"completed","version":"1.0.0","findings_count":0},{"name":"claim_evidence","ran_at":"2026-05-19T21:41:57.763351Z","status":"completed","version":"1.0.0","findings_count":0},{"name":"ai_meta_artifact","ran_at":"2026-05-19T21:33:23.703815Z","status":"skipped","version":"1.0.0","findings_count":0}],"snapshot_sha256":"8d897b2acc36da887215aa2eb577d6ce701194785e935fe9809280f3bceb289a"},"references":{"count":16,"sample":[{"doi":"","year":2025,"title":"Fit for the future: the 10-year health plan for England","work_id":"357e9c59-c362-4f4c-8fa1-2afe354b6cf3","ref_index":1,"cited_arxiv_id":"","is_internal_anchor":false},{"doi":"","year":2025,"title":"Adopting ambient scribing products in health and care settings","work_id":"56f8d821-4113-444f-a6d3-9eb88a48f788","ref_index":2,"cited_arxiv_id":"","is_internal_anchor":false},{"doi":"10.1056/nejm198306163082406","year":1983,"title":"Improving drug-therapy decisions through educational outreach","work_id":"576328f2-491f-461f-9352-53bb3e484512","ref_index":3,"cited_arxiv_id":"","is_internal_anchor":false},{"doi":"","year":2006,"title":"The grammar of society: the nature and dynamics of social norms","work_id":"dbab1e9a-b6f8-49b7-8140-a6cf3a68cf98","ref_index":4,"cited_arxiv_id":"","is_internal_anchor":false},{"doi":"10.2196/33046","year":2022,"title":"Workarounds in electronic health record systems and the revised sociotechnical electronic health record workaround analysis framework","work_id":"9f2f1ad6-f4ba-46cf-af50-03dfc5b2978b","ref_index":5,"cited_arxiv_id":"","is_internal_anchor":false}],"resolved_work":16,"snapshot_sha256":"d091a86532b3d2a8317760de043bac1792131a8280a560efb4b21c58ff139088","internal_anchors":0},"formal_canon":{"evidence_count":2,"snapshot_sha256":"af1d6181f427c86b72328caa1f13688bdc606c4e5284ebced7b330068af40696"},"author_claims":{"count":0,"strong_count":0,"snapshot_sha256":"258153158e38e3291e3d48162225fcdb2d5a3ed65a07baac614ab91432fd4f57"},"builder_version":"pith-number-builder-2026-05-17-v1"}