This final article in the innovation and adoption series explores a real-world example of a device struggling with market acceptance.
Smart inhalers fall into two categories: clip-on devices that attach to a primary inhaler, and integrated models where the sensors are built into the inhaler itself.
Smart inhalers are often presented as a breakthrough in managing chronic respiratory conditions such as asthma and COPD. These devices promise to improve medication adherence, reduce hospitalizations, and empower patients and healthcare professionals with real-time insights.
However, despite growing clinical evidence and enthusiastic media coverage, smart inhalers have not achieved widespread adoption and remain a niche technology.
Let’s explore why—through the lens of Everett Rogers’ five key factors for innovation diffusion.
Relative Advantage
While effective inhaler medications are available, nearly half of all asthma patients fail to achieve satisfactory control. One of the main reasons for inadequate asthma management is poor adherence to traditional inhalers.
Smart inhalers offer clear benefits: tracking usage by time, date, and location; sending reminders; and sharing data with healthcare providers. Several clinical trials have shown that smart inhaler reminders significantly improve drug compliance compared to standard care.
Yet for many clinicians and patients, the relative advantage in daily practice is not compelling enough.
Traditional inhalers, when used correctly, are already effective, and the added technology is often perceived as a nice-to-have rather than a must-have. Moreover, some patients dislike the constant and visible confrontation with their disease, and do not view it as a benefit.
Finally, the advantage is frequently framed in terms of data rather than outcomes. Patients and healthcare professionals want fewer attacks in routine clinical practice—not more charts and metrics.
Adoption depends on perceived improvements in clinical outcomes, not technical novelty. The advantage must deliver real-world impact, not just features.
Compatibility
Smart inhalers require patients to pair devices with a specific app, charge batteries, and manage data. These steps can disrupt well-established routines, and not all patients are ready for this shift.
For clinicians, integrating inhaler data into existing electronic health record systems can be cumbersome, and many lack clear protocols for acting on the data.
Additionally, patients and healthcare professionals need reassurance about data ownership, privacy, and security. Knowing who has access to the data—and that it is properly protected—is essential.
In some markets, privacy concerns and limited digital literacy further reduce compatibility with user expectations and normal workflows.
Since patients may use more than one inhaler, and smart inhalers are often incompatible across systems, this creates a significant barrier to adoption.
In real-world settings, smart inhalers are mainly prescribed to niche patient groups who are motivated and capable of using them effectively.
Seamless integration with daily habits and clinical systems is essential to increase adoption. Innovation must fit—rather than force—change.
Complexity
Although marketed as user-friendly, smart inhalers introduce a level of complexity compared to traditional solutions that many patients find overwhelming.
Setting up the app, syncing Bluetooth, and interpreting unclear data can create friction. For older patients, those with limited tech experience, or individuals with well-controlled conditions, the device may feel more like a barrier than a solution.
Simplicity drives adoption. In healthcare, complexity can erode trust and usability.
Trialability
Most smart inhalers were launched through pilot programs or select partnerships, with limited availability in standard distribution channels.
High upfront costs and lack of reimbursement have made trialability difficult for both patients and healthcare professionals. Without a low-risk way to test the device, many opt to stick with traditional options.
Trialability lowers the barrier to entry. Free trials, demos, and reimbursement pathways can accelerate adoption.
Observability
Unlike wearables that display heart rate or step count, smart inhalers offer benefits that are less immediately observable.
Improved adherence or fewer exacerbations are medium- to long-term outcomes—not instantly visible wins. Patients rarely “feel” the difference in daily use, and clinicians struggle to showcase success stories.
Make benefits visible. Observability builds momentum through validation and tangible results.
Final Thoughts
Smart inhalers exemplify how even clinically sound, well-funded innovations can struggle without strategic alignment to adoption drivers.
Rogers’ five factors—Relative Advantage, Compatibility, Complexity, Trialability, and Observability—remain essential for any medical marketer or product manager.
If you’re launching a new device, ask yourself: Does it solve a real problem in a way users can feel? Can it fit into existing processes and routines without disruption? Is it easy to try, understand, and share?
Let me know what you think about this example of applying Rogers’ five factors. If there’s anything else you’d like me to cover in this blog, feel free to contact me on LinkedIn—and don’t forget to subscribe.