life after the hsif: lessons from diffusion of innovation for sustaining the impact of embeddedness; comment on “early career outcomes of embedded research fellows: an analysis of the health system impact fellowship program”

Kasaai and colleagues examine the career outcomes of alumni from the canadian institutes of health research’s (cihr’s) health system impact fellowship (hsif), which embeds emerging scholars in health system organizations. the study of the 2017-2019 cohort shows all alumni are employed, with 92% working in canada, and highlights their presence in academia, public service, healthcare, and private industry. notably, 37% hold “hybrid” roles, blending academic and other sector work. while the fellowship effectively prepares fellows for impactful careers, the prevalence of hybrid roles raises concerns about sustaining academic partnerships post-fellowship. this commentary explores risks to embedded scholars, such as decentralization, competing innovations, and limited ongoing training, using the diffusion of innovations framework. it suggests strategies like strengthening network connectivity, focusing on high-impact innovations, increasing organizational embeddedness, and maintaining adaptability to ensure the longterm success of embedded scholars and the integration of evidence-based innovations in health systems.