Governing system innovation: assisted living experiments in the UK and Norway

Abstract

Debates on how to address societal challenges have moved to the forefront of academic and policy concerns. Of particular importance is the growing awareness that to deal with issues such as ageing, it will be necessary to implement concerted efforts on technological, social, institutional or political fronts. Drawing on a number of theoretical perspectives-including socio-technical transitions and embedded state theory-the aim of this paper is to identify and understand different approaches to the governance of such system innovations by comparing state responses to assisted living in two contrasting national systems of care, namely that of the UK and Norway. Its findings highlight that state-supported and funded experimentation projects have been instrumental in designing and implementing system innovation: through their emphasis on co-design and co-creation, these projects demonstrated the value of early implementation pilots to explore the 'fit' between novel technologies and prevailing practices and institutional structures in national systems of care. Still, competition, biases or conflicting interests should not be ignored between well-established agents and institutions and experimental solutions whose efficacy remains relatively untested and which involve a combination of new technical, social, organizational and institutional solutions.

User-driven innovation and technology-use in public health and social care: A systematic review of existing evidence

“…In general, UDI in public and private sectors pursue very different objectives. Where the private companies usually apply user-driven approaches to create valueadded products/services for maximizing the profit and enhance the competitive position in the ISSN 2183-0606 http://www.open-jim.org http://creativecommons.org/licenses/by/3.0 market, the public institutions are engaged in UDI aiming at increased welfare and democracy (Waugh et al, 2013;Savory and Fortune, 2015;Paiva et al, 2016;Bugge et al, 2017). Also, the health and social care sector may different from other public sectors, with regard to a wider range of user groups with different interests and a more complex dimensions of user involvement (Rubinelli et al, 2013;Bugge et al, 2017;Gasco, 2017;Pihlainen et al, 2017).…”

“…By focusing on the end-users, health and care recipients and professionals, UDI first unfolds welfare principles, such as empowerment and client self-determination (Humphreys, 2015;Lassen et al, 2015;Angelini et al, 2016); it also facilitates changes of culture of care, and organizational structure where top-down innovation process was dominate (Sugarhood et al, 2014;Wihlman et al, 2014;Luckock et al, 2017;Valaitis et al, 2017). Through involving different intermediate users, UDI brings closer cooperation among different health and social care stakeholders and facilitate the change of existing system for a better solution to addressed revealed challenges (Lindgren, 2013;Purkayastha et al, 2015;Savory and Fortune, 2015;Bugge et al, 2017). However, despite benefits of UDI, many user-driven projects presented via include articles encountered challenges during the operation, and the management of which was not always successful.…”

“…Not all studies (e.g., S5, 6, 9, 11, 14, 17, 20) have detailed information towards this stage although it is crucial to provide an opportunity for users to react and further provide input, and for the further adjustment to the innovation. Presented via S2, a Norwegian UDI conducted its testing via involving 31 municipalities (out of 426 nationally) to generate feedback and further help for the improvement of methodologies and practical tools and service models (Bugge et al, 2017). It is important to mention that the innovation process is not never linear, and often there are loops in which the project circled.…”

“…Usability testing is a most common technique used in UDI to evaluate a prototype by testing it on users. It is a crucial usability practice because it offers direct input from real users who use the system (Bugge et al, 2017). Usability testing focuses on measuring a human-made product's ISSN 2183-0606 http://www.open-jim.org http://creativecommons.org/licenses/by/3.0 capacity to meet its intended purpose.…”

“…Therefore, suggested via included papers (S2, 8, 18), involving those people directly as a participator in WHAT phase of UDI are crucial. Such direct participation helps to explore appropriate technological options and methodologies to users; simultaneously; it can empower end-users by enhancing their technical knowledge and innovation competencies (Bugge et al, 2017;Gasco, 2017). In another word, UDI in health and social care with a technology end goal must apply deliberate methods for experiencing the potentiality of technologies for more significant innovation by co-designers themselves to made possible (Savory and Fortune, 2015).…”