Priority setting for technology adoption at a hospital level: Relevant issues from the literature

Facilitating technology adoption in the NHS: negotiating the organisational and policy context – a qualitative study

“…Lettieri and Masella 55 suggest that when a hospital makes a decision about technology adoption it should consider the expected contribution to value generation and the level of sustainability. Considerations related to value generation include effectiveness, patient or family satisfaction, revenue generation, cost containment and gains in image or reputation, and, in the longer term, creating knowledge by developing new services and health-care technologies and building up new communities of knowledge.…”

“…Considerations related to value generation include effectiveness, patient or family satisfaction, revenue generation, cost containment and gains in image or reputation, and, in the longer term, creating knowledge by developing new services and health-care technologies and building up new communities of knowledge. 55 Considerations related to sustainability include the degree of self-funding and ratio of fixed to variable costs (economic sustainability); coherence to strategic goals, technology acceptance among physicians and uncertainty in clinical practice (organisational sustainability); technology life cycle and fit with the existing technology portfolio (technological sustainability); and training intensity and coherence of human and physical resources (resource sustainability). 55 Context sustainability issues of coherence to the legal framework and to generally accepted ethics are unlikely to be relevant where a technology has already been approved by national agencies, but will be crucial if the hospital is involved in the development and testing of an emerging technology.…”

“…55 Considerations related to sustainability include the degree of self-funding and ratio of fixed to variable costs (economic sustainability); coherence to strategic goals, technology acceptance among physicians and uncertainty in clinical practice (organisational sustainability); technology life cycle and fit with the existing technology portfolio (technological sustainability); and training intensity and coherence of human and physical resources (resource sustainability). 55 Context sustainability issues of coherence to the legal framework and to generally accepted ethics are unlikely to be relevant where a technology has already been approved by national agencies, but will be crucial if the hospital is involved in the development and testing of an emerging technology. 55 Ong et al 45 suggest that three types of decision-making models are used in NHS hospitals with regard to investing in new technologies: maximising profit is generally favoured by finance directors and managers; maximising competitive advantage is generally favoured by chief executives, marketing directors, research/teaching hospitals and private hospitals; and maximising utility (health outcomes) is generally favoured by clinicians and patients.…”

“…55 Context sustainability issues of coherence to the legal framework and to generally accepted ethics are unlikely to be relevant where a technology has already been approved by national agencies, but will be crucial if the hospital is involved in the development and testing of an emerging technology. 55 Ong et al 45 suggest that three types of decision-making models are used in NHS hospitals with regard to investing in new technologies: maximising profit is generally favoured by finance directors and managers; maximising competitive advantage is generally favoured by chief executives, marketing directors, research/teaching hospitals and private hospitals; and maximising utility (health outcomes) is generally favoured by clinicians and patients. 45 The types of information that have been considered in business cases prepared in support of new technologies have included efficacy, alternative treatments, training, cost, potential savings, duration of procedure, safety, benefits, numbers affected, length of stay, pre-operative assessment and cost-effectiveness.…”

Uncertainty inclusion in budgeting technology adoption at a hospital level: Evidence from a multiple case study

“…The first contribution is by Lettieri and Masella [19]. The authors carried out an extensive literature review on the factors that influence the success or failure of technology adoption at a hospital level.…”