The healthcare sector operates within a rapidly evolving technological landscape, where promising MedTech innovations are advancing at a rapid pace. Hospitals represent the main access point of these innovations, making it essential for them to identify emerging technologies through Technology Scanning and assess their value through Technology Assessment. However, hospitals’ professionals often face a lack of clear direction when it comes to developing scanning and assessment processes that align with their strategic goals. The first Research Objective of this Thesis, which consists of a collection of five papers, addresses this gap by understanding the challenges related to these practices and integrating them into a coherent hospital technology strategy framework. Paper 1, through expert elicitation, analyzes the current practices and limitations of these processes and highlights the related open issues. In order to contribute to both theory and practice, Paper 2 formulates three conceptual frameworks that describe how Technology Scanning, Technology Assessment and their integration vary according to hospitals' strategic orientations. The focus of the Thesis then shifts specifically to the assessment of MedTech innovations by hospitals, as Technology Assessment requires a more in- depth exploration due to its critical role in determining the adoption of new technologies, for which guidelines are currently lacking. This is done through two practical assessments in Paper 3 and Paper 4. Paper 3 reflects the current practice of Technology Assessment in hospitals, providing guidelines for assessing MedTech innovations with substantial evidence, focusing on a limited set of criteria and stakeholders. Paper 4, instead, holds a reference model for assessing technologies with low level of evidence and considering a broader spectrum of actors, including environmental impact. Building on these insights, Paper 5 presents an overarching framework of criteria that hospitals should consider when evaluating the value generated and captured from the introduction of MedTech innovations. This Paper reinterprets the existing literature on Technology Assessment in hospitals through the lens of the Value-Based Health Care paradigm, offering harmonized guidelines for the assessment of MedTech innovations in the hospital setting. The main theoretical contribution of this Thesis lies in the development of theoretical frameworks for the stages of the decision-making process associated with MedTech innovation in hospitals. Moreover, it is the first research to integrate Technology Scanning and Technology Assessment, emphasizing the interrelationship between these processes. From a practical perspective, this Thesis offers actionable insights into the management of Technology Scanning and Assessment, highlighting the criteria that hospitals should prioritize to generate and capture value from the introduction of novel MedTech innovations. As this Thesis is mainly based on qualitative studies, future research could further explore the topic also through quantitative methods, in order to validate and increase the robustness of the findings.
Il settore sanitario opera in un panorama tecnologico in rapida evoluzione, in cui le promettenti innovazioni MedTech avanzano a un ritmo sostenuto. Gli ospedali rappresentano il principale punto di accesso a queste innovazioni, rendendo essenziale per loro l’identificazione delle tecnologie emergenti attraverso il Technology Scanning e la valutazione del loro valore tramite il Technology Assessment. Tuttavia, i professionisti ospedalieri si trovano spesso a dover affrontare una mancanza di orientamento chiaro nello sviluppo di processi di Technology Scanning e Technology Assessment che siano allineati ai loro obiettivi strategici. Il primo obiettivo di ricerca di questa tesi, che consiste in una raccolta di cinque articoli, affronta questa lacuna analizzando le sfide associate a tali pratiche e integrandole in un quadro strategico coerente per la gestione delle tecnologie negli ospedali. L’Articolo 1, attraverso il parere di esperti, esamina le pratiche attuali e le limitazioni di questi processi, evidenziando le problematiche aperte. Al fine di contribuire sia alla teoria che alla pratica, l’Articolo 2 sviluppa tre framework concettuali che descrivono come il Technology Scanning, il Technology Assessment e la loro integrazione variano in base ai diversi orientamenti strategici degli ospedali. Il focus della tesi si sposta poi specificamente sulla valutazione delle innovazioni MedTech negli ospedali, poiché il Technology Assessment richiede un’analisi più approfondita a causa del suo ruolo cruciale nel determinare l’adozione delle nuove tecnologie, per cui attualmente mancano linee guida. Questo aspetto viene affrontato attraverso due valutazioni pratiche negli Articoli 3 e 4. L’Articolo 3 riflette le pratiche attuali di Technology Assessment negli ospedali, fornendo linee guida per la valutazione delle innovazioni MedTech con un solido supporto empirico, focalizzandosi su un limitato numero di criteri e stakeholder. L’Articolo 4, invece, propone un modello di riferimento per la valutazione di tecnologie caratterizzate da un basso livello di evidenza, considerando un più ampio spettro di attori, incluso l’impatto ambientale. Sulla base di questi risultati, l’Articolo 5 presenta un quadro complessivo dei criteri che gli ospedali dovrebbero considerare nella valutazione del valore generato e catturato dall’introduzione delle innovazioni MedTech. Questo articolo rielabora la letteratura esistente sul Technology Assessment negli ospedali attraverso la lente della Value-Based Health Care, offrendo linee guida per la valutazione delle innovazioni MedTech nel contesto ospedaliero. Il principale contributo teorico di questa tesi sta nello sviluppo di framework teorici per le fasi del processo decisionale riguardo l’innovazione MedTech negli ospedali. Inoltre, rappresenta il primo studio che integra il Technology Scanning e il Technology Assessment, enfatizzando l’interrelazione tra questi processi. Dal punto di vista pratico, questa tesi fornisce indicazioni operative per la gestione del Technology Scanning e del Technology Assessment, evidenziando i criteri che gli ospedali dovrebbero prioritizzare per generare e catturare valore dall’introduzione di nuove innovazioni MedTech. Poiché la tesi si basa principalmente su studi qualitativi, future ricerche potrebbero esplorare ulteriormente l’argomento anche attraverso metodi quantitativi, al fine di validare e rafforzare la solidità dei risultati.
MedTech innovation in hospitals: re-framing the integration between scanning and assessment and the determinants of value
Pinelli, Maria
2024/2025
Abstract
The healthcare sector operates within a rapidly evolving technological landscape, where promising MedTech innovations are advancing at a rapid pace. Hospitals represent the main access point of these innovations, making it essential for them to identify emerging technologies through Technology Scanning and assess their value through Technology Assessment. However, hospitals’ professionals often face a lack of clear direction when it comes to developing scanning and assessment processes that align with their strategic goals. The first Research Objective of this Thesis, which consists of a collection of five papers, addresses this gap by understanding the challenges related to these practices and integrating them into a coherent hospital technology strategy framework. Paper 1, through expert elicitation, analyzes the current practices and limitations of these processes and highlights the related open issues. In order to contribute to both theory and practice, Paper 2 formulates three conceptual frameworks that describe how Technology Scanning, Technology Assessment and their integration vary according to hospitals' strategic orientations. The focus of the Thesis then shifts specifically to the assessment of MedTech innovations by hospitals, as Technology Assessment requires a more in- depth exploration due to its critical role in determining the adoption of new technologies, for which guidelines are currently lacking. This is done through two practical assessments in Paper 3 and Paper 4. Paper 3 reflects the current practice of Technology Assessment in hospitals, providing guidelines for assessing MedTech innovations with substantial evidence, focusing on a limited set of criteria and stakeholders. Paper 4, instead, holds a reference model for assessing technologies with low level of evidence and considering a broader spectrum of actors, including environmental impact. Building on these insights, Paper 5 presents an overarching framework of criteria that hospitals should consider when evaluating the value generated and captured from the introduction of MedTech innovations. This Paper reinterprets the existing literature on Technology Assessment in hospitals through the lens of the Value-Based Health Care paradigm, offering harmonized guidelines for the assessment of MedTech innovations in the hospital setting. The main theoretical contribution of this Thesis lies in the development of theoretical frameworks for the stages of the decision-making process associated with MedTech innovation in hospitals. Moreover, it is the first research to integrate Technology Scanning and Technology Assessment, emphasizing the interrelationship between these processes. From a practical perspective, this Thesis offers actionable insights into the management of Technology Scanning and Assessment, highlighting the criteria that hospitals should prioritize to generate and capture value from the introduction of novel MedTech innovations. As this Thesis is mainly based on qualitative studies, future research could further explore the topic also through quantitative methods, in order to validate and increase the robustness of the findings.| File | Dimensione | Formato | |
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https://hdl.handle.net/10589/237277