[Adoption of new technologies by health services: the challenge of analyzing relevant factors].

The exponential increase in the incorporation of health technologies has been considered a key factor in increased expenditures by the health sector. Such decisions involve multiple levels and stakeholders. Decentralization has multiplied the decision-making levels, with numerous difficult choices and limited resources. The interrelationship between stakeholders is complex, in creative systems with multiple determinants and confounders. The current review discusses the interaction between the factors influencing the decisions to incorporate technologies by health services, and proposes a structure for their analysis. The application and intensity of these factors in decision-making and the incorporation of products and programs by health services shapes the installed capacity of local and regional networks and modifies the health system. Empirical observation of decision-making and technology incorporation in Brazilian health services poses an important challenge. The structured recognition and measurement of these variables can assist proactive planning of health services.

[1]  Louise Locock,et al.  Evidence-based medicine and organisational change: an overview of some recent qualitative research , 2001 .

[2]  Mihail C Roco,et al.  Science and Technology Integration for Increased Human Potential and Societal Outcomes , 2004, Annals of the New York Academy of Sciences.

[3]  A. Meyer,et al.  Organizational Assimilation of Innovations: A Multi-Level Contextual Analysis , 1988 .

[4]  H. Oxley,et al.  Health Care Reform Controlling Spending and Increasing Efficiency , 1994 .

[5]  M M McKinney,et al.  Integrating learning into integrated delivery systems. , 1998, Health care management review.

[6]  A. Møller,et al.  The mission of the cochrane anesthesia review group: preparing and disseminating systematic reviews of the effect of health care in anesthesiology. , 2002, Anesthesia and analgesia.

[7]  T. Valente Social network thresholds in the diffusion of innovations , 1996 .

[8]  J Lomas,et al.  Evaluating the Message: The Relationship Between Compliance Rate and the Subject of a Practice Guideline , 1994, Medical care.

[9]  A. Kaluzny Innovation in health services: Theoretical framework and rewiew of research. , 1974, Health services research.

[10]  Kenneth E. Warner,et al.  The need for some innovative concepts of innovation: An examination of research on the diffusion of innovations , 1974 .

[11]  James W. Dearing,et al.  Portraying the New: Communication Between University Innovators and Potential Users , 1994 .

[12]  Ethan A. Halm,et al.  The Changing Economics of Medical Technology , 1991 .

[13]  J. Morrissey,et al.  Innovation in an Interorganizational Context: The Case of Cancer Control Networks@@@The Diffusion of Medical Innovations: An Applied Network Analysis. , 1988 .

[14]  Kimberly S. Hamilton,et al.  The increasing linkage between U.S. technology and public science , 1997 .

[15]  A. Greer Advances in the study of diffusion of innovation in health care organizations. , 1977, The Milbank Memorial Fund quarterly. Health and society.

[16]  D. Cosgrove The innovation imperative. , 2000, The Journal of thoracic and cardiovascular surgery.

[17]  Diffusion of innovations theory and work-site AIDS programs. , 1998, Journal of health communication.

[18]  P. Conrad Types of medical social control. , 1979, Sociology of health & illness.

[19]  D Menon,et al.  Technology assessment in teaching hospitals. , 1990, Dimensions in health service.

[20]  F Champagne,et al.  Structural and Political Models of Analysis of the Introduction of an Innovation in Organizations: The Case of the Change in the Method of Payment of Physicians in Long-Term Care Hospitals , 1991, Health services management research.

[21]  Bjørn Hofmann,et al.  IS THERE A TECHNOLOGICAL IMPERATIVE IN HEALTH CARE? , 2002, International Journal of Technology Assessment in Health Care.

[22]  A. L. Wilson,et al.  Organizational context, climate and innovativeness: adoption of imaging technology , 2002 .

[23]  J. Ferguson,et al.  Court-ordered reimbursement for unproven medical technology. Circumventing technology assessment. , 1993, JAMA.

[24]  G. Robert,et al.  Diffusion of innovations in service organizations: systematic review and recommendations. , 2004, The Milbank quarterly.

[25]  Barbara Wejnert Integrating models of diffusion of innovations: a Conceptual Framework. , 2002 .

[26]  M. Becker Factors affecting diffusion of innovations among health professionals. , 1970, American journal of public health and the nation's health.

[27]  E. Rogers,et al.  Communication of Innovations; A Cross-Cultural Approach. , 1974 .

[28]  J. Pliskin,et al.  DECISION MAKING IN ACQUIRING MEDICAL TECHNOLOGIES IN ISRAELI MEDICAL CENTERS , 2003, International Journal of Technology Assessment in Health Care.

[29]  D. Mark,et al.  Exploring options for improving healthcare. , 2004, American heart journal.

[30]  Hilda Tellioglu,et al.  Work Practices Surrounding PACS: The Politics of Space in Hospitals , 2001, Computer Supported Cooperative Work (CSCW).

[31]  Gerald Silverberg,et al.  Adoption and diffusion of technology as a collective evolutionary process , 1991 .

[32]  Ramya B. Nagaraja Converging Technologies for Improving Human Performance , 2004 .

[33]  Caroline Ethington,et al.  Contrasting attributes of preventive health innovations , 1997 .

[34]  David H Gustafson,et al.  Developing and testing a model to predict outcomes of organizational change. , 2003, Health services research.

[35]  A. Greer Adoption of Medical Technology: The Hospital's Three Decision Systems , 1985, International Journal of Technology Assessment in Health Care.

[36]  Marc Berg,et al.  The practice of medical technology. , 2003, Sociology of health & illness.

[37]  S. Zahra,et al.  Absorptive Capacity: A Review, Reconceptualization, and Extension , 2002 .

[38]  N Ikegami,et al.  Health care reform in Japan: the virtues of muddling through. , 1999, Health affairs.

[39]  B. A. Auber,et al.  Adoption of smart cards in the medical sector: the Canadian experience. , 2001, Social science & medicine.

[40]  Raghu Garud,et al.  The innovation journey , 1999 .

[41]  P. Plsek,et al.  Complexity, leadership, and management in healthcare organisations , 2001, BMJ : British Medical Journal.

[42]  I. V. D. Ploeg Hermaphrodite Patients: In Vitro Fertilization and the Transformation of Male Infertility , 1995 .

[43]  J. D. Eveland,et al.  Diffusion, Technology Transfer, and Implementation , 1986 .

[44]  P. Sockeel,et al.  [Inguinal hernia in Africa and laparoscopy: utopia or realism?]. , 2000, Medecine tropicale : revue du Corps de sante colonial.

[45]  S. Webb,et al.  Insight and industry: on the dynamics of technological change in medicine , 1992, Medical History.

[46]  A. Hillman,et al.  Hospital adoption of medical technology: an empirical test of alternative models. , 1995, Health services research.

[47]  Michael Hill,et al.  The Policy Process in the Modern Capitalist State , 1984 .

[48]  E. Rogers,et al.  Communication of innovations: A cross-cultural approach, 2nd ed. , 1971 .

[49]  D. North Competing Technologies , Increasing Returns , and Lock-In by Historical Events , 1994 .

[50]  R. Bashshur Critical issues in telemedicine. , 1997, Telemedicine journal : the official journal of the American Telemedicine Association.

[51]  C. Goodman,et al.  The changing environment for technological innovation in health care. , 1996, The Baxter health policy review.

[52]  T. Wilson,et al.  Rejection of an innovation: health information management training materials in east Africa. , 2002, Health policy and planning.

[53]  N T Ellis,et al.  When protocols fail: technical evaluation, biomedical knowledge, and the social production of 'facts' about a telemedicine clinic. , 2001, Social science & medicine.

[54]  Johanna I. Westbrook,et al.  Research Paper: Clinical Team Functioning and IT Innovation: A Study of the Diffusion of a Point-of-care Online Evidence System , 2003, J. Am. Medical Informatics Assoc..

[55]  L. Ashburner Organisational behaviour and organisational studies in health care : reflections on the future , 2001 .

[56]  J. Grimshaw,et al.  Effectiveness and efficiency of guideline dissemination and implementation strategies , 2005, International Journal of Technology Assessment in Health Care.

[57]  J Gabbay,et al.  Understanding the role of opinion leaders in improving clinical effectiveness. , 2001, Social science & medicine.

[58]  D. Thomasma,et al.  Neonatal Viability in the 1990s: Held Hostage by Technology , 1999, Cambridge Quarterly of Healthcare Ethics.

[59]  E. Rogers A Prospective and Retrospective Look at the Diffusion Model , 2004, Journal of health communication.

[60]  E. Ferlie,et al.  Interlocking Interactions, the Diffusion of Innovations in Health Care , 2002 .

[61]  A. Lymberis,et al.  Intelligent biomedical clothing for personal health and disease management: state of the art and future vision. , 2003, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[62]  Geoffrey A. Moore,et al.  Crossing the Chasm , 1991 .

[63]  C. Dirksen,et al.  Diffusion of six surgical endoscopic procedures in the Netherlands. Stimulating and restraining factors. , 1996, Health policy.

[64]  S Cretin,et al.  Quality collaboratives: lessons from research , 2002, Quality & safety in health care.

[65]  J. Newton,et al.  Hierarchies and cliques in the social networks of health care professionals: implications for the design of dissemination strategies. , 1999, Social science & medicine.

[66]  D. Easton,et al.  The political system , 2009 .

[67]  Mark Hagland Up & comers. Whether with newer tools or familiar technology with a new twist, companies have a solution for everything. , 2004, Healthcare informatics : the business magazine for information and communication systems.

[68]  G. Hall Change in schools , 1987 .

[69]  Michel Callon,et al.  On Interests and their Transformation: Enrolment and Counter-Enrolment , 1982 .

[70]  M. Robinson,et al.  Issues and Strategies for Faculty Development in Technology and Biomedical Informatics , 2003, Advances in dental research.

[71]  A L Greer,et al.  The State of the Art Versus the State of the Science: The Diffusion of New Medical Technologies into Practice , 1988, International Journal of Technology Assessment in Health Care.

[72]  Graeme MacLennan,et al.  Attributes of clinical recommendations that influence change in practice following audit and feedback. , 2002, Journal of clinical epidemiology.

[73]  E. Rogers,et al.  Diffusion of innovations , 1964, Encyclopedia of Sport Management.

[74]  Scott Shane,et al.  Uncertainty Avoidance and the Preference for Innovation Championing Roles , 1995 .

[75]  J. Kimberly,et al.  Organizational innovation: the influence of individual, organizational, and contextual factors on hospital adoption of technological and administrative innovations. , 1981, Academy of Management journal. Academy of Management.

[76]  G. Elwyn,et al.  Organisational change theory and the use of indicators in general practice , 2004, Quality and Safety in Health Care.

[77]  Andrew Pettigrew,et al.  Shaping Strategic Change: Making Change in Large Organisations, the Case of the NHS , 1992 .

[78]  The Diffusion of Medical Innovations: An Applied Network Analysis.Mary L. Fennell , Richard B. Warnecke , 1989 .

[79]  G. Breithardt,et al.  Patient access to medical technology across Europe. , 2004, European heart journal.

[80]  Rajeev Sharma,et al.  Successful IS innovation: the contingent contributions of innovation characteristics and implementation process , 1999, J. Inf. Technol..

[81]  A. Langley,et al.  Explaining Diffusion Patterns for Complex Health Care Innovations , 2002, Health care management review.

[82]  C. McLaughlin,et al.  DIFFUSION OF INNOVATION IN MEDICINE: A PROBLEM OF CONTINUING MEDICAL EDUCATION. , 1965, Journal of medical education.

[83]  J. Kimberly,et al.  Organizational innovation: the influence of individual, organizational, and contextual factors on hospital adoption of technological and administrative innovations. , 1981, Academy of Management journal. Academy of Management.

[84]  Louise Locock,et al.  No magic targets! Changing clinical practice to become more evidence based. , 2002, Health care management review.

[85]  J. Newhouse,et al.  Medical care costs: how much welfare loss? , 1992, The journal of economic perspectives : a journal of the American Economic Association.

[86]  D. Kolb,et al.  Planning in the Face of Power. , 1988 .

[87]  Stephen K. Markham,et al.  A Longitudinal Examination of How Champions Influence Others to Support Their Projects , 1998 .