title: Technology identity: the role of sociotechnical representations in the adoption of medical devices.
abstract: This study explored the sociotechnical influences shaping the naturally-occurring adoption and non-adoption of device technologies in the UK's National Health Service (NHS), amid increasing policy interest in this area. The study was informed by Science and Technology Studies and structuration and Actor Network Theory perspectives, drawing attention to the performative capacities of the technology alongside human agentic forces such as agendas and expectations, in the context of structural and macro conditions. Eight technologies were studied using a comparative ethnographic case study design and purposive and snowball sampling to identify relevant NHS, academic and industry participants. Data were collected between May 2009 and February 2012, included in-depth interviews, conference observations and printed and web-based documents and were analysed using constructivist grounded theory methods. The study suggests that while adoption decisions are made within the jurisdiction of healthcare organisations, they are shaped within a dynamic and fluid 'adoption space' that transcends organisational and geographic boundaries. Diverse influences from the industry, health care organisation and practice, health technology assessment and policy interact to produce 'technology identities.' Technology identities are composite and contested attributes that encompass different aspects of the technology (novelty, effectiveness, utility, risks, requirements) and that give a distinctive character to each. We argue that it is these socially constructed and contingent heuristic identities that shape the desirability, acceptability, feasibility and adoptability of each technology, a perspective that policy must acknowledge in seeking to intervene in health care technology adoption.
authors: Cardiff University, Institute of Primary Care & Public Health, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, United Kingdom. Electronic address: tomlinz@cardiff.ac.uk.
authors: S
authors: S
authors: Ulucanlar
authors: University of Sussex, United Kingdom.
authors: A
authors: A
authors: Faulkner
authors: Cardiff University, Institute of Primary Care & Public Health, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, United Kingdom.
authors: S
authors: S
authors: Peirce
authors: Cardiff University, Institute of Primary Care & Public Health, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, United Kingdom; The Dartmouth Center for Health Care Delivery Science, United States.
authors: G
authors: G
authors: Elwyn
mesh_terms: D006291:Health Policy; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration*; D009936:Organizational Innovation; D036301:Qualitative Research; D013673:Technology Assessment, Biomedical; D006113:United Kingdom
keywords: Adoption; Adoption space; Diffusion; Medical devices; NHS; Science and technology studies; Technology identity; UK