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Understanding the adoption dynamics of medical innovations: Affordances of the da Vinci robot in the Netherlands

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  • Abrishami, Payam
  • Boer, Albert
  • Horstman, Klasien

Abstract

This study explored the rather rapid adoption of a new surgical device — the da Vinci robot — in the Netherlands despite the high costs and its controversial clinical benefits. We used the concept ‘affordances’ as a conceptual-analytic tool to refer to the perceived promises, symbolic meanings, and utility values of an innovation constructed in the wider social context of use. This concept helps us empirically understand robot adoption. Data from 28 in-depth interviews with diverse purposively-sampled stakeholders, and from medical literature, policy documents, Health Technology Assessment reports, congress websites and patients' weblogs/forums between April 2009 and February 2014 were systematically analysed from the perspective of affordances. We distinguished five interrelated affordances of the robot that accounted for shaping and fulfilling its rapid adoption: ‘characteristics-related’ affordances such as smart nomenclature and novelty, symbolising high-tech clinical excellence; ‘research-related’ affordances offering medical-technical scientific excellence; ‘entrepreneurship-related’ affordances for performing better-than-the-competition; ‘policy-related’ affordances indicating the robot's liberalised provision and its reduced financial risks; and ‘communication-related’ affordances of the robot in shaping patients' choices and the public's expectations by resonating promising discourses while pushing uncertainties into the background. These affordances make the take-up and use of the da Vinci robot sound perfectly rational and inevitable. This Dutch case study demonstrates the fruitfulness of the affordances approach to empirically capturing the contextual dynamics of technology adoption in health care: exploring in-depth actors' interaction with the technology while considering the interpretative spaces created in situations of use. This approach can best elicit real-life value of innovations, values as defined through the eyes of (potential) users.

Suggested Citation

  • Abrishami, Payam & Boer, Albert & Horstman, Klasien, 2014. "Understanding the adoption dynamics of medical innovations: Affordances of the da Vinci robot in the Netherlands," Social Science & Medicine, Elsevier, vol. 117(C), pages 125-133.
    • Handle: RePEc:eee:socmed:v:117:y:2014:i:c:p:125-133
    DOI: 10.1016/j.socscimed.2014.07.046
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    References listed on IDEAS

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    1. Raghu Garud & Michael A. Rappa, 1994. "A Socio-Cognitive Model of Technology Evolution: The Case of Cochlear Implants," Organization Science, INFORMS, vol. 5(3), pages 344-362, August.
    2. Ulucanlar, S. & Faulkner, A. & Peirce, S. & Elwyn, G., 2013. "Technology identity: The role of sociotechnical representations in the adoption of medical devices," Social Science & Medicine, Elsevier, vol. 98(C), pages 95-105.
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    1. Askfors, Ylva & Fornstedt, Helena, 2018. "The clash of managerial and professional logics in public procurement: Implications for innovation in the health-care sector," Scandinavian Journal of Management, Elsevier, vol. 34(1), pages 78-90.
    2. Smailhodzic, Edin & Boonstra, Albert & Langley, David J., 2021. "Social media enabled interactions in healthcare: Towards a taxonomy," Social Science & Medicine, Elsevier, vol. 291(C).
    3. Carboni, Chiara & Wehrens, Rik & van der Veen, Romke & de Bont, Antoinette, 2022. "Conceptualizing the digitalization of healthcare work: A metaphor-based Critical Interpretive Synthesis," Social Science & Medicine, Elsevier, vol. 292(C).
    4. Hofmann, Bjørn, 2020. "Biases distorting priority setting," Health Policy, Elsevier, vol. 124(1), pages 52-60.
    5. Francesca Iandolo & Pietro Vito & Irene Fulco & Francesca Loia, 2018. "From Health Technology Assessment to Health Technology Sustainability," Sustainability, MDPI, vol. 10(12), pages 1-22, December.

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