No abstract

Stimulating technological innovations and limiting access to expensive health technology require the coordination and coherence of overlapping policy sub-systems: research, market access, and reimbursement. This study investigates which procedural policy instruments proved more successful in integrating collaborative governance arrangements in Great Britain and Germany. A new classification of procedural policy instruments is developed based on the targeted dimensions of collaborative governance (network structure and policy phase). The comparative analysis rests on expert interviews and meeting records and reveals that, in Great Britain, active leadership prevails during the consultations, while Germany, in contrast, presents a case of inconsistent governance.

Governments that included e-health applications in policy documents rather early have adopted more telematics applications.

The first section of this chapter on Europeanization in relation to organizational change in national trade associations addresses the paradigm of Europeanization and business interest associations. The second section discusses change in sectoral business associations from an ecological perspective, looking at the different strategies that organizations can use to confront external challenges. Absorption and compensation, integration, cooperation and intervention. The third and final sections of the chapter are written with particular reference to the Information and Communications Technologies (ICT) Sector and the Chemicals Sector in Germany. The third section, on change-inducing environmental factors, distinguishes between the political, economic, technological and social environments that influence the individual groups and group populations in different ways according to sector via national, European or international channels. The final section looks at change in an intra- and inter-organizational perspective, and describes the interest group populations and focal organizations dominating both sectors before looking at selected results that shed some light on the ways that leading representatives of trade associations perceive external challenges and related modifications in the application of resources.

BackgroundNewly established high-technology areas such as eHealth require regulations regarding the interoperability of health information infrastructures and data protection. It is argued that government capacities as well as the extent to which public and private organizations participate in policy-making determine the level of eHealth legislation. Both explanatory factors are influenced by international organizations that provide knowledge transfer and encourage private actor participation.MethodsData analysis is based on the Global Observatory for eHealth - ATLAS eHealth country profiles which summarizes eHealth policies in 114 countries. Data analysis was carried out using two-component hurdle models with a truncated Poisson model for positive counts and a hurdle component model with a binomial distribution for zero or greater counts.ResultsThe analysis reveals that the participation of private organizations such as donors has negative effects on the level of eHealth legislation. The impact of public-private partnerships (PPPs) depends on the degree of government capacities already available and on democratic regimes. Democracies are more responsive to these new regulatory demands than autocracies. Democracies find it easier to transfer knowledge out of PPPs than autocracies. Government capacities increase the knowledge transfer effect of PPPs, thus leading to more eHealth legislation.ConclusionsAll international regimes – the WHO, the EU, and the OECD – promote PPPs in order to ensure the construction of a national eHealth infrastructure. This paper shows that the development of government capacities in the eHealth domain has to be given a higher priority than the establishment of PPPs, since the existence of some (initial) capacities is the sine qua non of further capacity building.