Differentiating innovation priorities among stakeholder in hospital care

Abstract

BackgroundDecisions to adopt a particular innovation may vary between stakeholders because individual stakeholders may disagree on the costs and benefits involved. This may translate to disagreement between stakeholders on priorities in the implementation process, possibly explaining the slow diffusion of innovations in health care. In this study, we explore the differences in stakeholder preferences for innovations, and quantify the difference in stakeholder priorities regarding costs and benefits.MethodsThe decision support technique called the analytic hierarchy process was used to quantify the preferences of stakeholders for nine information technology (IT) innovations in hospital care. The selection of the innovations was based on a literature review and expert judgments. Decision criteria related to the costs and benefits of the innovations were defined. These criteria were improvement in efficiency, health gains, satisfaction with care process, and investments required. Stakeholders judged the importance of the decision criteria and subsequently prioritized the selected IT innovations according to their expectations of how well the innovations would perform for these decision criteria.ResultsThe stakeholder groups (patients, nurses, physicians, managers, health care insurers, and policy makers) had different preference structures for the innovations selected. For instance, self-tests were one of the innovations most preferred by health care insurers and managers, owing to their expected positive impacts on efficiency and health gains. However, physicians, nurses and patients strongly doubted the health gains of self-tests, and accordingly ranked self-tests as the least-preferred innovation.ConclusionsThe various stakeholder groups had different expectations of the value of the nine IT innovations. The differences are likely due to perceived stakeholder benefits of each innovation, and less to the costs to individual stakeholder groups. This study provides a first exploratory quantitative insight into stakeholder positions concerning innovation in health care, and presents a novel way to study differences in stakeholder preferences. The results may be taken into account by decision makers involved in the implementation of innovations.

Applying the Analytic Hierarchy Process in healthcare research: A systematic literature review and evaluation of reporting

“…In order to do this, many studies relied on literature research [ 20 , 25 , 26 , 45 – 83 ]. In addition, many studies relied on expert interviews [ 20 , 45 – 49 , 51 , 54 , 56 – 58 , 61 , 66 – 71 , 74 , 75 , 77 , 78 , 81 – 97 ] or focus groups [ 26 , 51 , 69 , 82 , 87 , 98 ]. Almost all of the studies defined their criteria by analyzing more than one source of information, although five publications did not explain their process for this step [ 99 – 103 ].…”

“…Depending on the studies’ goal, the participants belonged to the following groups: hospital employees [ 49 , 92 ], patients [ 25 , 47 , 55 , 59 , 60 , 64 , 69 , 72 , 75 , 82 , 95 , 98 ], public/consumers [ 52 , 70 , 103 ], doctors or specialists [ 26 , 71 , 72 , 74 , 79 , 81 , 83 , 93 , 94 , 96 , 97 , 99 , 110 ], medical students [ 80 ] or teachers [ 77 ], biomedical engineers [ 94 ], technical experts [ 93 ], managers [ 93 ], administrators [ 20 ], and stakeholders [ 75 ]. Of the studies, 44 interviewed experts [ 20 , 26 , 45 , 46 , 48 – 51 , 54 , 56 – 58 , 61 , 62 , 66 – 68 , 71 , 74 , 76 – 79 , 81 , 83 – 94 , 96 , 97 , 99 , 104 – 107 , 110 ], 11 studies surveyed consumers or patients [ 25 …”

“…Next, we considered whether the AHP was applied at individual or group level. Most of the studies questioned their participants individually [ 20 , 25 , 26 , 47 , 55 , 56 , 59 , 61 , 62 , 64 , 66 , 69 – 71 , 74 , 75 , 77 , 79 – 83 , 87 – 90 , 94 , 97 – 99 , 103 , 104 , 109 – 111 ]. On the other hand, only six articles mentioned group decisions [ 46 , 49 , 72 , 84 , 92 , 96 ].…”

“…As explained in Subsection 1.1, the original scale implemented by Saaty ranges from nine (or 1/9) to one to nine. This scale was adopted by 37 of the articles in our sample [ 25 , 45 , 46 , 50 – 52 , 54 – 57 , 60 – 62 , 66 , 71 – 73 , 75 , 79 , 80 , 83 , 84 , 86 – 89 , 91 , 92 , 94 , 95 , 97 , 98 , 102 , 103 , 107 – 109 , 111 ]. Other studies used ranges between 1 and 4 [ 20 , 59 ], 1 and 5 [ 67 , 70 , 106 ], 5 and 1 and 5 [ 26 , 81 , 90 , 110 ], 6 and 1 and 6 [ 99 ],1 and 7 [ 47 ],1 and 9 [ 58 , 77 , 96 ], and 1 and 11 [ 74 ].…”

What Are Complex eHealth Innovations and How Do You Measure Them?

“…In multinational surveys, innovation is defined relative to the participating countries and their organisations as potential adopters. eHealth innovation is also relative in terms of the stakeholders within an adopting organisation [25]. To account for the conflicting needs between medical specialties [26] and stakeholder priorities and interests [27] views of different professional groups and the patients have to be captured and quantified.…”