The art and science of priority-setting: assessing the value of Public Health England’s Prioritization Framework

Background Findings are presented from the evaluation of Public Health England’s (PHE) Prioritization Framework (PF) aimed to assist local authority commissioners with their public health investment and disinvestment decisions. The study explored the take up of the PF in three early adopter local authority settings. Methods Semi-structured interviews (n = 30) across three local authorities supplemented by participant observation of workshops. Results Participants acknowledged that the PF provided a systematic means of guiding priority-setting and one that encouraged transparency over investment and disinvestment decisions. The role performed by PHE and its regional teams in facilitating the process was especially welcomed and considered critical to the adoption process. However, uptake of the PF required a significant investment of time and commitment from public health teams at a time when resources were stretched. The impact of the political environment in the local government was a major factor determining the likely uptake of the PF. Ensuring committed leadership and engagement from senior politicians and officers was regarded as critical to success. Conclusions The study assessed the value and impact of PHE’s PF tool in three early adopter local authorities. Further research could explore the value of the tool in aiding investment and disinvestment decisions and its impact on spending

The Imaginary Significations Of The IT Markets

Drawing upon Castoriadis’ (1987) notion of imaginary significations, this paper aims to advance the analysis of technology acquisition by exploring the ideological role of technology choice and consumption. The illustration of the theoretical background of this paper results in the formulation of two main research interests. First, the ways in which technological imaginaries form ideologies and how these ideologies influence institutional identities, narratives and actions associated with the evaluation of technology choice and consumption. Second, how such ideologies influenced by various socio-political, economical and technical conditions affect and constitute the technology selection process by providing a stabilized form of accountability

Lost in translation? : negotiating technological innovation in healthcare

Technological innovation in healthcare is growing at a rapid pace. Developments in genetics, stem cell research, bioinformatics, imaging and screening techniques have broadened out the arena of health technology. These developments in sophisticated technology, it is suggested, have the potential to revolutionize the practices of medicine and healthcare by providing more proactive and powerful tools for the diagnosis, treatment, and prevention of illness and disease (Liddell et al, 2008; Webster, 2002). In support of such claims, available research findings suggest that the adoption of new innovative health technologies (IHTs) can result in reducing healthcare costs, increasing productivity, healthcare effectiveness, and improving the patient’s experience of care by better management of chronic diseases (Liddell et al, 2008; Healthcare Industries Task Force, 2004). At the same time, new innovative health technologies present many challenges. Evidence indicates that patient safety and proven clinical effectiveness are insufficient to ensure the adoption and implementation of new clinical technologies. The prevailing organizational and policy context is crucially important as this may present barriers which slow or even prevent uptake (Lehoux 2006). In recent years there has been a continuing debate around issues of clinical resistance, organizational/clinical restructuring, procurement and commissioning, public trust, and, more widely, around the ethical and social implications of techno-scientific innovations in medicine and health (Williams and Dickinson, 2008; Webster, 2006; Ferlie et al., 2005). Moreover, cost-effectiveness evidence is now required to inform decisions about the funding and procurement of new healthcare services and technologies (Fitzgerald et al., 2002). Overall, the value of the innovation has to be clearly evident to a number of different stakeholders if technologies are to be embedded into actual work practices. These potential barriers have given rise to questions related to the diffusion and adoption of emerging medical and healthcare innovations. This paper examines the dynamics and complexity of innovation adoption processes in the context of a rapidly changing healthcare policy landscape. Drawing upon the inherently socially negotiated character of meaning, this paper illustrates the ambivalent nature of technological innovation by examining the complex ongoing interplay of heterogeneous discourses in shaping the adoption of innovative health technologies (Law, 1987, 1994). Drawing upon Rye and Kimberly (2007) adoption is here understood as a distinct organizational process related to an organization’s potential interest in implementing a technological innovation. In so doing, this paper draws on the findings of a three year research project which examines the adoption of innovative clinical technologies in the UK NHS. In particular, we explore the nature, role and dynamics of heterogeneous discourses (technological, managerial/professional, clinical), in shaping the adoption of a retinal imaging technology in a UK hospital Trust. In this regard, we contribute to the development of alternative ways of describing, analysing, and theorizing the process of technological innovation in healthcare

Advanced Testing Chain Supporting the Validation of Smart Grid Systems and Technologies

New testing and development procedures and methods are needed to address topics like power system stability, operation and control in the context of grid integration of rapidly developing smart grid technologies. In this context, individual testing of units and components has to be reconsidered and appropriate testing procedures and methods need to be described and implemented. This paper addresses these needs by proposing a holistic and enhanced testing methodology that integrates simulation/software- and hardware-based testing infrastructure. This approach presents the advantage of a testing environment, which is very close to f i eld testing, includes the grid dynamic behavior feedback and is risks-free for the power system, for the equipment under test and for the personnel executing the tests. Furthermore, this paper gives an overview of successful implementation of the proposed testing approach within different testing infrastructure available at the premises of different research institutes in Europe.Comment: 2018 IEEE Workshop on Complexity in Engineering (COMPENG

Inside a Digital Experiment: Co-producing Telecare Services for Older People

The problem of the user remains central to information systems research and practice, more so given the importance now given to user-led innovation. Telecare is a much-vaunted example of e-enabled health and social care which, over the past decade or more has received considerable policy attention and investment in Europe and beyond. However, it appears that the technological opportunities offered have not been taken-up in everyday practice and that the engagement of users—service providers and end users—has been identified as a major barrier. This article presents the experience of a European level project that sought to use a form of co-production to engage users in the development of a telecare system for older people. The outcome was a platform with infrastructural properties and a service-orientated architecture better able to support subsequent innovation in use

Falling through the gaps: exploring the role of integrated commissioning in improving transition from children’s to adults' services for young people with long-term health conditions in England

Objectives: To explore the role of integrated commissioning in improving the transition of young people with longterm conditions from child to adult services. We aimed to identify organizational and policy gaps around transition services and provide recommendations for integrated commissioning practice. Methods: Semi-structured in-depth interviews were conducted with two groups of participants: (1) twenty-four stakeholders involved in the commissioning and provision of transition services for young people with long-term conditions in two regions in England; (2) five professionals with national roles in relation to planning for transition. Transcripts were interrogated using thematic analysis. Results: There is little evidence of integrated commissioning for transitional care for young people with long-term conditions. Commissioners perceive there to be a lack of national and local policy to guide integrated commissioning for transitional care; and limited resources for transition. Furthermore, commissioning organizations responsible for transition have different cultures, funding arrangements and related practices which make inter- and intra-agency co-ordination and cross-boundary continuity of care difficult to achieve. Conclusions: Integrated commissioning may be an effective way to achieve successful transitional care for young people with long-term health conditions. However, this innovative relational approach to commissioning requires a national steer together with recognition of common values and joint ownership between relevant stakeholders

Facilitating the implementation of clinical technology in healthcare : what role does a national agency play?

Background: Accelerating the implementation of new technology in healthcare is typically complex and multi-faceted. One strategy is to charge a national agency with the responsibility for facilitating implementation. This study examines the role of such an agency in the English National Health Service. In particular, it compares two different facilitation strategies employed by the agency to support the implementation of insulin pump therapy. Methods: The research involved an empirical case study of four healthcare organisations receiving different levels of facilitation from the national agency: two received active hands-on facilitation; one was the intended recipient of a more passive, web-based facilitation strategy; the other implemented the technology without any external facilitation. The primary method of data collection was semi structured qualitative interviews with key individuals involved in implementation. The integrated-PARIHS framework was applied as a conceptual lens to analyse the data. Results: The two sites that received active facilitation from an Implementation Manager in the national agency made positive progress in implementing the technology. In both sites there was a high level of initial receptiveness to implementation. This was similar to a site that had successfully introduced insulin pump therapy without facilitation support from the national agency. By contrast, a site that did not have direct contact with the national agency made little progress with implementation, despite the availability of a web-based implementation resource. Clinicians expressed differences of opinion around the value and effectiveness of the technology and contextual barriers related to funding for implementation persisted. The national agency’s intended roll out strategy using passive web-based facilitation appeared to have little impact. Conclusions: When favourable conditions exist, in terms of agreement around the value of the technology, clinician receptiveness and motivation to change, active facilitation via an external agency can help to structure the implementation process and address contextual barriers. Passive facilitation using web-based implementation resources appears less effective. Moving from initial implementation to wider scale-up presents challenges and is an issue that warrants further attention

«Εισαγωγή νέων τεχνολογιών στη διοικητική δικαιοσύνη: Το παράδειγμα του ΟΣΔΔΥ-ΔΔ και της ηλεκτρονικής κατάθεσης δικογράφου. Εφαρμογή και προοπτικές».

Σκοπός της παρούσας εργασίας είναι η προβολή της προσπάθειας αναδιοργάνωσης και εκσυγχρονισμού του συστήματος οργάνωσης και λειτουργίας της διοικητικής δικαιοσύνης μέσω αφενός της εφαρμογής ενός ολοκληρωμένου πληροφοριακού συστήματος διαχείρισης δικαστικών υποθέσεων της Διοικητικής Δικαιοσύνης και αφετέρου της εισαγωγής, από 1-1-2021, του συστήματος της υποχρεωτικής ηλεκτρονικής κατάθεσης δικογράφου στα διοικητικά δικαστήρια.The purpose of this work is to promote the effort to reorganize and modernize the system of organization and operation of administrative justice through on the one hand the implementation of an integrated information system for the management of judicial cases of Administrative Justice and on the other hand the introduction, from 1-1-2021, of the system of mandatory electronic filing of a petition in the administrative courts