Investigating technological strategies in the hospital setting: insights from the Dutch context

Rapid advancements in technology are significantly impacting the healthcare system and, being it often very decentralized, decisions regarding technology procurement and adoption are made by different actors at various levels within hospitals and departments. Recognizing the limited literature delving into the viewpoints of hospital professionals regarding hospitals’ technological strategies, scanning and assessment processes, we aimed to explore this gap. Thus, the objective of the study was to grasp the diverse viewpoints among hospital staff regarding the visions and strategies of hospitals and their scanning and assessment processes. To do this, we performed an expert opinion elicitation through 24 semi-structured interviews with different professionals having experience regarding technology strategy, scanning and assessment, working in seven hospitals in the Netherlands, a country characterized by strong healthcare innovation and decentralization. The interviewees were CEOs, medical doctors, medical physicists or similar roles, and innovation managers. The interviews’ analysis allowed us to understand that hospitals primarily aim to provide optimal patient care, with academic hospitals emphasizing research and education. Some hospitals aspire to be pioneers in adopting new technologies and, in general, hospitals tend to prioritize areas where to concentrate their efforts. Technological strategies are not precisely designed in hospitals, and they are shaped by factors such as people, financial constraints, or external environments. Typically, the standard approach for implementing new technologies revolves around initiation by professionals, followed by approval from upper management. While this method is generally considered favourable, it has occasionally resulted in discontent among practitioners. Hospitals' scanning of emerging technologies lacks systematization, and some interviewees expressed the need for better standardization. Regarding technology assessment, hospitals employ various practices, but evaluations before and after the introduction of technologies are not univocally performed. The need for systematic assessments is recognized by some interviewees, while others emphasize the importance of experimenting without the constraint of evaluation, and this could depend on the role they have in the hospital. We advise that a more detailed technology strategy and a better structured scanning and assessment process could represent a benefit for hospitals, allowing them more streamlined decision-making addressing their challenges. Involving hospitals’ specialists and stakeholders in the implementation of more structured processes would be crucial not to impose it from the top, but to achieve it through a joint effort. Suggestions for future research of this study could be focusing on a specific hospital, involving more stakeholders, and exploring other decentralized healthcare systems like Italy.