NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Medical information technology is often thought of in the modern context of computers, but the careful collection and analysis of information related to observation of patient condition, effectiveness of different treatments, and design of new treatments dates back to the time of Hippocrates (ca. 460 BC – ca. 370 Be) (Washburn & Hornberger, 2008). Hippocrates took meticulous notes that enabled him to make numerous breakthroughs both in the understanding of the workings of the human body and in the ethics and approach to thinking that are essential to modern medical practice and investigation (Olguin, Gloor & Pentland, 2009). Comparatively little innovation took place in furthering, the practice of medicine from the time of Hippocrates until the early 20th century, with developments such as the smallpox vaccine in 1901. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

During the 20th century, the growth of medical technology has increased continuously, with innovations such as penicillin, X-ray, PET/MRI scanning, computers, robotic surgery, radiation therapy, chemo-therapy, and many other forms of technology and treatments (Garson, 2008; Munnelly & Clarke, 2007). While the use of medical hardware and information technology has been essential to healthcare for thousands of years, these same tools can create difficult problems (Appari & Johnson, 2010; Ziefle & Rocker, 2010). For example, the over-use of antibiotics has caused a new form of pathogen commonly called super-bugs, such as methicillin-resistant staphylococcus aureus (MRSA) and other antibiotic resistance strains that are extremely difficult and expensive to treat.NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Healthcare facilities (buildings) can also be considered to be a form of technology. As with other forms of technology, physical facilities involve a mutual interaction between users of the technology and the technology Anderson & Wittwer, 2011). In healthcare contexts, the physical facilities are often intimately interrelated with the staff and other technology that the building contains (Munnelly & Clarke, 2007). Often, technology is integrated into the building itself. As with other forms of technology in healthcare, organizations spend significant sums of money on their facilities. If these funds are not spent wisely, they contribute to the rising cost of healthcare and can affect the financial or operational viability of the organization (Aziz et al. 2006; Washburn & Hornberger, 2008). NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Among the pioneers of Healthcare Technology, the National Aeronautics and Space Administration (NASA) has been one of the most supportive. Concerned with the wellness of the astronauts during space missions, NASA scientists developed technological devices for the measurement and transmission of physiological and medical data between space and earth stations in the 1960s (Lankton & Wilson, 2007). This effort was later applied in the 1970s to support medical services to the rural Papago Native American Reservation in Arizona using a manned mobile medical unit linked to local hospitals. The first full service Healthcare Technology operation appeared in 1968 between Logan Airport Health station and the Massachusetts General Hospital (MGH) of Harvard Medical School (Garson, 2008; Munnelly & Clarke, 2007). The service included 10 remote sites linked through the New Hampshire-Vermont Medical Interactive Television Network with a central hub stationed at Dartmouth. The service supported medical education and specialty medical services including psychiatry, cancer, and dermatology (Pai & Huang, 2011). NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Another significant Healthcare Technology event occurred in the 1990s when NASA launched the first large scale international Healthcare Technology project, Spacebridge. Spacebridge currently supplies a variety of medical specialist consultations and medical educational opportunities to the Eastern European region (Sneha & Varshney, 2007; Varshney, 2009). Modern Healthcare Technology in the last century evolved from basic telephone consultations as experimental projects. Propelled by emerging technologies and the information superhighway, Healthcare Technology has resurfaced with new content and meaning. Healthcare Technology experiments that are currently used in pilot form will prove to be routine in the future. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Impact of Technology on Healthcare

The purpose of this section is to review the literature on the impacts of technology in healthcare. Evidence on the impact of technology in healthcare is mixed. Literature on technology impacts in healthcare have looked at both final outcome measures, such as productivity or output or mortality , as well as intermediate performance measures such as error rates, cycle times, utilization, and complications (Pai & Huang, 2011). A recurring theme among studies on technology and healthcare is the role of time lags; the empirical evidence generally supports the notion that technology investments require a substantial time period for users to learn how to use the technology (Ziefle & Rocker, 2010). NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Studies drawing from technology literature base, consistent with the literature on technology investment, appeared more likely to include complementary investment factors such as business process reengineering (BPR) and training (Varshney, 2009). These studies find positive impacts to technology and often included (Varshney, 2009). Studies based in the medical literature painted a more mixed view of outcomes technology investment (Bardram, 2008; Coronato & Pietro, 2010). These studies generally did not include complementary investments and generally took a “tool view” of technology investments. The studies based in the medical literature used a more nuanced choice of outcomes; consistent with the idea that healthcare is a unique context, including outcome measures such as error rate, differential mortality, utilization rates, and complication rates (Sneha & Varshney, 2007; Varshney, 2009). NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

What is missing from this literature is a study that takes into account the unique nature of technology investment, as well as the unique context of healthcare. Theory and evidence about the impacts of technology investment suggest that technology: a) is a general-purpose technology which often requires complementary investments to yield positive returns, b) lowers search costs, which lower the variance of outcomes, c) facilities the accumulation of “memory capital” over time, d) lowers monitoring costs, e) speeds information diffusion, and f) exhibits network effects (Ziefle & Rocker, 2010). While many of the potential impact of technology would seem to result in positive returns in healthcare, findings on the impact of technology in healthcare to date are mixed. Most studies on the impacts of technology in healthcare have either: a) used a rich understanding of technology investments focused upon the impact of technology on traditional outcome measures such as profitability or response time, or b) used a simplified view of technology investment with a rich understand of the particular phenomena which arise out of the unique context of healthcare (Coronato & Pietro, 2010). What is needed in this literature is a study which takes into account the particular impacts of technology investments on phenomena which are unique to healthcare, such as treatment inconsistency. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Research Conceptual Framework and Theoretical Background

Present research examines the factors that influence patient Healthcare Technology adoption drawing support from the following theory.

Theory of Reasoned Action

The Theory of Reasoned Action asserts that beliefs influence attitudes. Attitudes, in turn, influence the intentions that guide behaviour, and acceptance of technology is then demonstrated through behaviour. TRA is well-tested and has been proven valid in predicting and explaining behaviours in general human behaviours. The concept of Theory of Reasoned Action was founded on Fishbein and Ajzen’s social psychology research. TRA suggested that significant relations exist between beliefs, attitudes, intentions, and behaviours (Aziz et al. 2006; Washburn & Hornberger, 2008). According to TRA, most social behaviours are not automatic actions; instead, they are under volitional controls. TRA asserts that people consider the implications of their action based on the information available to them before they decide to perform behaviour (Aziz et al. 2006; Washburn & Hornberger, 2008). NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Since behaviour is a result of cognitive reasoning, behaviour is predictable. Theory of Reasoned Action is built on three constructs: attitude (AT), subjective norm (SN), and behavioural intention (BI). TRA has been examined and tested through numerous research studies. In TRA, attitude reflects personal behavioural beliefs and subjective norm refers to social influences. TRA suggests that behaviour intention is a function of two determinants, a person’s attitude and the subjective norm. A person’s behavioural intention, in turn, is the immediate determinant of the actual action (Aziz et al. 2006; Washburn & Hornberger, 2008). Based on the pictorial presentation of TRA by Ajzen and Fishbein, TRA may be expressed as:

BI = AT + SN and actual behaviour = BI. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

A person holds different beliefs from past experience about objects, actions, and events. Beliefs serve as the immediate determining factors of a person’s attitude (Aziz et al. 2006; Washburn & Hornberger, 2008). Positive belief means stronger conviction and acceptance toward the behaviour in question. With positive beliefs, a person tends to gather positive attitudinal intention to behaviour, which in turn leads to more potential realization of the behaviour. Attitude is a person’s evaluation of the entity in question (Lankton & Wilson, 2007). Attitude arises as a function of beliefs. Beliefs may change due to time and circumstances or be replaced by new beliefs; these changes in turn affect a person’s attitude. Social scientists have long established that attitude is a critical behavioural disposition (Lankton & Wilson, 2007). NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

However, a person’s favourable or unfavourable perception to behaviour in consideration alone does not always produce the behavioural outcome. To accurately predict attitude, an additional variable must be taken into account of the attitude-behaviour relationship. This additional variable in TRA is the subjective norm (Aziz et al. 2006; Washburn & Hornberger, 2008). Subjective norm refers to a person’s perceived expectations from relevant individuals or groups on whether or not to perform the behaviour in question (Varshney, 2009). Subjective norm is a function of normative beliefs, the resulting influence of the social environment. Social pressure can force an individual to perform or avoid behaviour in consideration regardless of the person’s existing intention. Since it has the potential of overriding a person’s own intention, subjective norm is an independent construct to attitude in the TRA model. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Concept of Pervasive Healthcare Technology

Many Pervasive Healthcare Technology devices have undergone experimental trials in hospitals as well as in patients’ homes. Infrared technology, motion sensors (infra-red detection or acoustical detection), video cameras, and so on, that use wireless, Internet, ISDN, and telephone lines have been installed in healthcare facilities (Snyder, 2007). Traditional non-invasive Pervasive Healthcare Technology often requires patient engagement with devices at a set time and location. For at risk cases, such as post-stroke and postoperative wound-related complications where a close un-obstructive monitor is crucial in the recovery process, periodic monitoring may not catch episodic signs at the critical time (Washburn & Hornberger, 2008). Recent development of pervasive monitoring systems focuses on automated and un-obstructive Pervasive Healthcare Technology without the restrictions of time and place. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Pervasive healthcare requires wireless technologies and the matching infrastructure capabilities. Pervasive services are supported through wireless LANs, cellular GSM/3G networks, satellite-based systems, and so forth (Varshney, 2007). Pervasive healthcare applications include “pervasive health monitoring, intelligent emergency management system, pervasive healthcare data access, and ubiquitous mobile Healthcare Technology” (Varshney, 2007). Research on pervasive Healthcare Technology started in the early 2000s using the then budding pervasive computing technologies. The goal was to utilize ubiquitous communication technologies to improve patient autonomy and healthcare mobility through continuous monitoring. In cases such as myocardial ischemia and post abdominal operations, continuous physiological data for timely detection of deterioration can change the entire care outcome.

Extended from Varshney’s definition for pervasive healthcare (2007), present research defines pervasive Healthcare Technology as a Pervasive Healthcare Technology for anyone, anytime, and anywhere without location, time, and other restraints. Earlier pervasive Healthcare Technology experimented with video-telephony installations (Thuemmler et al. 2009). These devices provide live video interactive communication through plain old POTS for its wide availability and relatively low costs (Lankton & Wilson, 2007). Using video-telephony, the healthcare professional can review the therapies and provide support in real-time. More importantly, these devices alleviate the gap of distance, allowing care providers to monitor the patient’s emotional and mental states and not simply physiological information (Olguin, Gloor & Pentland, 2009). NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Other types of pervasive Healthcare Technology are enabled by portable topical sensors that integrate wireless technology with clinical devices. Tele-devices such as tele-ECG and ring-sensors are worn by the patients for Pervasive Healthcare Technology. Data, such as ECG, pulse rate, respiration rate, and oxygen saturation levels, is collected and forwarded to the healthcare providers automatically (Tu, Zhou, & Piramuthu, 2009; Varshney, 2007). This continuously monitored data can provide important clinical insight for timely and accurate diagnosis. Advanced pervasive devices for automatically collecting multiple clinical parameters have shown success in a body sensor network system (Nachman et al. 2010).

This Pervasive Healthcare Technology system equipped with multiple sensors is able to collect, process, and wirelessly transmit the received data via a secured link to a laptop for further diagnosis. Pervasive Healthcare Technology devices that do not require patients to wear the tele-devices also have been developed in the past years. For example, mattresses, toilets, kitchen appliances, and clothing embedded with monitors can sense sleep pattern, body weight, body temperature, pulse rate, and so forth (Bardram, 2008; Coronato & Pietro, 2010). NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Further experiments on advanced tele-sensing systems utilize the Doppler radar technique to gather scattered vital signs from throughout the body (Ziefle & Rocker, 2010).

These systems can gather multiple clinical parameters and are able to operate autonomously without disturbing the lives of the patients. Pervasive Healthcare Technology is built on widely deployed wireless networks and advanced computing technologies. Pervasive Healthcare Technology solutions have focused mainly on at risk disease management Anderson & Wittwer, 2011). However, a growing market in a wide range of the healthcare field is ready to propel the development and consumption of pervasive Healthcare Technology. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

PACS is the healthcare technology of the future. “A picture archiving and communication system (PACS) is a computerized means of replacing the role of conventional radiological film: images are acquired, stored, transmitted, and displayed digitally.” PACS is not just used in the radiology department it can be used all over the hospital in any location, anytime, anywhere and even be used with other hospitals, between different physicians. There are advantages and disadvantages to choosing to use the PACS system. There are other technologies that have a dramatic impact on the delivery of patient care as well these technology along with the PACS system make healthcare better. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

One of the biggest advantages to using the PACS system is the fact that everything is done digitally. In my research I have found several reasons that hospitals should chose PACS to operate there radiology department as well as all the other areas in the hospital. In several articles it has stated that the use of PACS main advantage is “the improvement in efficiency.” PACS has been proven to decrease medical errors due to the fact “once an image has been acquired onto PACS it cannot be lost, stolen, or misfiled.” The PACS system also allows images to be available anywhere in the hospital whereas conventional film can only physically exist in one place at any one time. With the PACS system the physician can compare images at the same time. If an image is too dark or too light before you would have to retake the x-ray but with the PACS system you can adjust these things on the computer. Physician can also take an image from ten years ago and put it into the PACS system and compare it with the most recent image. Things like this can really help with diagnosis and treatment of patients. PACS also helps patient care be quicker because the physician can view the images anytime and anywhere in the hospital. For example if a patient is have trouble in the ICU the physician can view any images necessary to help treat the patient without leaving the ICU area therefore if the physician is needed he/she is right there. These images are available to all the members of the care team not just the physician. PACS system has been proven to save lives as well as lower medical errors. I read an article that stated “when the PACS system is fully utilized, the technology can play a significant role in reducing the potential for error by eliminating steps in the distribution and management of images and associated patient information across the enterprise. PACS system also allows hospital staff and physicians can schedule and order exams, update patient information across an enterprise, provide information and images to physicians at the point of care, and provide diagnostic tools, features, and functionality to ensure the highest quality of interpretation and diagnosis. Currently 20% of films are missing when needed. This wouldn’t happen if they were using the PACS system. “All images in the PACS database are automatically grouped into the correct examination, are Chronologically ordered, correctly oriented and labeled, and can be easily retrieved which is not necessarily the case without the PACS system.” The pediatrics and neonatal unit were among the first clinical specialties to start using the PACS system. Radiographic images play a big role in these departments. Time is very crucial in these units so it is a great advantage that you don’t have to go to the radiology department to retrieve these images. This is one good example how the PACS system can save lives and why the hospital should be using this system. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

There are some disadvantages to the PACS system as well as with any system that you may choose to use. One disadvantage to the PACS system is cost of installing the PACS system in the hospital setting. In the year 1999 the cost of intalling the PACS system was one to two million dollars with a six percent annual maintenance. Studies have shown that PACS would pay for itself in five years. Another disadvantage is once you have gone filmless there is risk that the PACS system could have a system failure with this in mind as long as the data is backed up daily. One other potential problem of PACS is that the staff may not have the knowledge to be able to use the PACS system. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

In my research I found that when the PACS system is used along with the EMR and the CPOE there is a dramatic impact on patient care. The EMR is where all medical records, including all of patient images, pathology, surgical results and history are done and stored electronically. The CPOE is where the physicians use computers to due order entry. “Each of these things in isolation helps somewhat with patient care but when the three are used together the results are much greater.

In Conclusion, healthcare technology is going to computerization and there is no stopping it. We are in an era where computers are an important part of daily life not just in the healthcare field. Learning how to use computers and there software is crucial for survival. In this paper I talked about one of the most rapidly growing systems in healthcare the PACS system. PACS is the healthcare technology of the future. “A picture archiving and communication system (PACS) is a computerized means of replacing the role of conventional radiological film: images are acquired, stored, transmitted, and displayed digitally.” PACS is not just used in the radiology department it can be used all over the hospital in any location, anytime, anywhere and even be used with other hospitals, between different physicians. I also talked about the advantages and disadvantages of the PACS system as well as other systems that work along with the PACS System. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Any nurse who has spoken to a patient over the phone has practiced telehealth nursing. Telehealth is defined as “the use of technology to deliver health care, health information or health education at a distance” (“What Is Telehealth?,” n.d., para. 1). Although the use of technology changes how nursing care is delivered and may require competencies related to its use to deliver nursing care, the nursing process and scope of practice does not differ with telehealth nursing. Nurses engaged in telehealth nursing practice continue to assess, plan, intervene, and evaluate the outcomes of nursing care, but they do so using technology. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

In an environment of limited number of nurses, technology can help meet the need to provide nursing care and increase the efficiency of those nurses. When a patient leaves the hospital, the patient is responsible for his or her own health care at home. Telehealth services can make it more efficient to manage ongoing care and improve patient safety. Telehealth nursing is used when there is a need to deliver nursing care remotely and improve efficiency and access to healthcare. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Telehealth offers healthcare providers with an opportunity to serve people who are in poor health, live in remote areas and do not have adequate access to health care. One of the major benefits of telehealth is that it promotes safety in healthcare. Patients are being discharged from the hospital earlier than ever before, with numerous medications and often lacking the knowledge they need to care for their condition adequately. Telehealth allows these patients to return home, which saves money, but allows them to be supported by a professional until they are well or are managing their condition with confidence. Telehealth provides a safety net for patients who may be struggling with managing their condition at home, preventing complications that could result in being hospitalized again. There is a need for standards and guidelines to support telehealth nursing practice and to reduce liability risk for nurses. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Practice standards and guidelines are evidence-based, and many people are involved in the development and distribution of nursing telehealth practice standards. Input from a wide array of experts is solicited in developing the standards and guidelines, in order to assure adequate consideration of technological, medical, nursing, legal, and ethical issues. (Hutcherson, 2001) To ensure safe and high quality telehealth nursing practice, technical requirements for privacy and security of personal health data should adhere to local and national laws governing the storage and transmission of personal health information. The future of telehealth is promising, but it may not work for addressing the chronic care burden of every patient. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Telehealth is a means of enhancing an organization’s ability to provide quality care in patients’ homes and delay the need for expensive hospital admissions or traditional nursing home care. Besides cost savings and bridging healthcare access barriers in rural areas, telehealth provides the opportunity to gain significant medical insights by analyzing continuous health data for a patient collected through remote monitoring, combined with other data sources. Telehealth services extend the skills and knowledge that nurses use every day. It is also one of the most promising and practical solutions, available not only to address an inevitable nursing crisis, but also to bring modern day healthcare to more people and save more lives.

Innovation in health care has aroused interest in many different fields. The role of innovation presented in this paper is dual 1) Innovation is a tool for necessary changes in the health care systems to adapt to demographical and epidemiological conditions. 2) Innovation is the way to develop new treatments and cure illness. Public financed health care is an activity in the innovation system on local as well as national and international level. It is also an arena for entrepreneurship where entrepreneurs and academic researchers in medical technology, medicine etc. share the workload to transfer knowledge into clinical practice and routine care in the health care facilities. This is an important and demanding task, as health care organizations are typically considered resistant to innovation. All activities health care related or not are dependent on policy issues, hence innovation policy must be designed to facilitate and accelerate innovation processes not only in firms and academia but also inside public organizations. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay
Introduction
Innovation is a hot topic, and the term is circulated in several contexts in society. In the political debate, on a national as well as an international level, innovation is considered a condition for welfare and growth (Zahra et al, 1994; in Baregheh, 2009). Historically, Swedish industry, both medical technology and pharmaceutical industries, has been successful in this regard. Fostering products such as Losec, Xylocain (drugs), the implantable pacemaker and the Lexell gamma knife, Sweden, as an innovative nation, is considered globally to be high standing. (Action Medtech report, 2007) The development of medical technology as well as pharmaceuticals and health care services is dependent upon the possibility to perform clinical trials and to test concepts together with patients and health care professionals. Highly advanced technologies available in health care today save lives, and as long as mankind is at risk of incurable diseases innovation for development of functional diagnostics and therapies will be required. In order to meet the challenges we face, with demographical changes and high pressure on the health care system, there is a need for technology, which facilitates the organization and the activities of health care in the future. (Ilinca et al, 2012; Thakur et al, 2012) There is also an interest for ‘frugal innovation’ with more cost-efficient products. This is expected to open up for new markets in developing countries and to decrease the costs for the industrialized countries. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

In Sweden, the amount of clinical trials is decreasing (Pettersson, 2013) and big companies such as St Jude Medical and AstraZeneca move their R&D facilities abroad, as of June 18, 2014, the last 200 researchers at St. Jude medical have been given notice and all R&D activities are to be moved from Uppsala. The relationship between industry and health care providers are today regulated due to ethical concerns, procurement regulations and business reasons (LIF, Swedish labtech, Swedish medtech, SKL, 2013).

Since health care is a civic function, predominantly financed by the public, the assignments on hospitals and other health care facilities are politically governed. The space for clinicians to participate in research activities and external collaborations beside the daily workload taking care of patients (and administration) has been diminishing. Subsequently, the space for individual clinicians to take part in innovation processes at work is limited. Nonetheless, worth mentioning is that university hospitals perform research and there are still positions combining the roles as professor at the medical faculty and chief physician in the hospital. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

The ability and willingness to adopt innovations is dependent on a mixture of factors and these phenomena can be analyzed on individual as well as organizational level (Rogers, 2003; Greenhalgh et al 2004). The hierarchical organization between and among the professional categories working in health care is one aspect, both considering the capacity to adopt innovations and the conditions for the individual to be innovative. Regarding innovation in general, it is estimated that one third is based on research and the other two thirds originate from other sources (M??ller H, 2014).

In order to facilitate innovation in Swedish health care, hospital management and county councils organize innovation departments e.g. ‘Innovationsplatsen at Karolinska University hospital’ or ‘SLL innovation’, where the first coordinates collaboration and innovation with companies and the latter helps health care professionals innovate themselves, i.e. clinicians who come up with ideas that could be developed into products or services. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

As described above, health care has been an arena for innovation, through research findings and high tech products such as drugs, pacemakers and radiation therapy. Health care is also mentioned as a context ‘where innovation happens’ in the Oxford Handbook of Innovation (Fagerberg et al, 2006). This is somewhat puzzling since the organization providing health care can be regarded quite resistant to innovation. (Nilsen et al, 2010). In addition, the entrepreneurial mindset is not the most commonly mentioned trait among health care professionals.
Aim of the study
The objective of this study is to elaborate on the discussion of the role of innovation in health care based on theoretical underpinnings found in the course literature on innovation and entrepreneurship. An interdisciplinary perspective on innovation presented by Baregheh et al. (2009) is reflected on, as a compliment to the original Schumpeterian definition, since the ‘production’ in health care constitutes of services. To frame the discussion, the scope of this paper will focus on the following questions: What is the role of innovation in healthcare? And what is the role of the healthcare system in the national innovation system? Is it reasonable to expect health care to contribute to national growth? NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

The remainder of the paper is structured as follows; the first section summarizes the concept of innovation and entrepreneurship from the course literature. The theoretical part then moves on to innovation systems and the aspects of innovation and growth highlighted by Edquist and colleges. Internationalization and globalization of innovation will be shortly mentioned in relation to ‘frugal innovation’ i.e. medical technology devices that are ‘ultra-low cost, durable, easy to use, draw sparingly on raw materials and minimize environmental impact, they are often well suited to any health sector under growing pressure to achieve better outcomes at significantly lower costs.’ (Dandonoli, 2013 p.2). From Edquist’s contributions on innovation systems I will touch on the role of growth, which pushes the discussion to the works of Delmar (2011) on entrepreneurship and growth. Here, knowledge spillovers from clinical research fostering entrepreneurs are mentioned. The last topic for discussion is the knowledge translation from academia to clinicians might take place thanks to the system with double roles for professors in academia who also have part-time engagements as clinicians in the hospitals. In the end, the discussion is summarized and conclusions are drawn. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay
Theoretical background
This part of the paper will present and utilize commonly used concepts and definitions in entrepreneurship and innovation research in order to analyze and discuss the role of health care in the innovation system.

Entrepreneurship
Already the ancient Greeks have referred to the phenomenon of entrepreneurship. Although entrepreneurial activities have taken place ever since, the research field is quite young. Some of the great economists that have had strong influence on the research field and the approach to entrepreneurship are Schumpeter, Kirzner, Knight and Gartner. (Davidsson 2004; Landstr??m 2010; Landstr??m 2012)

According to the first, Schumpeter (1912), the entrepreneur creates imperfections in the market by introducing new arrangements of existing resources, resulting in innovation. Kirzner (1973), in contrast, presents an entrepreneur aiming to remove imbalances by means of entrepreneurial alertness. From Kirzner’s perspective there is a clear distinction between innovation and entrepreneurship, while in the Schumpeterian view, they two are intertwined. Hence, Schumpeter’s entrepreneur forms something new, but not Kirzner’s, at least not primarily; The perspectives are complementary as the first ‘generates uncertainty at the market’ and the second ‘recognizes and act on it’. In behavior science, entrepreneurship has been explored with a strong focus on the entrepreneur as an individual and definitions related to personal traits. Already Cantillon (1755) described the entrepreneur as a ‘rational decision maker who assumed risk and provided management for the firm’ (in Landstr??m, p. ). This connects well to Knights reasoning on risk, uncertainty and true uncertainty as prerequisites for entrepreneurship. (Landstr??m 2010, Landstr??m 2012) NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

The individual-focused approach was criticized by William Gartner who contributed to change the way of thinking in entrepreneurship research in his book ‘Who is the entrepreneur is the wrong question’ (1988). Gartners addition to the discussion is his argumentation on entrepreneurship and the development process of a new organization. Venkataraman and Shane (1997, 2002) ‘focus on the emergence of opportunities, before/ ahead of the emergence of organizations’ (in Landstr??m ). From their vantage point, entrepreneurship research should be concerned with why, when and how 1) opportunities for creation of services/goods occur, 2) some people manage to discover and exploit these opportunities, and 3) diverse approaches are applied to exploit and take advantage of opportunities. (Landstr??m, 2010) NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

Innovation
The concept of innovation was first introduced by Schumpeter (1912, 1934), presented as a driving force for economic development. The term is defined as ‘new combinations of existing resources’ (Fagerberg et al., 2006, p.6). Examples of innovations are new products, new methods of production, new sources of supply, exploitation of new markets and new ways to organize businesses. Schumpeter worked on ‘the role of innovation in economic and social change’. He categorized innovations as incremental (marginal), radical (introduction of new types of technology/organization etc.) or technological revolutions (i.e. clusters of innovations that have higher impact when put together than they would have separately). Schumpeter emphasizes the tendency of innovations clustering in certain areas or businesses. (Fagerberg et al., 2006; Fagerberg et al., 2012) NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay

The field of innovation studies emerged as a research field in the 1960s. The ‘black box’ (see Fig 1) containing the innovation process has aroused great interest in social science and a more cross-disciplinary approach. While the distribution of resources for innovation and the economic effects of innovation have been of research interest among economists. Traditionally, the main focus among economists has been on new products and production methods. The social and economic impact of product and process innovation can differ. Introduction of new products on the market may have implications in terms of income and employment while the consequences of process innovation are more uncertain, since process innovation aims to optimize and save resources. Organizational innovation may include the rearrangement of positions, actors and individuals and can ultimately result in restructuring and reorganization of industries, which in this paper is considered to include health care organizations. NURS 5051 – Transforming Nursing and Healthcare Through Technology Essay