Value in co-creation: Subjecting innovative in-hospital technologies to multi-stakeholder appraisal

Abstract: This article addresses how we can account for a value-drivenintroduction of in-hospital innovations when value is prone to – sometimesconsiderable – uncertainty. The contribution of multi-disciplinary, evidenceinformed multi-stakeholder deliberation (MSD) to deal with value issues is examined. Despite a widespread recognition of multi-stakeholder participation in health care policy-making, it is still uncommon in the decision-making settinginvolving in-hospital technologies. An ‘interpretative knowledge synthesis’ method has been adopted. This approach involves constructing a conceptual crossdisciplinary analysis by drawing on different strands of literature from Health Technology Assessment (HTA), public policy, and Science and Technology Studies. The authors describe that during introduction of in-hospital innovations, the social value of these technologies is at stake and that the formal evidence basis of the innovation is, by itself, inadequate to legitimise their introduction. It is then explained how MSD can help maintain public legitimisation of new technology. By sustaining mutual learning about what matters to one another, stakeholders can take their understanding of value upstream, towards value to society at large. MSD, then serves as a platform for ‘value in co-creation’: engaging in discursive appraisal of an innovation’s value. Concrete guidance is proposed for a multistakeholderappraisal of value as part of business/implementation planning inorder to responsibly introduce new technologies in hospital setting. Acollaborative endeavour to co-create value attends to current processes ofdecentralised, market-oriented introduction of in-hospital innovations. The aim isto legitimise dissemination, realise a socially-desirable impact from limitedresources, and act collectively to mitigate uncertainties during the course of implementation