Hospital-based Health Technology Management: Analysing the Procurement Process from a Network Perspective

From a practical perspective, the UK, like so many other countries, is struggling to have a complete HTM implementation. The sources suggest that British health care managers face financial and personnel availability pressures, and this makes it difficult to follow the instructions provided by the various organizations for the implementation of HTM activities including procurement. It is worth mentioning that the guidelines and decision-making frameworks provided by national organizations and various authors, mainly follow a project-based approach, characterized by linear HTM implementation/decision-making, and usually focusing on purely technical and legislative aspects of HTM. However, the health care sector, as well as procurement of medical devices, is characterised by complexity, constitutes an interconnected network of actors, parties and policies, and it is mainly context-dependent. Therefore, in addition to technical and legislative advice, it would be sensible to train health care managers in recognising the presence of internal networking relationships, and how to negotiate with all the actors involved in the different procurement, or more in general HTM, activities. From an academic perspective, almost all the articles analysing procurement aim to identify potential challenges, mainly related to financial and technical concerns, and subsequently provide decision-making frameworks to indicate the right path to follow when deciding which device to purchase. Very few articles perform a satisfactory analysis of the main actors involved during the procurement process and their responsibilities. Moreover, no attempts have been made to look at hospital-based procurement from a networking perspective and apply ‘Management in Networks’ theories and strategy to understand and improve it. Considering the aforementioned practical and academic issues, this study wants to investigate how hospital-based procurement could be analysed under the network point of view. Therefore, this dissertation wants to propose a new way of looking at hospital-based procurement, taking into account the presence of potential internal networks and interactions proper of an interconnected world. More specifically, this thesis project aims to provide a satisfactory description of the main procurement activities performed within the hospital, inform about who are the actors involved, how they interact, how/if they follow specif guidelines, and the main challenges encountered. Once the author will arrive at a satisfactory description of hospital-based procurement, she will analyse this last one under the paradigms of an interconnected world, explaining how the various networking strategies and paradigms can be used to understand and analyse hospital-based procurement. Finally, this research will identify factors that could be addressed by health care decision-makers to manage technology successfully. In particular, this study intends to identify valuable strategies for technology management decision-making and activities, to detect which one should be addressed by hospitals, and to establish technology management system priorities for health care managers and clinical engineers.Management of Technology (MoT