Complexities in building innovation systems : the case of radical medical technologies

The main goal of this thesis is to facilitate a further understanding of how firms behind innovative technologies deal with different complexities in system-building strategies and the co-dependencies among different technologies, actors and system-building activities, while contributing to the build-up of a technological innovation system (TIS). In particular, it seeks to deepen our understanding of not only the strategies involved in technological innovation, but also the build-up of the sociotechnological system around it. Empirically, this thesis focuses on two different cases in the healtcare sector—personalised cancer medicine and point-of-care testing (POCT)—because both of these technologies serve as interesting examples of radical innovation and they require major technical, economic and social changes around them for a successful implementation. This dissertation concludes that technological co-dependency, co-dependency among actors and different system-building activities are very important complexities in system building that strongly influence actors’ strategic activities around radical innovations. Firms deal with these co-dependencies in building innovation systems around radically innovative medical technologies by applying different system-building strategies in knowledge diffusion, resource allocation, creation of legitimacy and in formation of networks. The choice of a concrete system-building strategy is a complex decision that does not depend only on a technology—this thesis shows that also the size of a company, specific system-building activities, presence of other firms in the same market segment, customer needs and institutional structure have a major role in influencing a concrete timing and strategy choice. This thesis makes some key theoretical contributions to TIS literature. It recommends that the three studied system-building complexities should become more central in a TIS analysis to better understand how a technological innovation system develops. Also, it makes a contribution to the literature on technological innovation systems by applying the current TIS framework to the healthcare field, as until now majority of TIS analysis have been done on the sustainability and transport field. Additionally, this thesis creates more detailed insights on how the institutional change processes develop within TIS and demonstrates that their role in the TIS analysis could be emphasised more to clarify the dynamics of TIS. Last, this thesis argues that the complexity of the technological field in general and around radical medical innovations in particular, should be considered more carefully in setting the boundaries of a technological innovation system so that relevant contextual factors in TIS analysis are not overlooked. This thesis also highlights a number of areas, where more fine-tuned policy measures would be necessary to better meet technological and scientific progress in medical innovation. These include the regulation of personalised drugs and diagnostics as one single product, clearly defined approval and reimbursement rules of innovative medical technologies, national level policy instruments to provide equal access to innovative medical products for everybody, regardless of their location. Also higher involvement of different stakeholder groups along the whole value chain of innovative medical products is recommended in order to better consider their demands, needs and capabilities, which would hopefully facilitate eventually a smoother uptake of innovative medical technologie