Out with the Old, In with the New
How do health care professionals decide when it’s time to ditch some innovation in medical technology in favor of the latest upgrade or advice from the medical community?
Nov 28, 2017

Out with the Old, In with the New

As Featured In 
Management Science

Knowing When to Upgrade Technology in Health Care

How do health care professionals decide when it’s time to ditch some innovation in medical technology in favor of the latest upgrade or advice from the medical community?

Researchers from the University of Maryland’s Robert H. Smith School of Business took a close look at how health care professionals abandoned their use of coronary stents, in response to either the emergence of a technology upgrade or in light of new information questioning the efficacy of the existing technology.

The study, “The When and Why of Abandonment,” by the University of Minnesota’s Brad N. Greenwood and the Smith School’s Ritu Agarwal, Rajshree Agarwal and Anandasivam Gopal, was published by the journal Management Science.

While there is a huge literature on adoption of new technologies, less is known about technology abandonment, the researchers said. This is not a trivial issue — if physicians and medical professionals do not keep up with what's state-of-the art in medical knowledge, the downside can be very severe. What drives some professionals to shift to new practices while others don’t is not clear, but it is highly likely that the workplace has some role in encouraging this shift. In this paper, the authors look at features of the hospital where physicians work to see if that influences how soon they abandon older practices for newer ones.

Their research examined coronary stents across three technological upgrades, with data that covered about two million Florida patients over a 12-year period, from 1995 to 2007.

They found striking differences in how quickly physicians in certain hospitals abandoned older technology in favor of a newer upgrade, based on whether the medical center was for-profit, not-for-profit or academic in nature.

Physicians in for-profit hospitals abandoned earlier generation stents in favor of newer stents faster than physicians in not-for-profit hospitals, thereby adopting newer and more expensive stents. But that difference was erased in cases when the efficacy of the technology was questioned.

Academic medical centers, meanwhile, demonstrated the highest rates of abandonment, regardless of the efficacy findings.

“Importantly,” the researchers explained, “we find that organizational factors dominate physician differences as explanatory factors for abandonment.”

Their research identifies which factors play into an organization’s decision to ditch older technology in favor of the new. And it underscores the importance of the organization’s mission in determining how readily it abandons obsolete technology.

Read more: The When and Why of Abandonment: The Role of Organizational Differences In Medical Technology Life Cycles is featured in Management Science.

About the Author(s)

Ritu Agarwal is Senior Associate Dean for Research, Professor and the Robert H. Smith Dean’s Chair of Information Systems at the Robert H. Smith School of Business, University of Maryland, College Park. She is also the founder and Director of the Center for Health Information and Decision Systems at the Smith School.

Rajshree Agarwal is the Rudolph P. Lamone Chair and Professor in Entrepreneurship at the University of Maryland and director of the Ed Snider Center for Enterprise and Markets. Rajshree’s research interests focus on the implications of entrepreneurship and innovation for industry and firm evolution. Her recent projects examine the micro-foundations of macro phenomena, linking knowledge diffusion among firms, industries, and regions to the underlying mechanisms of employee entrepreneurship and mobility.

Anand Gopal is a Professor and Van Munching Faculty Fellow at the Robert H. Smith School of Business, University of Maryland. His research interests are broadly in technology platforms, contracts and entrepreneurship. He has specific projects in technology-based entrepreneurship, secondary markets for tech products, mobile platforms and healthcare.

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