Understanding the Adoption Dynamics of Medical Innovations: Affordances of the Da Vinci Robot in the Netherlands

Soc Sci Med. 2014 Sep;117:125-33. doi: 10.1016/j.socscimed.2014.07.046

Posted: 30 Aug 2014

See all articles by Payam Abrishami

Payam Abrishami

National Health Care Institute; Maastricht University

Albert Boer

National Health Care Institute

Klasien Horstman

Maastricht University

Date Written: July 2014

Abstract

This study explored the rather rapid adoption of a new surgical device -- the da Vinci robot -- in the Netherlands despite the high costs and its controversial clinical benefits. We used the concept 'affordances' as a conceptual-analytic tool to refer to the perceived promises, symbolic meanings, and utility values of an innovation constructed in the wider social context of use. This concept helps us empirically understand robot adoption. Data from 28 in-depth interviews with diverse purposively-sampled stakeholders, and from medical literature, policy documents, Health Technology Assessment reports, congress websites and patients' weblogs/forums between April 2009 and February 2014 were systematically analysed from the perspective of affordances. We distinguished five interrelated affordances of the robot that accounted for shaping and fulfilling its rapid adoption: 'characteristics-related' affordances such as smart nomenclature and novelty, symbolising high-tech clinical excellence; 'research-related' affordances offering medical-technical scientific excellence; 'entrepreneurship-related' affordances for performing better-than-the-competition; 'policy-related' affordances indicating the robot's liberalised provision and its reduced financial risks; and 'communication-related' affordances of the robot in shaping patients' choices and the public's expectations by resonating promising discourses while pushing uncertainties into the background. These affordances make the take-up and use of the da Vinci robot sound perfectly rational and inevitable. This Dutch case study demonstrates the fruitfulness of the affordances approach to empirically capturing the contextual dynamics of technology adoption in health care: exploring in-depth actors' interaction with the technology while considering the interpretative spaces created in situations of use. This approach can best elicit real-life value of innovations, values as defined through the eyes of (potential) users.

Keywords: Affordance, Decision-making, Qualitative ethnographic evaluation, Science, Technology and Society Studies, Surgical device, Technology adoption, The Netherlands, da Vinci robot

Suggested Citation

Abrishami, Payam and Boer, Albert and Horstman, Klasien, Understanding the Adoption Dynamics of Medical Innovations: Affordances of the Da Vinci Robot in the Netherlands (July 2014). Soc Sci Med. 2014 Sep;117:125-33. doi: 10.1016/j.socscimed.2014.07.046, Available at SSRN: https://ssrn.com/abstract=2488945

Payam Abrishami (Contact Author)

National Health Care Institute ( email )

Diemen
Netherlands
+31 20 797 85 55 (Phone)

HOME PAGE: http://www.zorginstituutnederland.nl

Maastricht University

P.O. Box 616
Maastricht, 6200MD
Netherlands

Albert Boer

National Health Care Institute ( email )

Netherlands

Klasien Horstman

Maastricht University ( email )

P.O. Box 616
Maastricht, 6200MD
Netherlands

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