The Role of Controversy in Medical Technology Adoption

  • Olga Mikhailova
  • Per Ingvar Olsen


In Chapter 11, Mikhailova and Olsen present a study of a radical innovation in heart surgery and its adoption and implementation at a university hospital. The authors explore the complex inter- and intra-organizational adjustment processes of technology and practice integration by focusing on controversies at the frontiers of interaction and their effects on the adjustments and outcomes of the process. The case concerns the introduction of Transcatheter Aortic Valve Implantation (TAVI) implementation in a Scandinavian hospital and shows that interdisciplinary frictions between cardiologists and thorax surgeons had a substantial impact on the innovation process. The authors argue that interactions between suppliers, their networks and users were critical to the particular paths of implementation and assimilation that bring radically new technologies into sustainable medical procedures.



We acknowledge the financial support from The Research Council of Norway (grant no. 210511) and we are grateful to informants participated in our research project. We also thank editors for the valuable comments and helpful suggestions.


  1. Anderson, J. C., Håkansson, H., & Johanson, J. (1994). Dyadic business relationships within a business network context. The Journal of Marketing, 58(4), 1–15.CrossRefGoogle Scholar
  2. Biemans, W. G. (1991). User and third-party involvement in developing medical equipment innovations. Technovation, 11(3), 163–182.CrossRefGoogle Scholar
  3. Bleiziffer, S., Krane, M., Deutsch, M., Elhmidi, Y., Piazza, N., Voss, B., & Lange, R. (2013). Which way in? The necessity of multiple approaches to transcatheter valve therapy. Current Cardiology Reviews, 9(4), 268–273.CrossRefGoogle Scholar
  4. Bridges, J., Fitzgerald, L., & Meyer, J. (2007). New workforce roles in health care. Journal of Health Organization and Management, 21(4/5), 381.CrossRefGoogle Scholar
  5. Callon, M. (1986). Some elements of a sociology of translation: domestication of the scallops and the fishermen of St. Brieuc Bay. In J. Law (Ed.), Power, action, and belief: A new sociology of knowledge? Sociological Review Monograph, Vol. 32, pp. 196–229. London: Routledge & Kegan Paul.Google Scholar
  6. Ciabuschi, F., Perna, A., & Snehota, I. (2012). Assembling resources when forming a new business. Journal of Business Research, 65(2), 220–229.CrossRefGoogle Scholar
  7. Cribier, A. (2012). Development of transcatheter aortic valve implantation (TAVI): A 20-year odyssey. Archives of Cardiovascular Diseases, 105(3), 146–152.CrossRefGoogle Scholar
  8. Cribier, A., Eltchaninoff, H., Bash, A., Borenstein, N., Tron, C., Bauer, F.,…Leon, M. B. (2002). Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis first human case description. Circulation, 106(24), 3006–3008.CrossRefGoogle Scholar
  9. Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implement Science, 4(1), 50.CrossRefGoogle Scholar
  10. Edmondson, A. C., Bohmer, R. M., & Pisano, G. P. (2001). Disrupted routines: Team learning and new technology implementation in hospitals. Administrative Science Quarterly, 46(4), 685–716.CrossRefGoogle Scholar
  11. Edmondson, A. C., Winslow, A. B., Bohmer, R. M., & Pisano, G. P. (2003). Learning how and learning what: Effects of tacit and codified knowledge on performance improvement following technology adoption. Decision Sciences, 34(2), 197–224.CrossRefGoogle Scholar
  12. Fitzgerald, L., Ferlie, E., Wood, M., & Hawkins, C. (2002). Interlocking interactions, the diffusion of innovations in health care. Human Relations, 55(12), 1429–1449.CrossRefGoogle Scholar
  13. Ford, D., Gadde, L., Hakansson, H., & Snehota, I. (2002). Managing networks. Paper presented at the The XVIII IMP Conference, Perth.Google Scholar
  14. Gallivan, M. J. (2001). Organizational adoption and assimilation of complex technological innovations: Development and application of a new framework. ACM Sigmis Database, 32(3), 51–85.CrossRefGoogle Scholar
  15. Gelijns, A., & Rosenberg, N. (1994). The dynamics of technological change in medicine. Health Affairs, 13(3), 28–46.CrossRefGoogle Scholar
  16. Goodman, R. M., & Steckler, A. B. (1987). The life and death of a health promotion program: An institutionalization case study. International Quarterly of Community Health Education, 8(1), 5–21.CrossRefGoogle Scholar
  17. Goodman, R. M., McLeroy, K. R., Steckler, A. B., & Hoyle, R. H. (1993). Development of level of institutionalization scales for health promotion programs. Health Education & Behavior, 20(2), 161–178.Google Scholar
  18. Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Quarterly, 82(4), 581–629.CrossRefGoogle Scholar
  19. Greenhalgh, T., Robert, G., Bate, P., Macfarlane, F., & Kyriakidou, O. (2008). Diffusion of innovations in health service organisations: A systematic literature review. Oxford: Blackwell.Google Scholar
  20. Greer, A. L. (1985). Adoption of medical technology: The hospital’s three decision systems. International Journal of Technology Assessment in Health Care, 1(03), 669–680.CrossRefGoogle Scholar
  21. Håkansson, H., & Waluszewski, A. (2002a). Co-evolution in technological development – The role of friction. Syneriga, 58, 171–190.Google Scholar
  22. Håkansson, H., & Waluszewski, A. (2002b). Managing technological development. IKEA, the environment and technlogy. London and New York: Routledge.CrossRefGoogle Scholar
  23. Hoholm, T., & Olsen, P. I. (2012). The contrary forces of innovation. A conceptual model for studying networked innovation processes. Industrial Marketing Management, 41(2), 344–356.CrossRefGoogle Scholar
  24. Ingemansson, M. (2010). Success as science but burden for business? – On the difficult relationship between scientific advancement and innovation. Doctoral thesis. Sweden: Uppsala University.Google Scholar
  25. Johanson, J., & Vahlne, J.-E. (2003). Business relationship learning and commitment in the internationalization process. Journal of International Entrepreneurship, 1(1), 83–101.CrossRefGoogle Scholar
  26. Johanson, J., & Vahlne, J.-E. (2006). Commitment and opportunity development in the internationalization process: A note on the Uppsala internationalization process model. Management International Review, 46(2), 165–178.CrossRefGoogle Scholar
  27. Kitson, A., Harvey, G., & McCormack, B. (1998). Enabling the implementation of evidence based practice: A conceptual framework. Quality in Health Care, 7(3), 149–158.CrossRefGoogle Scholar
  28. Latour, B. (1987). Science in action: How to follow scientists and engineers through society. Cambridge, MA: Harvard university press.Google Scholar
  29. Latour, B. (1990). Technology is society made durable. The Sociological Review, 38(S1), 103–131.CrossRefGoogle Scholar
  30. Latour, B. (2005). Reassembling the social: An introduction to actor-network-theory. Oxford: Oxford University Press.Google Scholar
  31. Laurell, H., Andersson, S., & Achtenhagen, L. (2013). The importance of industry context for new venture internationalisation: a case study from the life sciences. Journal of International Entrepreneurship, 11(4), 297–319.CrossRefGoogle Scholar
  32. Levin, S. (2010). Edwards: Transcatheter valve leader proves you can go home again. In-Vivo: The Business and Medicine Report 28, (10) (2010): 36.Google Scholar
  33. Meyer, A. D., & Goes, J. B. (1988). Organizational assimilation of innovations: A multilevel contextual analysis. Academy of Management Journal, 31(4), 897–923.CrossRefGoogle Scholar
  34. Meyers, P. W., Sivakumar, K., & Nakata, C. (1999). Implementation of industrial process innovations: Factors, effects, and marketing implications. Journal of Product Innovation Management, 16(3), 295–311.CrossRefGoogle Scholar
  35. Mikhailova, O., & Olsen, P. I. (2016). Internationalization of an academic invention through successive science-business networks: The case of TAVI. Journal of International Entrepreneurship, 14(3), 441–471.CrossRefGoogle Scholar
  36. Miles, M. B. (1983). Unraveling the mystery of institutionalization. Educational Leadership, 41(3), 14–19.Google Scholar
  37. Mørk, B. E., Aanestad, M., Hanseth, O., & Grisot, M. (2008). Conflicting epistemic cultures and obstacles for learning across communities of practice. Knowledge and Process Management, 15(1), 12–23.CrossRefGoogle Scholar
  38. Mørk, B. E., Hoholm, T., Ellingsen, G., Edwin, B., & Aanestad, M. (2010). Challenging expertise: On power relations within and across communities of practice in medical innovation. Management Learning, 41(5), 575–592.CrossRefGoogle Scholar
  39. Nielsen, H. H. M. (2012). Transcatheter Aortic Valve Implantation. Aarhus University Hospital, Danish Medical Journal. Dissertation.Google Scholar
  40. Nielsen, H. H. M., Thuesen, L., Egeblad, H., Poulsen, S. H., Klaaborg, K.-E., Jakobsen, C.-J.,…Hjortdal, V. E. (2011). Single center experience with transcatheter aortic valve implantation using the Edwards SAPIEN™ Valve. Scandinavian Cardiovascular Journal, 45(5), 261–266.CrossRefGoogle Scholar
  41. Olsen, P., & Håkansson, H. (2017). The roles of deals and business networks in innovation processes. IMP Journal, 11(1), 25–50.CrossRefGoogle Scholar
  42. Rogers, E. M. (1995). Diffusion of innovations. New York: Free Press.Google Scholar
  43. Siggelkow, N. (2007). Persuasion with case studies. Academy of Management Journal, 50(1), 20–24.CrossRefGoogle Scholar
  44. Smith, L., Bhan, A., & Monaghan, M. J. (2010). The expanding role of echocardiography in interventional cardiology. Eur Cardiol, 6, 71–77.CrossRefGoogle Scholar
  45. Szulanski, G. (1996). Exploring internal stickiness: Impediments to the transfer of best practice within the firm. Strategic Management Journal, 17, 27–43.CrossRefGoogle Scholar
  46. Szulanski, G., & Jensen, R. J. (2006). Presumptive adaptation and the effectiveness of knowledge transfer. Strategic Management Journal, 27(10), 937–957.CrossRefGoogle Scholar
  47. Tyre, M. J., & Orlikowski, W. J. (1994). Windows of opportunity: Temporal patterns of technological adaptation in organizations. Organization Science, 5(1), 98–118.CrossRefGoogle Scholar
  48. Van Brabandt, H., Neyt, M., & Hulstaert, F. (2012). Transcatheter aortic valve implantation (TAVI): risky and costly. BMJ, 345(e4710).Google Scholar
  49. Von Hippel, E. (1976). The dominant role of users in the scientific instrument innovation process. Research Policy, 5(3), 212–239.CrossRefGoogle Scholar
  50. Walther, T., Falk, V., Borger, M. A., Dewey, T., Wimmer-Greinecker, G., Schuler, G.,…Mohr, F. W. (2007). Minimally invasive transapical beating heart aortic valve implantation – proof of concept. European Journal of Cardio-Thoracic Surgery, 31(1), 9–15.CrossRefGoogle Scholar
  51. Walther, T., Kempfert, J., & Mohr, F. W. (2012). Transcatheter aortic valve implantation: Surgical perspectives. Archives of Cardiovascular Diseases, 105(3), 174–180.CrossRefGoogle Scholar
  52. Webb, J. G., Chandavimol, M., Thompson, C. R., Ricci, D. R., Carere, R. G., Munt, B. I.,…Lichtenstein, S. (2006). Percutaneous aortic valve implantation retrograde from the femoral artery. Circulation, 113(6), 842–850.CrossRefGoogle Scholar
  53. Webb, J. G., & Wood, D. A. (2012). Current status of transcatheter aortic valve replacement. Journal of the American College of Cardiology, 60(6), 483–492.CrossRefGoogle Scholar
  54. Wheelwright, S. C., & Clark, K. B. (1992). Revolutionizing product development: Auantum leaps in speed, efficiency, and quality. New York: The Free Press.Google Scholar
  55. Yetton, P., Sharma, R., & Southon, G. (1999). Successful IS innovation: The contingent contributions of innovation characteristics and implementation process. Journal of Information Technology, 14(1), 53–68.CrossRefGoogle Scholar
  56. Yin, R. K. (1989). Case study research: Design and methods. Newbury Park, CA: Sage.Google Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  1. 1.Department of StrategyBI Norwegian Business SchoolOsloNorway

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