Débat public sur la valeur sociale des innovations médicales : l'expérience d'un Café scientifique

Les innovations médicales ont un impact considérable sur les pratiques cliniques, sur la formulation des politiques et sur les attentes du public envers le système de santé. Dans un contexte de système de santé public, les conséquences économiques importantes des innovations médicales freinent grandement leur adoption alors qu’elles sont souvent représentées dans les médias comme étant hautement désirables. Une telle définition de la problématique limite le débat sur ce qui rend les innovations sociales et technologiques en santé pertinentes d’un point de vue de santé des populations. Il apparaît donc intéressant de tirer profit d’une pratique communicationnelle innovante, le Café scientifique. Ce projet de recherche analyse un Café scientifique ayant mis en scène en mars 2007 un échange entre quatre experts et environ 80 membres du public autour des enjeux relatifs aux innovations en santé. Les objectifs sont : 1) analyser l’application d’une intervention de type Café scientifique; et 2) analyser ses retombées sur les participants. Cette étude de cas unique s’appuie sur des données qualitatives et quantitatives: 1) observation semi-participative; 2) enregistrement audiovisuel de l’activité; 3) questionnaires distribués à la fin de l’activité; et 4) entrevues semi-dirigées (n=11) avec des participants. L’analyse intégrée de ces données permet de mieux comprendre comment le contexte est structurant pour le débat, décrit les principaux rôles adoptés par les participants lors des échanges, identifie les principaux enjeux relatifs aux innovations médicales qui ont été débattus et dégage les dynamiques qui favorisent ou nuisent à un dialogue entre des scientifiques et le public. Le Café scientifique est une pratique encore peu répandue, mais qui suscite un intérêt à la fois chez les chercheurs et les participants.

Implication des utilisateurs dans le développement des innovations médicales : une analyse sociotechnique de la collaboration et de ses enjeux pour l’organisation des soins

Les changements technologiques ont des effets structurants sur l’organisation des soins dans notre système de santé. Les professionnels de la santé et les patients – les principaux utilisateurs des innovations médicales – sont des acteurs clés dans les trajectoires suivies par les nouvelles technologies en santé. Pour développer des technologies médicales plus efficaces, sécuritaires et conviviales, plusieurs proposent d’intensifier la collaboration entre les utilisateurs et les développeurs. Cette recherche s’intéresse à cette prémisse sur la participation des utilisateurs dans les processus d’innovation médicale. L'objectif général de cette recherche est de mieux comprendre la collaboration entre les utilisateurs et les développeurs impliqués dans la transformation des innovations médicales. Adoptant un cadre d’analyse sociotechnique, cette thèse par articles s’articule autour de trois objectifs : 1) décrire comment la littérature scientifique définit les objectifs, les méthodes et les enjeux de l’engagement des utilisateurs dans le développement des innovations médicales; 2) analyser les perspectives d’utilisateurs et de développeurs de technologies médicales quant à leur collaboration dans le processus d’innovation; et 3) analyser comment sont mobilisés, en pratique, des utilisateurs dans le développement d’une innovation médicale. Le premier objectif s’appuie sur une synthèse structurée des écrits scientifiques (n=101) portant sur le phénomène de la participation des utilisateurs dans les processus d’innovation médicale. Cette synthèse a dégagé les méthodes appliquées ou proposées pour faire participer les utilisateurs, les arguments normatifs véhiculés ainsi que les principaux enjeux soulevés. Le deuxième objectif repose sur l’analyse de trois groupes de discussion délibératifs et d'une plénière impliquant des utilisateurs et des développeurs (n=19) de technologies médicales. L’analyse a permis d’examiner leurs perspectives à l'égard de diverses approches de collaboration dans les processus d'innovation. Le troisième objectif implique l’étude d’une innovation en électrophysiologie lors de la phase de recherche clinique. Cette étude de cas unique s'appuie sur une analyse qualitative d'études cliniques (n=57) et des éditoriaux et synthèses de connaissances dans des revues médicales spécialisées (n=15) couvrant une période de dix ans (1999 à 2008) ainsi que des entrevues semi-dirigées avec des acteurs clés impliqués dans le processus d’innovation (n=3). Cette étude a permis de mieux comprendre comment des utilisateurs donne un sens, s’approprient et légitiment une innovation médicale en contexte de recherche clinique. La contribution générale de cette thèse consiste en une meilleure compréhension de l’apport des utilisateurs dans les processus d’innovation médicale et de sa capacité à aligner plus efficacement le développement technologique avec les objectifs du système de santé.

Promoting Open Access and Innovations : From Synergies to Le Centre de recherche interuniversitaire sur les humanités numériques

This article discusses the relationship between digital humanities and disciplinary boundaries in the last decade, primarily in the context of the national project Synergies. It offers first an overview of Synergies as a concrete example of the way technological change impacts the very notion of disciplines by trying to create a platform that was interdisciplinary by nature, then discusses the creation of a new Digital Humanities centre in Québec—Le Centre de recherche interuniversitaire sur les humanités numériques – and the ways it was conceived as encompassing a range of disciplinary approach.

Biased technological change, human capital and factor shares

We propose a one-good model where technological change is factor saving and costly. We consider a production function with two reproducible factors: physical capital and human capital, and one not reproducible factor. The main predictions of the model are the following: (a) The elasticity of output with respect to the reproducible factors depends on the factor abundance of the economies. (b) The income share of reproducible factors increases with the stage of development. (c) Depending on the initial conditions, in some economies the production function converges to AK, while in other economies long-run growth is zero. (d) The share of human factors (raw labor and human capital) converges to a positive number lower than one. Along the transition it may decrease, increase or remain constant.

Energy saving innovations, non-exhaustible sources of energy and long-run: what would happen if we run out of oil?

We formulate and solve a model of factor saving technological improvement considering three factors of production: labor, capital and energy. The productive activities have three main characteristics: first, in order to use capital goods firms need energy; second, there are two sources of energy: non-exhaustible and exhaustible; third, capital goods can be of different qualities and the quality of these goods can be changed along two dimensions -reducing the need of energy or changing the source of energy used in the production process. The economy goes through three stages of development after industrialization. In the first, firms make use of exhaustible energy and the e¢ ciency in the use of energy is constant. In the second stage, as the price of energy grows the e¢ ciency in its use is increased. In the third stage, the price of exhaustible sources is so high that firms have incentives to use non-exhaustible sources of energy. During this stage the price of energy is constant. In this set up, the end of the oil age has level effects on consumption and output but it does not cause the collapse of the economic system.

Factor saving innovations and factor income shares

We present an endogenous growth model where innovations are factor saving. Technologies can be changed paying a cost and technological change takes place only if the benefits are larger than the costs. Since the gains derived from factor saving innovations depend on factor abundance, biased innovations respond to changes in factors supply. Therefore, as an economy becomes more capital abundant agents try to use capital more intensively. Consequently, (a) the elasticity of output with respect to reproducible factors depends on the capital abundance of the economy and (b) the income share of reproducible factors increases as the economy grows. Another insight of the model is that in some economies the production function converges to an AK in the long run, while in others long-run growth is zero

Health in Brazil 6 Health conditions and health-policy innovations in Brazil: the way forward

Brazil is a large complex country that is undergoing rapid economic, social, and environmental change In this Series of six articles, we have reported important improvements in health status and life expectancy, which can be ascribed largely to progress in social determinants of health and to implementation of a comprehensive national health system with strong social participation. Many challenges remain, however. Socioeconomic and regional disparities are still unacceptably large, reflecting the fact that much progress is still needed to improve basic living conditions for a large proportion of the population. New health problems arise as a result of urbanisation and social and environmental change, and some old health issues remain unabated. Administration of a complex, decentralised public-health system, in which a large share of services is contracted out to the private sector, together with many private insurance providers, inevitably causes conflict and contradiction. The challenge is ultimately political, and we conclude with a call for action that requires continuous engagement by Brazilian society as a whole in securing the right to health for all Brazilian people.

Blogs, wikis and creative innovations

In this article, recent developments in the creation of web content, such as blogs and wikis, are surveyed with a focus on their role in technological and social innovation. The innovations associated with blogs and wikis are important in themselves, and the process of creative collaboration they represent is becoming central to technological progress in general. The internet and the world wide web, which have driven much of the economic growth of the past decade, were produced in this way. Standard assumptions about the competitive nature of innovation are undersupported in the new environment. If governments want to encourage the maximum amount of innovation in social production, they need to de-emphasize competition and emphasize creativity and cooperation.

Technological diversification within UK’s small serial innovators

This paper investigates the determinants of technological diversification among UK’s small serial innovators (SSIs). Using a longitudinal study of 339 UK-based small businesses accounting for almost 7000 patents between 1990 and 2006, this study constitutes the first empirical examination of technological diversification among SMEs in the literature. Results demonstrate that technological diversification is not solely a large firm activity, challenging the dominant view that innovative SMEs are extremely focused and specialised players with little technological diversification. Our findings suggest a nonlinear (i.e. inverse-U-shaped) relationship between the level of technological opportunities in the environment and the SSIs’ degree of technological diversification. This points to a trade-off between processes of exploration and exploitation across increasingly volatile technology regimes. The paper also demonstrates that small firms with impactful innovations focus their innovative activity around similar technological capabilities while firms that have introduced platform technologies in the past are more likely to engage in technological diversification.

On the adoption decision and the intensity of use of complementary innovations: The intra firm diffusion of management practices across UK establishments

This paper contributes to the literature on the intra-firm diffusion of innovations by investigating the factors that affect the firm’s decision to adopt and use sets of complementary innovations. We define complementary innovations those innovations whose joint use generates super additive gains, i.e. the gain from the joint adoption is higher than the sum of the gains derived from the adoption of each innovation in isolation. From a theoretical perspective, we present a simple decision model, whereby the firm decides ‘whether’ and ‘how much’ to invest in each of the innovations under investigation based upon the expected profit gain from each possible combination of adoption and use. The model shows how the extent of complementarity among the innovations can affect the firm’s profit gains and therefore the likelihood that the firm will adopt these innovations jointly, rather than individually. From an empirical perspective, we focus on four sets of management practices, namely operating (OMP), monitoring (MMP), targets (TMP) and incentives (IMP) management practices. We show that these sets of practices, although to a different extent, are complementary to each other. Then, we construct a synthetic indicator of the depth of their use. The resulting intra-firm index is built to reflect not only the number of practices adopted but also the depth of their individual use and the extent of their complementarity. The empirical testing of the decision model is carried out using the evidence from the adoption behaviour of a sample of 1,238 UK establishments present in the 2004 Workplace Employment Relations Survey (WERS). Our empirical results show that the intra-firm profitability based model is a good model in that it can explain more of the variability of joint adoption than models based upon the variability of adoption and use of individual practices. We also investigate whether a number of firm specific and market characteristics by affecting the size of the gains (which the joint adoption of innovations can generate) may drive the intensity of use of the four innovations. We find that establishment size, whether foreign owned, whether exposed to an international market and the degree of homogeneity of the final product are important determinants of the intensity of the joint adoption of the four innovations. Most importantly, our results point out that the factors that the economics of innovation literature has been showing to affect the intensity of use of a technological innovation do also affect the intensity of use of sets of innovative management practices. However, they can explain only a small part of the diversity of their joint adoption use by the firms in the sample.

Informal boundary-spanning links and networks in successful technological innovation

The sources of ideas embodied within successful technological innovation has been a subject of interest in many studies since the 1950s. This research suggests that sources external to the innovating organisation account for between one and two-thirds of the inputs important to the innovation process. In addition, studies have long highlighted the important role played by the personal boundary-spanning relationships of engineers and scientists as a channel for the transference of such inputs. However, research concerning the role and nature of personal boundary-spanning links in the innovation process have either been primarily structurally orientated, seeking to map out the informal networks of scientists and engineers, or more typically, anecdotal. The objective of this research was to reveal and build upon our knowledge of the role, nature and importance of informal exchange activity in the innovation process. In order to achieve this, an empirical study was undertaken to determine the informal sources, channels and mechanisms employed in the development of thirty five award-winning innovations. Through the adoption of the network perspective, the multiple sources and pluralistic patterns of collaboration and communication in the innovation process were systematically explored. This approach provided a framework that allowed for the detailed study of both the individual dyadic links and morphology of the innovation action-sets in which these dyads were embedded. The research found, for example, that the mobilisation of boundary-spanning links and networks was an important or critical factor in nineteen (54%) of the development projects. Of these, informal boundary-spanning exchange activity was considered to be important or critical in eight (23%).

Technology policy and technological innovation in the People's Republic of China

The objective of this research is to unveil the dynamics of technological innovation in planned economies in transition. It is proposed in the thesis that all innovation systems in the world, in fact, consist of certain configurations of market and hierarchy. These systems have always been shifting from one existing market-hierarchy mix to a new one, which is expected to be more conducive to technological innovation and economic development. Current reforms in many planned economies in transition reflect this theoretical proposition. A research framework is constructed to include three main dimensions for the study of a specific innovation system, i.e. Arrangements, Achievements and Actors. China, which has undergone reforms since 1978, is chosen as the empirical basis of the research. The research examined technology policy and technological innovation in China between 1978 to 1988. The thesis starts from Arrangements - R&D System in China and Its Reform. The thesis illustrates reforms in the R&D system in relation to government technology policy. There exist coherent government efforts to promote innovations through various plans, and the planning process incorporates both market and command elements. The institutional structure of Chinese R&D system remains still vertically departmentalised, but horizontal links are created through the market. Secondly, Achievements - Performance of Chinese R&D System is assessed through patterns of technological innovation. Data from National Awards for S&T Progress (1978-1988) are included in a substantial database, which is used to generate patterns of technological innovation and patterns of innovating organisations. These patterns were presented and interpreted in relation to geographical differences, sectoral differences, typological differences, forms of co-operation and the impacts of S&T policy and reform. The third dimension is study on Actors - Innovation in Applied R&D institutes. Through semi-structured interviews and questionnaire survey, internal structure and research management are analysed in the light of ongoing reforms. The reform of R&D funding system greatly affected the way applied R&D institutes operate. Both organisational and individual incentives for innovating are increasingly associated with economic or material benefits. The research suggests there is a need to put reforms in the R&D system into a wider societal and political context. Some general attributes of applied R&D institutes are also discussed in the thesis.

Indigenous and foreign innovation efforts and drivers of technological upgrading:evidence from China

This paper explores the drivers of technology upgrading in emerging economies using a recent Chinese firm-level panel dataset over the 2001-2005 period. It extends the Directed Technical Change theory by considering differences in technology intensities across industries within a country; examines the drivers of technical change, efficiency improvement and TFP growth in Chinese manufacturing firms; and explores the roles of indigenous innovations and foreign technology. It finds that FDI contributes to static industry capabilities by advanced technologies embedded in imported machineries, but not to dynamic technological capabilities of indigenous firms in developing countries. Collective indigenous R&D activities at industry level are the major driver of technology upgrading of indigenous firms that push up the technology frontier. Policy implications are discussed.

Technological innovation in electronic inventory solutions:an analysis of patent data

The purpose of this paper is to investigate the technological development of electronic inventory solutions from perspective of patent analysis. We first applied the international patent classification to classify the top categories of data processing technologies and their corresponding top patenting countries. Then we identified the core technologies by the calculation of patent citation strength and standard deviation criterion for each patent. To eliminate those core innovations having no reference relationships with the other core patents, relevance strengths between core technologies were evaluated also. Our findings provide market intelligence not only for the research and development community, but for the decision making of advanced inventory solutions.

Development of a technological innovation capability assessment model:a case study of manufacturing SMEs in Sialkot, Pakistan

Small and Medium Enterprises (SMEs) play an important part in the economy of any country. Initially, a flat management hierarchy, quick response to market changes and cost competitiveness were seen as the competitive characteristics of an SME. Recently, in developed economies, technological capabilities (TCs) management- managing existing and developing or assimilating new technological capabilities for continuous process and product innovations, has become important for both large organisations and SMEs to achieve sustained competitiveness. Therefore, various technological innovation capability (TIC) models have been developed at firm level to assess firms‘ innovation capability level. These models output help policy makers and firm managers to devise policies for deepening a firm‘s technical knowledge generation, acquisition and exploitation capabilities for sustained technological competitive edge. However, in developing countries TCs management is more of TCs upgrading: acquisitions of TCs from abroad, and then assimilating, innovating and exploiting them. Most of the TIC models for developing countries delineate the level of TIC required as firms move from the acquisition to innovative level. However, these models do not provide tools for assessing the existing level of TIC of a firm and various factors affecting TIC, to help practical interventions for TCs upgrading of firms for improved or new processes and products. Recently, the Government of Pakistan (GOP) has realised the importance of TCs upgrading in SMEs-especially export-oriented, for their sustained competitiveness. The GOP has launched various initiatives with local and foreign assistance to identify ways and means of upgrading local SMEs capabilities. This research targets this gap and developed a TICs assessment model for identifying the existing level of TIC of manufacturing SMEs existing in clusters in Sialkot, Pakistan. SME executives in three different export-oriented clusters at Sialkot were interviewed to analyse technological capabilities development initiatives (CDIs) taken by them to develop and upgrade their firms‘ TCs. Data analysed at CDI, firm, cluster and cross-cluster level first helped classify interviewed firms as leader, follower and reactor, with leader firms claiming to introduce mostly new CDIs to their cluster. Second, the data analysis displayed that mostly interviewed leader firms exhibited ‗learning by interacting‘ and ‗learning by training‘ capabilities for expertise acquisition from customers and international consultants. However, these leader firms did not show much evidence of learning by using, reverse engineering and R&D capabilities, which according to the extant literature are necessary for upgrading existing TIC level and thus TCs of firm for better value-added processes and products. The research results are supported by extant literature on Sialkot clusters. Thus, in sum, a TIC assessment model was developed in this research which qualitatively identified interviewed firms‘ TIC levels, the factors affecting them, and is validated by existing literature on interviewed Sialkot clusters. Further, the research gives policy level recommendations for TIC and thus TCs upgrading at firm and cluster level for targeting better value-added markets.