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A dynamic model for analyzing the emergence of new medical technologies

IP.com Disclosure Number: IPCOM000128025D
Original Publication Date: 1983-Dec-31
Included in the Prior Art Database: 2005-Sep-14
Document File: 5 page(s) / 20K

Publishing Venue

Software Patent Institute

Related People

Homer, Jack Bernard: AUTHOR [+3]

Related Documents

http://theses.mit.edu:80/Dienst/UI/2.0/Describe/0018.mit.theses/1983-1: URL

Abstract

Many new medical products and practices have great potential for improving health but also involve high costs or risks. A number of government agencies have become involved in attempting to manage the process by which new medical technologies are disseminated, improved, and controlled. But this complex process of emergence is understood only in pieces. As a result, a consistent, comprehensive set of policies regarding new medical technologies has yet to be adopted. This thesis develops and tests a general theory of medical technology emergence which can serve as a foundation for sounder policymaking. A system dynamics computer simulation model was formulated which reflects existing knowledge relevant to the problem. Additional information contributing to the model was obtained through the extensive study of two medical technologies with distinctly different characteristics and histories, the implantable cardiac pacemaker and the antibiotic drug clind amycin. The model portrays activities of physicians and manufacturers which can affect the use of a new medical technology and which are, in turn, affected by the results of that use. When the model is parameterized to correspond to each of the two case technologies, a close fit to historical behavior is obtained. In both cases, dramatic changes in perceptions of the technology's relative advantage over alternative technologies play a central role in determining the observed pattern of use. Adjustments made by physicians in the criteria used for patient selection are at least as important a determinant of system-wide behavior as the adoption process in both cases. Sensitivity testing reveals that the pattern of use and outcomes is insensitive to many of the uncertainties regarding the technology or its context for emergence. But under certain conditions, the medical community may fall into traps of complacency or inactivity which markedly alter the path of emergence. A model-based policy analysis suggests that a governmentsponsored registry of clinical data which insures a smooth flow of timely information to physicians may reduce the likelihood of falling into these traps. Thesis Supervisor: Dr. Edward B. Roberts Title: David Sarnoff Professor of Management

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A DYNAMIC MODEL FOR ANALYZING THE EMERGENCE OF NEW MEDICAL TECHNOLOGIES

by

JACK BERNARD HOMER
B.S., Stanford University (1977) M.S., Stanford University (1977) Submitted in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY at the Massachusetts Institute of Technology March 1983


(c) Jack B. Homer 1983

The author hereby grants to M.I.T. permission to reproduce and to distribute copies of this thesis document in whole or in part.

SIGNATURE OF author: [[signature omitted]]

Department of Management

March 1983
CERTIFIED BY: [[SIGNATURE OMITTED]]

Edward B. Roberts Thesis Supervisor
ACCEPTED BY: [[SIGNATURE OMITTED]]

Chairman, Department Committee on Graduate Studies ARCHIVES MASSACHUSETTS INSTITUTE OF TECHNOLOGY LIBRARIES MAR 15 1983

Massachusetts Institute of Technology Page 1 Dec 31, 1983

Page 2 of 5

A dynamic model for analyzing the emergence of new medical technologies

A DYNAMIC MODEL FOR ANALYZING THE EMERGENCE OF NEW MEDICAL TECHNOLOGIES

Jack Bernard Homer

Submitted to the Department of Management in March 1983 in partial fulfillment of the requirements for the degree of Doctor of Philosophy

ABSTRACT

Many new medical products and practices have great potential for improving health but also involve high costs or risks. A number of government agencies have become involved in attempting to manage the process by which new medical technologies are disseminated, improved, and controlled. But this complex process of emergence is understood only in pieces. As a result, a consistent, comprehensive set of policies regarding new medical technologies has yet to be adopted.

This thesis develops and tests a general theory of medical technology emergence which can serve as a foundation for sounder policymaking. A system dynamics computer simulation model was formulated which reflects existing knowledge relevant to the problem. Additional information contributing to the model was obtained through the extensive study of two medical technologies with distinctly different characteristics and histories, the implantable cardiac pacemaker and the antibiotic drug clind amycin. The model portrays activities of physicians and manufacturers which can affect the use of a new medical technology and which are, in turn, affected by the results of that use.

When the model is parameterized to correspond to each of the two case technologies, a close fit to historical behavior is obtained. In both cases, dramatic changes in perceptions of the technology's relative advantage over alternative technologies play a central role in determining the observed pattern of use. Adjustments made by physicians in the criteria used for patient selection are at least as important a determinant of s...