دانلود رایگان مقاله لاتین تبدیل خطرات بالینی ارزش اقتصادی از سایت الزویر
عنوان فارسی مقاله:
تبدیل خطرات بالینی به ارزش اقتصادی: نقش انتظارات و نهادها در توسعه فناوری سلامت
عنوان انگلیسی مقاله:
Converting clinical risks into economic value: The role of expectations and institutions in health technology development
سال انتشار : 2016
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بخشی از مقاله انگلیسی:
3. Converting clinical risks into economic value: a three-step process
Business news reports share a strikingly similar narrative structure: the future is where everything happens, as explained in a large Canadian daily: Now the Internet balloon has developed a serious leak —many stocks are down 50 per cent or more from their peaks— and the mad money from the venture capitalists is drying up. It's probably too late for Canadians to make a big splash in the Internet market, but it's not too late for them to do so in the next hot industry —health care. That boat is about to dock. Health care is one those nebulous terms that encompasses pharmaceuticals, biotechnology (also known as life sciences) and medical devices. It is in the latter two categories that Canadian companies are making headway and it's all happening very quickly. Canada stands a good chance of building health care “clusters” —groupings of like-minded companies that both compete with, and feed off, each other— in Vancouver, Toronto and Montreal. So far, the Montreal area is leading the pack (PGB-13).3 The gist of this excerpt is the same as that of the light bulb story: a race is on and a foreseeable (bright) future will erase the (disappointing) past. But there is more than a seemingly anodyne narrative at play. Our findings describe below how expectations acquire potency through institutional requirements that involve: 1) measuring clinical risks that can be converted into business opportunities; 2) structuring technological entrepreneurship for growth; and 3) mitigating economic risks when facing material challenges. Fig. 2 illustrates this three-step process, which begins with estimates of the clinical risks the innovations promise to address and ends when economic value can be extracted from the spin-offs. The vertical arrows depict the gap between expectations and achievements, which increases over time. 3.1. Step n°1: Measuring clinical risks that are convertible into business opportunities The first step emphasizes the clinical risks (negative expectations) associated with existing technologies that a spin-off must measure and make explicit in its business plan (an institutional requirement). For instance, before introducing cryoablation, an innovation that uses extremely cold temperatures in the treatment of cardiac arrhythmia, the clinical shortcomings of the “rival” heat-based catheter procedures using radiofrequency (RF) are carefully described: Doctors perform 800,000 RF ablations annually in the US alone. But with a hot chunk of metal snaking around inside the heart, there are bound to be risks. «Although RF is a very useful and safe technique in general, it has some downsides that are begging for improvement,» says Dr. George Klein, an arrhythmia specialist at the London Health Sciences Centre (LHSC) in London, Ont. «RF can be very unstable.» Klein, who performs a couple of RF procedures every day, says it can be extremely difficult to hold the flexible catheter steady. And once the tip burns into the tissue, the damage is irreversible. So if a doctor hits the wrong spot, too bad. There's also the risk of poking a hole right through the heart wall, which could cause a lifethreatening hemorrhage. Or of forming a clot, which could lead to a stroke. «RF essentially fries the tissue,» says Klein. «It's like dropping an egg on a hotplate» (PSB-2).
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