Abstract
The paper examines the link between institutional change and the development and diffusion of social innovations. Patient-centred education in diabetes is a radical social innovation that alters the social and medical relationship between patients and medics. This paper discusses the ways in which institutional work conducted by national and international professional associations has shaped development and diffusion of this social innovation within the Austrian health system. The case study contributes to our understanding of social innovation and institutional change in two respects. First, it highlights the need for purposive institutional work in order to disrupt pre-existing institutions and, thereby, ensure the development and diffusion of a social innovation amongst a community of medical practitioners. Second, the case shows the overtly political work, policing and educating work that professional associations undertook with funding bodies and key policy-makers in order to develop a national programme for diabetes education.
Highlights
This paper contributes to this special issue by examining the link between institutional change and the development and diffusion of therapeutic patient education (TPE) for Type 2 diabetes in Austria
This additional set of interviewees includes senior practitioners from medical fields directly connected to diabetes care in hospitals, and senior representatives from two powerful organizations that play a key role in the funding of education programmes and the training of doctors in evidence-based medicine (EBM): the Social Health Insurance Fund and the Physicians’ Chamber
Of the paper we examine the institutional work that has been conducted by these professional associations and how these lay the ground for the establishment of the national Diabetes Management Programme (DMP) programme that finances the delivery of TPE for diabetes patients in six provinces in Austria
Summary
This paper contributes to this special issue by examining the link between institutional change and the development and diffusion of therapeutic patient education (TPE) for Type 2 diabetes in Austria. This case study provides a unique opportunity to examine the type of institutional work required to establish a social innovation within medicine It shows how a social innovation in chronic healthcare management, previously developed and tested in Germany and Switzerland, enter the Austrian healthcare system. This occurred through an interplay between various national professional associations, university hospitals and key policy organizations. The framing of the TPE programme for those newly diagnosed with Type 2 diabetes establishes a new patient-practitioner relationship, it is the start of a process of patient empowerment This aim of patient empowerment is very much in line with Mendell and Neamtan’s (2010) discussion of social innovation. Austrian diabetologists connected with British specialists who later conceptualised and implemented the DAFNE programme
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