Abstract

BackgroundWelfare technology has been launched as a concept to accelerate digital transformation in care services, but the deployment of these technologies is still hindered by organisational resistance, lack of infrastructure, and juridical and ethical issues. This paper investigates decision-making among municipal actors in the application and deployment of welfare technology from a procurement process perspective. The study explores the perceptions and negotiations involved in purchasing welfare technology at each stage of the procurement model, revealing the impact of technical, economic, juridical and ethical competence on the mapping, planning, procurement, implementation and management of welfare technology.MethodsThe study presents empirical findings from qualitative interviews conducted among municipal actors in Sweden. Semi-structured interviews were gathered in 2020 among procurement managers, IT managers, and managers in social administration in three different municipalities (n = 8). Content analysis and systematic categorisation were applied resulting in the division of procurement practices into sub-categories, generic categories and main categories.ResultsChallenges in the application and deployment of welfare technology occur at all stages of the procurement model. In mapping and planning, barriers are identified in the need analysis, requirement specification and market analysis. In the procurement stage, economic resources, standardisation and interoperability hinder the procurement process. Implementation and management are complicated by supplier assessment, legislation, cross-organisational collaboration and political strategy. Building on these findings, this study defines ‘procurement competence’ as consisting of technical, economic, juridical and ethical expertise in order to assess and evaluate welfare technology. Technical and ethical competence is needed in early stages of procurement, whereas juridical and economic competence relates to later stages of the model.ConclusionsProcurement competence is associated with the application and deployment of welfare technology in (1) assessment of the end-user’s needs, (2) estimation of the costs and benefits of welfare technology and (3) management of juridical and legislative issues in data management. Economic and juridical decisions to purchase welfare technology are not value-neutral, but rather associated with socially shared understandings of technological possibilities in care provision. Optimisation of procurement processes requires a combination of capabilities to introduce, apply and deploy welfare technology that meets the demands and needs of end-users.

Highlights

  • Digital transformation and the uptake of welfare technology in care services is expected to improve the quality and cost-effectiveness of care provision

  • Procurement competence is associated with the application and deployment of welfare technology in (1) assessment of the end-user’s needs, (2) estimation of the costs and benefits of welfare technology and (3) management of juridical and legislative issues in data management

  • Optimisation of procurement processes requires a combination of capabilities to introduce, apply and deploy welfare technology that meets the demands and needs of end-users

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Summary

Introduction

Digital transformation and the uptake of welfare technology in care services is expected to improve the quality and cost-effectiveness of care provision. Welfare technologies are assistive technologies that provide physical, social and cognitive assistance for older adults and persons at risk of disability, designed to increase their safety, participation and independence, and to improve care delivery and the work environment of healthcare professionals [3, 23] These technologies include various forms of digital devices, including care robots [24, 25], telecare and alarms [19, 26], monitoring systems [27, 28, 29], digital reminders [30], and mobile health applications [25, 31]. This may include, for instance, resistance to chance-established routines, resistance due to language differences, clash of professional cultures, resistance due to patient safety, concerns regarding care quality, patient privacy, dignity, and justice [4]

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