The influence of operative Clinical Decision Support System developers on the Dutch CDSS Innovation System: an analysis of the interplay between systemic hurdles experiences and system building activities success
Summary
This study analyses the difference in hurdle experience and system building activities by Dutch CDSS developers and how they influence the innovation system. By making use of a priori argument, this study addressed if public and private developers carrying out different activities, aiming for products with different socio-characteristics and therefore striving for a different institutional set-up. Theoretically, this study combined several analytical perspectives from the innovation literature to formulate a comprehensive view for researching the expected interactions. Using real-life insights of eighteen semi-structured with developers and institutional actors, this study found that both developers produce a mix of CDSS and carry out overlapping system building activities. The results showed that public developers only experience substantially less market-economic related hurdles and are better able to influence the system with successful activities. Yet, activities aimed at strengthening the guidance of the search and legitimacy creation were rather unsuccessful, explaining the formative phase of the innovation system. Given this and the aim for a mix of product types, explains the absence of the expected distinction between public and private developers strive. Overall, the findings of the study are framed within theoretical implications for similar analysis and managerial implications for the Dutch CDSS innovation system.