Know When to Update Your Technology

Women Leading Research: Ritu Agarwal

SMITH BRAIN TRUST – How do health care professionals decide when it’s time to ditch some innovation in medical technology in favor of the latest upgrade or advice from the medical community? Research from professor Ritu Agarwal and others at the University of Maryland’s Robert H. Smith School of Business took a close look at how health care professionals abandoned their use of coronary stents, in response to either the emergence of a technology upgrade or in light of new information questioning the efficacy of the existing technology.

The study, co-authored by the University of Minnesota’s Brad N. Greenwood and the Smith School’s Ritu Agarwal, Rajshree Agarwal and Anandasivam Gopal, was published by the journal Management Science.

While there is a huge literature on adoption of new technologies, less is known about technology abandonment, the researchers said. This is not a trivial issue — if physicians and medical professionals do not keep up with what's state-of-the art in medical knowledge, the downside can be very severe. What drives some professionals to shift to new practices while others don’t is not clear, but it is highly likely that the workplace has some role in encouraging this shift. In this paper, the authors look at features of the hospital where physicians work to see if that influences how soon they abandon older practices for newer ones.

Their research examined coronary stents across three technological upgrades, with data that covered about two million Florida patients over a 12-year period, from 1995 to 2007.

They found striking differences in how quickly physicians in certain hospitals abandoned older technology in favor of a newer upgrade, based on whether the medical center was for-profit, not-for-profit or academic in nature.

Physicians in for-profit hospitals abandoned earlier generation stents in favor of newer stents faster than physicians in not-for-profit hospitals, thereby adopting newer and more expensive stents. But that difference was erased in cases when the efficacy of the technology was questioned.

Academic medical centers, meanwhile, demonstrated the highest rates of abandonment, regardless of the efficacy findings.

“Importantly,” the researchers explained, “we find that organizational factors dominate physician differences as explanatory factors for abandonment.”

Their research identifies which factors play into an organization’s decision to ditch older technology in favor of the new. And it underscores the importance of the organization’s mission in determining how readily it abandons obsolete technology.

Read more:  The When and Why of Abandonment: The Role of Organizational Differences In Medical Technology Life Cycles is featured in Management Science.

Ritu Agarwal is the Robert H. Smith Dean's Chair of Information Systems and Senior Associate Dean for Faculty and Research. She is the founder and co-director of the Center for Health Information and Decision Systems.

Research interests: The use of information technology in healthcare settings, health analytics, technology-enabled strategic transformations in various industrial sectors, and consumer behavior in technology-mediated settings.

Selected accomplishments: Selected in 2013 as Distinguished Fellow for the Information Systems Society, Institute for Operations Research and the Management Sciences; winner in 2013 and 2004 of UMD’s Robert H. Smith School of Business Krowe Teaching Award for Excellence; and winner in 2011-2012 of a UMD Distinguished Scholar-Teacher Award.  Editor-in-Chief of Information Systems Research from 2011-2016.

About this series: The Smith School faculty is celebrating Women’s History Month 2018 in partnership with ADVANCE, an initiative to transform the University of Maryland by investing in a culture of inclusive excellence. Daily faculty spotlights support activities from the school’s Office of Diversity Initiatives, starting with the seventh annual Women Leading Women forum on March 1, 2018.

Other fearless ideas from:  Rajshree Agarwal  |  Ritu Agarwal  |  T. Leigh Anenson  |  Kathryn M. Bartol  |  Christine Beckman  |  Margrét Bjarnadóttir  |  M. Cecilia Bustamante  |  Jessica M. Clark  |  Rellie Derfler-Rozin  |  Waverly Ding  |  Wedad J. Elmaghraby  |  Rosellina Ferraro  |  Rebecca Hann  | Amna Kirmani  |  Hanna Lee  |  Hui Liao  |  Jennifer Carson Marr  |  Wendy W. Moe  |  Courtney Paulson  |  Louiqa Raschid  |  Rebecca Ratner  |  Debra L. Shapiro  |  M. Susan Taylor  |  Niratcha (Grace) Tungtisanont  |  Vijaya Venkataramani  |  Janet Wagner  |  Yajin Wang  |  Yajun Wang  |  Liu Yang  |  Jie Zhang  |  Lingling Zhang