The Policies of Provision of Assistive and Welfare Technology—A Literature Review

Supporting and Studying Organizational Change for Introducing Welfare Technologies as a Sociomaterial Process

Welfare technologies (WT) for older people is a rapidly expanding sector that offers a way to tackle the challenge of an aging population. Despite their promise in terms of advances in care services and financial savings, their use is still limited. Their design and implementation remain problematic, as they require changes in working practices through coordination among a multiplicity of actors. In order to address these challenges, the need for change is often expressed in terms of a lack of working methods appropriate to their scope. This has led to a proliferation of different toolkits, guidelines, models, etc.; however, these methods often imply a linear understanding of an implementation project and thus fail to take into consideration the emergent and situated character of the processes that lead up to the adoption of welfare. The aim of this article is to propose an alternative means of providing support for the introduction of these technologies by initiating a process for organizational change. The term “change” is understood here as something that is produced by practitioners—in collaboration with researchers—and not brought by researchers to practitioners. To this end, using the tradition of intervention research as inspiration, a learning process at the crossroads of different practices and objects was initiated. The center of attention of this article’ is the sociomaterial process by which different communities of practitioners interact on the co-creation of a checklist. This is a new working method in which the focus is not the artifact in itself but how it emerges through successive interactions and iterations among different objects, practitioners and researchers, resulting in a joint sociomaterial process that reconfigures power relations and the work objective associated with WT. In other words, a new working method artifact is developed in a process in which practitioners, researchers and contextual objects interact and become one with each another.

The application and deployment of welfare technology in Swedish municipal care: a qualitative study of procurement practices among municipal actors

Background

Welfare 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.

Methods

The 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.

Results

Challenges 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.

Conclusions

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. 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.

Decision-Making Is in the Making! Aspects of Decision-Making in the Area of Assistive and Welfare Technology-A Qualitative Study

Assistive and welfare technology (AT/WT) has been introduced as a way of facing an ageing population and providing support for older adults in their daily lives. There is much research concerning the assessment and recommendation of AT/WT to individual end-users. However, few studies have explored AT/WT decision-making from a managerial perspective. This study explores what aspects influence decision-making in assistive technology organizations concerning new technology procurements. The study is based on interviews with 24 managers engaged in assistive technology organizations, representing 13 of 21 regions in Sweden. The interview data consisted of the participants’ experiences deciding on AT/WT procurement. A reflexive inductive thematic analysis was used to identify aspects that influenced decision-making. The main findings show that decision-making is in the making, meaning that decision-making is a constant on-going managerial process. Furthermore, the findings show that managers experience uncertainty in the decision-making, sometimes make ad hoc decisions and request an evidence-based, person-centred approach to improve decision-making. The study concludes that supportive, technology, patient, and knowledge aspects influence managers’ decisions.