Paper long abstract:

Nowadays diagnostic innovations, such as point-of-care and lab-on-a-chip technology, are evolving at high pace within the healthcare arena. At the same time, both public and private actors must early anticipate on the grand societal challenges such as globalization, ageing, individualization and personalization of health, care and diagnostics. Diagnostic innovation, therefore, could be perceived as a co-evolutionary process, an institutional interplay in which many stakeholders interact in complex ways. Interactions between users, patients and developers of diagnostic technologies take place both in laboratory and clinic, and in the wider society where the application of diagnostic innovations not only meets a medical need, but is also accompanied by increased health awareness and increased diagnostic needs and values of citizens due to increasing (early) diagnostic possibilities. Heterogeneous stakeholders in society provide feedback about how a new diagnostic technology, with still a high degree of uncertainty about measuring specific functions, technical specifications and related social, cultural and ethical aspects, matches their needs, preferences and performance criteria. It is therefore interesting to understand how the transition towards responsible diagnostic innovation proceeds. In other words, this paper studies potential scenarios of responsible future diagnostic innovations in the Netherlands. This will be done by using the Multi-Level Perspective, taking into account the dynamics of emerging diagnostic technologies and various transition pathways. The study is based on literature search and semi-structured interviews with experts in the Dutch diagnostic field.