Biomedical Engineering Reference
In-Depth Information
room to distinguish their services through provision of supplementary poli-
cies and services. Such mechanism should contribute to the competitiveness
in the market and at the same time facilitate an enhanced quality of care in
general (Bomhoff 2002). This is deemed necessary to deal with demographic
and epidemiologic changes (aging society, increasing number of chronically
ill) that are occurring. In this context, the issue of patient empowerment also
plays an important role especially for citizens (or patients) who are dealing
with chronic diseases and for the elderly who want to remain living inde-
pendently for as long as possible. Such demand is recognized by the medi-
cal devices industry as they have to assess society's needs and adjust to the
norms and values of the public; however, at the same time, they have to com-
ply with legal contexts, regulations, and rules.
Meanwhile, the situation has caused health-care professionals to increas-
ingly operate efficiently and negotiate for reimbursement for services that
they find necessary for their patients. On the other hand, while governmen-
tal supervision on the health-care system is moving to the background and
other actors in the health-care market find more room to safeguard their own
stakes, they will attempt to incorporate their own interests in the services to
be offered to the customers. One possible impact to be considered then is
that as more weight is given to the individual needs for provision of health
care, the control over collective interests such as equal access to high-quality
care and affordability of health care might decrease. Another possibility that
is suggested is the adjustment of health-care policies to the state of health of
patients as a plausible market mechanism (reward mechanism) to encourage
efficiency and quality (KPN 2006).
The health-care professionals that were interviewed in this study have col-
lectively raised the concern with regard to the way medical devices and ser-
vices are envisioned to be offered to patients. Their concern is based on the
argument that citizens (and patients) are not always capable of making the
right choices with regard to what kind of care and services they need. This
does not only have to do with knowledge and availability of information
about a specific procedure, but also the fact that there is a difference between
healthy individuals and ill patients in their ability to consider the pros and
cons of specific diagnostic or treatment service. Moreover, it was argued by
health-care professionals that information that is provided to patients by pri-
vate parties might be biased because there are commercial interests involved.
Finally, it was emphasized that considerations and choices of health-care
professionals with regard to what is appropriate for the patient has to be
balanced in many different dimensions and is dependent on the context and
individual situations.
In this brief section, we have shown that there are specific issues to be
addressed with regard to social embedding of BAN and the position and
perspectives of different actors play a crucial role in shaping that process.
Therefore, we will first look at the major stakeholders and their positions
with regard to the introduction of BAN applications in a broad sense. This
