Context as a relational configuration during new technology implementation in healthcare

This article proposes a new way of viewing the concept and significance of context during the implementation of new evidence-based medical procedures. Implementation theories and models often emphasize the importance of considering the context as a facilitator or a barrier to the sustainability of healthcare innovations. One of the drawbacks has been addressing the complex interconnections and dynamic relationships within the inner and outer contexts. The paper suggests the relational perspective as a new way of viewing this phenomenon. In the article, some principles of the relational perspective are applied to the findings of a longitudinal ethnographic study of introducing a new cardiothoracic procedure in Norway. TAVI (Transcatheter Aortic Valve Implantation) is an evidence-based, minimally invasive procedure to repair a damaged aortic valve. It has become a preferred treatment option for many patient groups suffering from aortic stenosis. The research followed the implementation of TAVI from its experimental phase to its standardization as a multiple case study. This manuscript examines the initial stages of its implementation from a relational standpoint, discussing environmental frictions and value configurations to present an alternative approach to understanding the context and multiple interactions during innovation implementation in healthcare.