Operational Process and Agency Considerations in Managing Emerging Technologies in Healthcare
探讨医疗行业新兴技术（如物联网、AI、3D打印）带来的运营机遇与挑战，强调从社会技术视角设计流程，平衡技术潜力与人类信任、伦理及系统准备度，对医疗运营管理者和研究者有参考价值。
In recent years, emerging technologies have seen explosive, and arguably unprecedented, growth in most industries. The healthcare industry has been no exception (Dai and Tayur 2020). We are at a crucial point where close consideration of the operational and strategic implications of emergent technologies in the healthcare industry is both observable and fully warranted. Emerging technologies, such as the internet of things (IoT), genetic technologies, 3D printing, advanced social platforms, as well as advanced analytics (e.g., artificial intelligence [AI] and other big data-driven analytics systems) are driving rapid growth and transformation in this industry (Gardner et al. 2015; Ganju et al. 2020; Xu et al. 2021; Adjerid et al. 2022; Rajpurkar et al. 2022). What is now needed are theoretical and practical insights to help identify new opportunities, operational challenges (and their solutions), arising from the advancement and adoption of these powerful emerging technologies in healthcare. Consider some of the current opportunities in healthcare: Emerging technologies are empowering physicians and improving patient care in multiple ways (Ferrand et al. 2018; Mukherjee and Sinha 2020). Developments in AI capabilities have been perhaps most notable in public discourse. AI has been deployed to augment diagnostic, clinical, and even surgical functions, therapy selection, risk prediction, and disease stratification. Resulting benefits include reductions in medical errors and increases in case throughput (Kalis et al. 2018). 3D printing technology has now advanced to the point at which it can be used to produce a wide range of customized medical devices, prosthetics, and implants. It can also fill emergent needs in place of dedicated production capacity for healthcare products (Bendoly, Chandrasekaran, et al. 2024). Robotic surgery has also been leveraged to greatly increase the precision of complex surgical activities. Emerging technologies are also changing the social reach and special opportunities for healthcare delivery (Bavafa et al. 2018). The interest in facilitating physically separate service engagement between patients and physicians, prompted in part by the COVID-19 pandemic, has prompted large-scale adoptions of telehealth technologies, often termed telemedicine, through which patients can access medical care remotely. Online consultations and live medical streaming are becoming normal experiences for many, permitting patients to obtain physical and mental health support virtually. Advanced wearables bring forth additional implications for such engagement. Ambulatory facilities, often located close to where patients live in suburban or rural areas, are becoming more valuable for patients when integrated with the aid of Electronic Health Record (EHR) systems. Robotic surgical options also present a similar degree of availability, enabling physicians to perform surgery without the need for travel. In short, emerging technologies not only have the potential to enhance the performance of healthcare systems and create innovative healthcare models, they also revolutionize the way healthcare operates in terms of care delivery, patient routing, allocation of resources, and the organizational design of healthcare systems (Dai and Tayur 2020). Such advancements, powered by these emerging technologies, collectively signal a paradigm shift toward more decentralized, accessible, and patient-centric models of healthcare delivery. Opportunities for process enhancement and innovation aside, numerous operational challenges also exist. These stem from complexities in the implementation of emerging healthcare technologies at scale, advancement of adoption and use, and design of maintenance plans and implementation policies (Heim et al. 2021; Stevens and van Schaik 2020). These issues are also highly intertwined. The acceptance (thus, adoption and use) of these emerging technologies by physicians and patients is directly related to the measurable effectiveness of their implementation and success, as well as to the manner in which further development and maintenance activities occur (Jussupow et al. 2021). Physicians may resist the large-scale implementation of emerging new healthcare technologies due to the fear of being diminished or even replaced, while patients may feel uncomfortable receiving advice provided remotely by virtual physicians through telemedicine, and especially by non-human AI agents. Further complicating things, emerging technologies also often raise legal and ethical issues, particularly in healthcare, such as liability issues for the application of new technologies in clinical settings and ethical issues for compliance with healthcare regulatory frameworks (Rajpurkar et al. 2022). Entangled in these are privacy concerns that can emerge relating to the processes by which patient data is collected in support of emerging technology use. Taken together, these practical challenges stress the need for integration strategies that balance the promise of emerging technologies with human trust, ethical safeguards, and systemic readiness across the healthcare ecosystem to achieve that promise. From an Operations Management perspective, these challenges raise the most fundamental question of how best to design processes that capitalize on the value that emerging technologies may provide in healthcare, while sufficiently accounting for the constraints and complex system relationships inherent to healthcare. In order to effectively chart a course of practical and theoretically informed consideration, and given the critical role of engaged interaction between physicians and patients, physicians and technology, and patients and technology, it is critical to adopt a socio-technical perspective. That is, it is not sufficient to merely consider the attributes of a technology when considering its impact on operational processes; rather, one must consider the manner in which those technological attributes are capitalized on in actual social application, or conversely, are either hindered or involved in misapplication. To that end, an understanding of the agency and role that patients, physicians, and specific emerging technologies play across a given service process is similarly critical. Ultimately, a socio-technical perspective, as a theoretical lens, is useful for designing healthcare operations that harness the potential of emerging technologies while accounting for human interactions, ethical issues, and systemic complexities that reflect real-world care delivery. In this Special Issue and associated discussion, we endeavor to draw attention to such issues and provide guidance for future work in this domain. A testament to the value of these considerations has been the Special Issue itself, which saw significant interest since its call for papers (CFP) in late 2023. A total of 70 formal submissions were made to the SI, 19 of which were considered for full review. While the full SI team was responsible for managing the SI call and intake of articles, and are thus listed on each article, only those without conflict of interest were involved in the review of each submission. Of those 19, seven were ultimately accepted (10% acceptance rate), based on their holistic contribution, and fit to the extant editorial mission, the SI CFP, and the body of knowledge represented in the literature on healthcare operations and technology and operations management, more broadly. When it comes to technology management and the associated operational outcomes that such management derives, a number of attributes distinguish healthcare from other contexts. These stem largely from the nature of the services rendered to patients, who are typically inherently involved in the conduct of the process (as principals, agents, and co-producers, as we will discuss further in the next section), while also embodying inputs and outputs of the service process. As a result, technology management efforts must not only be conducted with keen attention to the well-being of these individuals, but also an eye on such measures as operational efficiency. Further, and somewhat uniquely, technological developments in healthcare must not only attend to the benefit that such technology can yield for the health outcomes of patients, it must also attend to the care in which patient information is collected, stored, and used in order to deliver those outcomes over time. Failing to take care of the human-informational infrastructure can prove as harmful to patients in the long term as can failures in care delivery. In sum, effective technology management in healthcare demands a dual focus on operational performance alongside the ethical management of both patient well-being and data. This underscores the healthcare sector's uniquely human-centered technological complexity standards. For these reasons, regulations play a significant role in affirming standards across processes in healthcare. Such standards can touch everything from hiring patterns to contracting, capacity management to triage. Most salient to our present discussion, regulation can influence technology management decisions from the very onset of new tool development, through implementation, use, and maintenance of technology in healthcare settings. 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