| The main objective of this thesis by articles is to gain a better understanding of the technological progress, the competition between two technological regimes and the emergence of a dominant design in the specific context of the healthcare sector. This thesis focuses on the technological strategies to improve medicines management.;The first article analyses the technological anticounterfeiting strategies as they are envisioned in Europe and North America and evaluates their respective potential in improving the integrity of the pharmaceutical supply chains. It shows that the consensus among the pharmaceutical actors to determine the best technological strategy for tracking and tracing medicines is far from being reached. Although RFID technology holds a strong potential to improve logistics, the popularity of the barcodes (old technology) and the technical problems associated with the new technology proved to be the main obstacles for the RFID adoption. Hybrid solutions combining barcodes and RFID entail significant advantages for improving medicines management.;The second article focuses on the processes of the logistics function of the hospital pharmacy and demonstrates the importance of analyzing the levels of drug packaging and inefficiencies of logistics processes to determine the most appropriate solution for tracing and tracking medicines. The hybrid configuration, combining RFID technology for tracking cases, bundles and bins, and barcodes for identifying primary packages, seems to be, taking into account the contextual constraints, the most promising solution. This hybrid solution points to a coexistence between the barcode and RFID technology as a preferred strategy for automatic identification and tracking of medicines. Moreover, this paper analyzes the impacts (real or perceived) of this coexistence, such as the benefits for medication management, the implementation issues and the development of new inter-organizational relationships between the actors in the value chain drug.;The third article explores four different adoption paths for improving the medication process of an emergency department, namely full barcode implementation, full RFID implementation, migration and hybridization. Taking into account the characteristics of the medication processes, the relative merits of the two data carriers, the characteristics of healthcare organizations, and the perceived or real impacts, the coexistence of barcode and RFID technology seems to be the most effective and most compatible adoption path.;This thesis makes several contributions. At the theoretical level, it improves our collective understanding of the era of ferment in general and the coexistence of two competing technologies in particular. Our results support to some extent the previous work on technological progress as proposed by Tushman and Anderson and confirm the presence of an era of ferment between barcodes and RFID. However, our research suggests that a dominant design may not be reached and, consequently, multiple technological configurations could coexist. Coexistence between RFID and barcode can lead to three models, a convergence model, a migration model (from barcodes to RFID) and a hybrid model that capitalizes on the advantages of both data carriers.;As for practical contributions, results may be useful to policy makers, managers and technological developers for counteracting the issues and problems related to the medicine management. The detailed process maps presented in this document may be used as a reference for assessing existing processes and for elaborating action plans. Finally, our research assesses the relative merits of the different technological configurations. This analysis can be used to reduce some of the technological uncertainty experienced by the healthcare sector. (Abstract shortened by UMI.). |
