In the field of health care there is an extremely strong tradition to both develop and practice new knowledge. This is by some emphasised as a requirement for an advanced health-care system. An often emphasised need is however to adopt new medical innovations, both technologies and methods, more systematically, since the use of technologies and methods are different depending on the care giver and geographical areas. Another argument is that in a tax-financed health-care system it is reasonable to monitor that methods are suitable and effective. It was in this setting the County Council of Östergötland in Sweden established a Health Technology Advisory Committee (HTAC). The top level managers’ intention was to support a controlled introduction and disinvestment of medical technologies. The aim was to develop an efficient way which would combine evidence-based knowledge with practice-based knowledge. Issues should be initiated by clinicians who, in their everyday practise, encountered knowledge gaps related to a medical technology. Few issues were however initiated to the HTAC which could be regarded as a setback. The aim of the paper is to study the different problem frames the various actors (clinicians and unit managers, experts, higher administrators and politicians) associate to “the problem” of introduction of new medical technologies. Is HTAC a solution of a non-problem? Are other solutions available? The paper explores issues related to problem-structuring, puzzling, powering, participation, evidence-based medicine and other factors as contextual-bound knowledge, social- and political aspects.
7th International Conference in Interpretive Policy Analysis. Tilburg, The Netherlands