Anticipating emerging medical technologies: The start of an international horizon scanning tool for medical devices

The governance of innovative medical technologies is fraught with uncertainties. Responsible governing bodies prepare for future advances by engaging in anticipatory practices aimed at knowing and acting earlier-on, but little is known about such work. We examine an anticipatory practice of a multinational, mostly European horizon scanning collaboration, drawing on the analytical framework of anticipatory governance and micro-regimes of anticipation. We distinguish four inter-related micro-regimes that emerge from participants' expectations of a horizon scanning tool. We show how all micro-regimes relate to ideas about anticipatory governance that focus on prediction and reducing uncertainties. Moreover, participants' expectations about the tool are vested on prior experiences with horizon scanning for pharmaceuticals. We argue that this may affect the governance of medical technologies that do not fit a linear approach, conventional for pharmaceuticals, but develop more iteratively. Finally, we highlight the importance as well as the complexity of engagement between different stakeholder groups. Overall, we conclude a need for anticipatory practices to become more reflexive about the consequences of future visions, the assumptions behind them, and the implications for the actions needed in the present. This would increase the relevance and value of policy tools developed for the governance of emerging medical technologies.