[Truncated abstract] Technological innovation is considered the main contributor to economic growth. The systems of innovation framework aims to examine the causal pathways leading to technological innovation. However, most existing research under this framework, due to theoretical or methodological weaknesses, is unable to validate causal pathways or determinants of innovation. Institutions that guide human interaction within innovation systems are thought to be particularly important. The challenge has been to develop a taxonomy with which to conduct an empirical analysis of the impact of the institutional milieu on innovation. This thesis examines medical technological innovation within Australia and provides a basis from which such a taxonomy and other associated measures for systems of innovation have been developed. Medical industries are economically significant in developed countries and are amongst the most profitable worldwide. They use patents extensively to protect their innovations. In this context medical patents are an efficient means of examining the determinants of innovation. Few studies worldwide have explored the commercialisation process from patent to technological innovation and none has examined medical patents specifically. This thesis contains three empirical studies: - a description of Australian medical technology patented in the US between 1984-1999; - a survey of their inventors to examine the commercialisation process and identify the determinants of technological innovation; and - a case study of the commercialisation of an invention arising within an Australian university using qualitative methods. The first study is a population-based descriptive study of all US medical patents granted to Australian resident inventors between 1984 and 1999. During this period 7,835 US patents were granted to Australian resident inventors. Of these, 17% are identified as medical, and the proportion of medical patents rose from 10% to 25% of all Australian patents in the US from 1984 to 1999. The increase is largely due to Australian biotechnology patents, which increased from 10% to 55% of all medical patents during this period. Overall, medical patents are an increasingly significant proportion of Australia’s intellectual property portfolio. The second study is a survey of 402 first-named Australian inventors listed on the 602 medical patents granted in the US in 1984-1994. The aim is to assess their experience and success in commercialising their patented inventions. The correct address was found for 274 inventors of whom 177 (65%) were surveyed with no evidence of a significant response bias. This is the first known study surveying a nationally representative sample of medical inventors listed on patents