Document Type : Original Article

Authors

1 Department of Health Management, Evaluation and Policy, University of Montreal, Montreal, QC, Canada

2 Center for Public Health Research of the University of Montreal, Montreal, QC, Canada

3 Institute for Data Valorization (IVADO), Montreal, QC, Canada

4 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK

5 Université of Quebec at Rimouski, Levy, QC, Canada

6 Executive Office & Research Centre of The University of Montreal Hospital, Montreal, QC, Canada

7 Department of Entrepreneurship and Innovation, Montreal Business School (HEC), Montreal, QC, Canada

8 Faculty of Medicine, Laval University, Quebec, QC, Canada

9 VITAM Research Centre on Sustainable Health, Faculty of Medicine, Laval University, Quebec, QC, Canada

Abstract

Background 
Digital health technologies (DHTs) have expanded exponentially since the COVID-19 crisis and have prompted questions about their impact across all levels of health systems. Because health organisations and systems play a central role in the success or failure of the transition to more equitable and sustainable societies, the concept of Responsible Innovation in Health (RIH), focused on aligning the processes and outcomes of innovation with societal values, is gaining interest in research, policy, and practice. This study aims to explore enablers and constraints to the development, procurement and/or utilisation of responsible DHTs in health organisations.

Methods 
Semi-structured interviews were conducted with 29 stakeholders concerned with the development, procurement, and/or utilisation of DHTs in a large Canadian academic health centre. Data were thematically analysed through a mixed deductive-inductive process using the RIH framework.

Results 
Our findings highlight that the consideration of RIH principles in the development, procurement, and/or utilisation of DHTs depends mainly on organisational and systemic factors and conditions, namely: 1) the presence of an organisational culture that promotes RIH in its innovation-related practices and processes; 2) availability of material and financial resources as well as expertise in certain fields (e.g., environmental sustainability); 3) the evolution of health technology assessment practices to include other dimensions beyond effectiveness, safety, and costs; 4) the scope of the regulatory and legal frameworks that govern the approval and use of DHTs; and 5) the role of the market (e.g., venture capital) in the design of federal and provincial innovation policies.

Conclusion 
This study provides insights on practice, policy, and political issues that health organisations may face in the development, procurement, and/or utilisation of responsible DHTs. It can help scholars, practitioners, decision-makers, and industry to create the conditions for a better integration of RIH principles into health organisations and systems.

Keywords