Mission
In Fieri is a research program that focuses on Responsible Innovation in Health (RIH). It is led by What is RIH
Responsible Innovation in Health (RIH) builds on the field of Responsible Research and Innovation, which promotes the involvement of societal actors in scientific and technological development processes through inclusive participatory approaches. The aim is to develop “ethically acceptable, socially desirable and sustainable” solutions to major societal challenges (von Schomberg, 2013). Innovation stakeholders operate in the private, public or non-governmental sectors and are involved at different stages of innovation: financing, design, production, regulation, diffusion, reimbursement, etc. These stakeholders possess complementary skills and pursue objectives that sometimes conflict with each other. Deliberation is therefore central to RIH.
The RIH conceptual framework articulates different attributes that should be considered when designing innovations, throughout their lifecycle and in the light of the context where users are located. These attributes highlight the processes by which an innovation is developed, its characteristics as well as the organisation that develops it and makes it available to users (Silva et al. 2018).
The RIH attributes in brief
* Only applicable to digital solutions that operate with or without AI.
What RIH is not
RIH considers responsibility in the processes and decisions of organisations that develop and bring innovations to market, including their suppliers and distributors. These organisations must comply with environmental regulations, adopt proper governance frameworks and respect human and labor rights. Corporate Social Responsibility is necessary for RIH, but it is not sufficient. The RIH attributes rather draw attention to the way health innovations foster equity and sustainability in health systems.
Two key RIH tools
Our team has developed two RIH assessment tools. While the first applies to different types of devices and interventions in health and social services, the second has been developed to specifically capture the challenges of digital solutions that operate with or without artificial intelligence (D/AI solutions). Both are available online:
1. The RIH Assessment Tool and its User Guide
Video
2. The Responsible Digital and AI Solutions Assessment Tool
Essa ferramenta também está disponível em português.
Don’t hesitate to write to us if you have any questions about these two tools, or if you’d like to make any suggestions.
Research program
In Fieri is a 7-year research program that obtained funding through the highly competitive “Foundation Scheme” of the Canadian Institutes of Health Research (CIHR; 2015-2023). Responsible Innovation in Health (RIH) was developed by leading multiple studies structured around three research streams:
A. The design of RIH
- To clarify what RIH is and what it is not, considering health system needs and challenges;
- To define the processes and products of RIH by taking into account the views of clinicians and technology developers;
B. The emergence and contribution of RIH
- To elicit the way alternative business models and entrepreneurship support the design and commercialization of RIH;
- To analyse how patients, caregivers, clinicians and healthcare managers may participate to the co-design of RIH;
C. The institutionalization of RIH
- To examine how social finance may support the development and scaling of RIH;
- To identify the policy, reimbursement, procurement and health technology assessment mechanisms that interact with RIH.
In Fieri Studies
Stream A— The design of RIH
Stream A—The design of RIH
Stream A—The design of RIH
Stream A—The design of RIH
Research training activities
Knowledge mobilisation activities
Stream B—The emergence and contribution of RIH
Stream B—The emergence and contribution of RIH
Stream B—The emergence and contribution of RIH
Stream C—The institutionalization of RIH
Stream C — The institutionalization of RIH
Stream C— The institutionalization of RIH
Prior Research
Team
Our research team’s activities are supported by the University of Montreal’s Public Health Research Center (CReSP) and led by Pascale Lehoux who is known for her ability to engage into path-breaking research. In Fieri builds on her Canada Research Chair program (2005-2015), which clarified the impact of business models, capital investment and economic policy on technology design processes in academic spin-offs. In 2008, she created Hinnovic — a blog whose mission is to transform how innovation in health is envisaged— and has pioneered multimedia-based public engagement methods.
The leader and her research team
The research team has a strong command of complex mixed method research and developed a unique set of KTE skills, which include organizing practice-oriented workshops and multimedia-based events.
Pascale Lehoux’s career has been shaped by industrial design, which fosters the creative envisioning and pragmatic appraisal of the way technologies fulfill user needs, and by a public health perspective: her work is motivated by the desire to improve our understanding and collective ability to govern technological change in health.
Lysanne holds a BA in Psychology (Univerty of Ottawa), an MA in Child Studies (Concordia University) and a PhD in Educational Studies (McGill University). Health, well-being, gender equality, and innovative practices that value and integrate participant's knowledge and priorities are at the heart of her research.
After completing a bachelor’s degree in food sciences and a master’s degree in management in the State of São Paulo (Brazil), Renata is pursuing a PhD in public health at the University of Montreal. Her thesis focuses on transitions in food systems, looking at the emergence of responsible food production in different economic contexts.
Hudson P. Silva is an economist and was Assistant Professor in Public Policy and Management at the State University of Campinas. His research activities are in public policy analysis, focusing on social protection, public health and health technology management. He holds practical experience as a technical advisor for the Brazilian Ministry of Health and the State Government of Sao Paulo.
Robson is an M.D. specialized in public health and health services management. He has practical experience in the Brazilian health system (public and private sector). He has been Assistant Professor of Public Health and Director of the Medicine Program at Anhembi Morumbi University. His research focuses on AI and digital tools and the analysis of social networks.
Interested in how objects work and invention, Patrick worked in mechanical engineering and later became a programmer, analyst and teacher of applied computer sciences in various cities in North America. After a few years in TV post-production, he joined the team in 2007 to combine two passions - science and communication - and contribute to a key societal issue: our health.
Former graduate students and postdoctoral fellows supervised by Pascale Lehoux
Innovation policies
|
Health services and policy research
|
Patient and public engagement
|
Knowledge transfer and exchange (KTE)
|
Information technologies
|
Health technology assessment (HTA)
|
Program experts and collaborators
Our research team benefits from the insights of academics from Canada, the United States, France and the United Kingdom, with a background in medicine, engineering, design, ethics, sociology, economics and public policy. We also benefit from the collaboration of the Canadian medical device industry association (MEDEC), the McConnell Foundation (Montreal) and MaRS (Toronto), which are instrumental to innovation and social entrepreneurship in Canada.
Catherine Beaudry (Polytechnique) is an economist and engineer and holds the Canada Research Chair on the Creation, Development and Commercialization of Innovation. Her research addresses innovation economics, the impact of innovation policies on scientific and technological performance, and the performance and survival of businesses. She brings expertise in partnerships and open innovation in high-tech industries.
Antoine Boivin (Univ. of Montreal) is a family physician and a CIHR clinician-scientist. His research focuses on patient involvement in primary care, chronic disease management, aging and end-of-life care. His policy-oriented research is geared at advancing the design of patient involvement interventions, evaluating its impact and supporting the implementation of sustainable partnerships in clinical settings. He is Co-Chair of the patient engagement strategy of the Quebec SUPPORT Unit.
Jean-Louis Denis (ENAP) is an anthropologist and holds the Canada Research Chair in Governance and Transformation of Health Organizations and Systems. He has over 20 years of experience in health services and policy research. His research examines healthcare reforms, medical leadership and the role of scientific evidence in the implementation of clinical and managerial innovation. He is a member of the Royal Society of Canada and Fellow of the Canadian Academy of Health Sciences.
Philippe Gauthier (Univ. of Montreal) is an industrial designer and sociologist who cofounded the Design and Society research group. His research addresses the normative and regulatory requirements of user centered and participatory design strategies in product, service and policy development and the role of expert judgments in modern democracies. He recently examined citizen involvement in the redesign of public institutions in Montreal.
Nicola Hagemeister (ETS) is a biomedical engineer with an affiliation at the Department of Surgery at University of Montreal. Her research at the Montreal University Teaching Hospital Research Center examines how a new technology (KneeKG™) may improve the surgical planning and care management of patients suffering from knee osteoarthritis. This research applies an early technology assessment framework to inform health policy.
Réjean Hébert (Univ. of Montreal) is a geriatrician and epidemiologist with a long career in health services research for frail older people. He was the Director of PRISMA, which designed and validated a new integrated services model for frail elderly. PRISMA was successfully implemented in Quebec and in other countries and won a CIHR KT Award. Hébert was Dean of the Faculty of Medicine of Sherbrooke University, the 1st Scientific Director of the CIHR Institute of Aging and Quebec Health Minister. He is a member of the Canadian Academy of Health Sciences.
William Lazonick (Univ. of Massachusetts Lowell) is an economist and chairs the Center for Industrial Competitiveness. He is co-founder of the Academic-Industry Research Network and was Distinguished Researcher at INSEAD in France. His research focuses on the social conditions of innovation and economic development in advanced and emerging economies. He was awarded the 2010 Schumpeter Book Prize and the H. Larson Award from Harvard Business School for best paper in Business History Review. His research focuses on the role of financial institutions and capital in high-tech industries.
Marguerite Mendell (Concordia Univ.) is an economist who co-founded the Karl Polanyi Institute of Political Economy. Her research addresses impact investing, social enterprise, community economic development and economic democracy. She was a member of the Advisory Group of the Global Task Force on Impact Investing. She is a member of the Chantier de l’économie sociale Board, a founding member of CAP Finance and of the Scientific Advisory Group on Social Economy and Social Innovation of the Trento Center and of LEED-OECD-Paris. She received the Marie-Andrée Bertrand Prix du Québec and was appointed Officer of Ordre national du Québec.
Fiona Miller (Univ. of Toronto) is a historian, a member of the Joint Centre for Bioethics and the Director of the Division of Health Policy and Ethics at the Toronto Health Economics and Technology Assessment Collaborative (THETA). Her research centres on health technology policy, including the dynamics of technology development, assessment and adoption within systems of health research and healthcare. She brings expertise in health policy, science-based entrepreneurship and institutional theory.
Xavier Pavie (ESSEC Business School) is a philosopher and management scholar. He has spent 15 years as Marketing Director in leading organizations. He is the Director of the Institute for Strategic Innovation & Services and Chairs the Imagination Week seminar for ESSEC’s 600 Master students. He leads the responsible innovation definition efforts of an international network of academic institutions supported by the European Commission. He is President of the “Innovation-Regulation-Governance” commission of the French National Agency for Research as part of Horizon 2020.
Andrew Webster (York Univ., UK) is a sociologist and the Director of the Science and Technology Studies Unit and a Fellow of the Academy of Social Science. His research addresses funding models for regenerative medicine and responsible biobanking innovation. He serves on national policy committees including the UK Stem Cell Bank Steering Committee and the Regenerative Medicine Expert Group Sub-committee.
Publications
The findings of this 7-year research program are of strategic importance to entrepreneurs, investors, health and innovation policymakers as well as clinicians and patients. They show alternative ways of designing, financing and commercializing technologies.
Business, Ethics, the Environment & Responsibility
This study explores the relationship between the entrepreneurial skillsets of 16 Canadian and Brazilian for-profits and not-for-profits producing Responsible Innovations in Health (RIH) and their degree of responsibility. We identify four skillsets: Technical, Technical + Business, Social, and Social + Business. Findings associated to the overall RIH score are intriguing: the presence of business skills appears to mediate the relationship between skillsets and the degree of responsibility. This may be linked to ordinary capabilities —“doing things right”— and dynamic capabilities —“doing the right things.” Because “falling in love” with RIH is not sufficient, there is a need to properly orchestrate capabilities to reconcile economic and social goals.
Lehoux, P., Silva, H.P., Denis-, J.-L, Morioka, S.N., Harfoush, N., Sabio, R.P. (2023). What entrepreneurial skillsets support responsible value creation in health and social care? A mixed methods study. Business, Ethics, the Environment & Responsibility.
Journal of the Knowledge Economy
Small and medium-sized enterprises (SMEs) play a critical role in driving innovations and creating value for society. Yet, SMEs are also particularly vulnerable in times of crisis, in part because of their newness and smallness. This study provides insights into how Covid-19 triggered transformative responses in the business model of SMEs producing responsible innovation in health and social care. A multilevel approach to business model challenges can help entrepreneurs be better prepared for what may remain a challenging entrepreneurial journey.
Silva, H., Lehoux, P., Sabio, R. (2023). Challenges to responsible value creation during the Covid-19 pandemic: A multiple case study on SMEs’ transformative responses. Journal of the Knowledge Economy.
Digital Health
This article examines the divergent and at times antagonistic objectives pursued by stakeholders at different levels of governance regarding the environmental impact of Digital Health Technologies (DHTs). Micro-level factors include stakeholders’ recognition of the environmental issue and the extent to which it is feasible for them to address this issue. Meso-level factors include organisational culture, leadership, policies, and practices, as well as the expertise and professional skillsets available. Macro-level factors include political, regulatory, economic, professional and scientific factors.
Alami, H., Rivard, L., Lehoux, P., Ag Ahmed, M. A., Fortin, J. P. Fleet, R. (2023). Integrating environmental considerations in digital health technology assessment and procurement: Stakeholders’ perspectives. Digital Health Journal. 9(12): 1-17.
Journal of Medical Internet Research
Clinicians’ scope of responsibilities is being steadily transformed by digital health solutions that operate with or without artificial intelligence (DAI solutions). Most tools developed to foster ethical practices lack rigor and do not concurrently capture the health, social, economic, and environmental issues that such solutions raise. The tool that our team developed through a rigorous 3-step study design offers a comprehensive, valid, and reliable means of assessing the degree of responsibility of DAI health solutions. As regulation remains limited, this forward-looking tool has the potential to change practice toward more equitable as well as economically and environmentally sustainable digital health care.
Lehoux, P., Rocha de Oliveira, R., Rivard, L., Silva, H. P., Alami, H. Mörch, C.-M., Malas, K. (2023). A comprehensive, valid, and reliable tool to assess the degree of responsibility of digital solutions that operate with or without artificial intelligence. 3-phase mixed methods study. Journal of Medical Internet Research.
Journal of Responsible Innovation
This qualitative study addresses how social finance investors select potential innovative projects and the principles they judge important in their work. Our findings show a combination of criteria, including entrepreneurial motivations and environmental, social and governance commitments, and clarify the nature of the impacts they seek. Though not all interviewees had knowledge about the concept of responsibility, they nonetheless mobilized a broad set of principles that are closely aligned with the aims and practices of Responsible Innovation.
Silva., H., Lehoux, P., Sabio R. P., (2023). Mobilizing capital for responsible innovation: the role of social finance in supporting innovative projects. Journal of Responsible Innovation.
BMJ Leader
Focusing on a subset of 34 tools identified through a comprehensive scoping review, this qualitative thematic analysis identifies and illustrates how two responsibility principles—environmental sustainability and organisational responsibility—are meant to be put in practice. Recognising that key design and development decisions in the digital health industry are largely shaped by market considerations, this study indicates that significant work lies ahead for medical and organisation leaders to support the development of solutions fit for climate change.
Rivard. L., Lehoux, P., Rocha de Oliveira, R., Alami, H. (2023). Thematic analysis of tools for health innovators and organisation leaders to develop digital health solutions fit for climate change. BMJ Leader.
Renewable Agriculture and Food Systems
This case study, conducted in Québec (Canada) and in the state of São Paulo (Brazil), characterizes their respective food system to identify their vulnerabilities as well as characteristics associated to responsible innovation. Because neoliberal food regimes currently prioritize economic goals over food security goals, supporting a transition towards sustainable food systems is urgent.
Pozelli Sabio, R., Lehoux, P. (2023). Characterizing food systems to better understand their vulnerabilities: A case study in Québec and São Paulo. Renewable Agriculture and Food Systems. 38, E25.
Health Policy and Technology
This scoping review examines the measures used in research to report power asymmetries in online public deliberations. Guidance is offered for researchers and practitioners to choose the most appropriate measures in view of their properties and conceptual relevance.
Jimenez-Pernett, J., Lehoux, P., Olry-de-Labry, A., & Bermudez-Tamayo, C. (2023). Accounting for power imbalances in online public deliberations. A Systematic Review of asymmetry measures. Health Policy and Technology, 100721.
The International Journal of Health Planning and Management
This paper examines policy and practical avenues to integrate ‘environmental sustainability’ as the Sextuple aim to the five health care aim model: 1) quality and experience of patient care; 2) population health; 3) quality of work and satisfaction of healthcare providers; 4) equity and inclusion; and 5) cost reduction.
Alami, H., Lehoux, P., Miller, F. A., Shaw, S. E., & Fortin, J. P. (2023). An urgent call for the environmental sustainability of health systems: A ‘sextuple aim’ to care for patients, costs, providers, population equity and the planet. The International Journal of Health Planning and Management, 38(2), 289-295.
International Journal of Health Planning and Management
This study examines how the experience of 16 small- and medium-sized entreprises in Canada and Brazil can inform mission-oriented innovation policies to support Responsible Innovation in Health (RIH). Policy instruments that can align, orchestrate, and reconcile health priorities with a renewed understanding of innovation-led economic development are needed.
Lehoux, P., Silva, H. P., Miller, F., Denis, J. L., & Pozelli, R. S. (2023). How can entrepreneurs experience inform responsible health innovation policies? A longitudinal case study in Canada and Brazil. The International Journal of Health Planning and Management.
The European Business Review
As we face the health, social, and economic impacts of climate change, the transformative power of AI does not lie in what it can do, but in why and how business leaders will implement it. This blog post describes strategic “do’s and don’ts” to guide business leaders along an AI development pathway fit for the 21st century.
Rivard, L., Lehoux, P. (2023). AI is not ready for the 21st century: What can business leaders do? The European Business Review. January 11, 2023.
International Journal of Environmental Research and Public Health
This perspective discusses the extent to which virtual care offered in the context of COVID-19 followed the “Inverse Care Law.” The latter stipulates that the availability and quality of health care is inversely proportionate to the level of population health needs.
Alami, H., Lehoux, P., Shaw, S. E., Papoutsi, C., Rybczynska-Bunt, S., & Fortin, J. P. (2022). Virtual Care and the Inverse Care Law: Implications for Policy, Practice, Research, Public and Patients. International Journal of Environmental Research and Public Health, 19(17), 10591.
International Journal of Medical Informatics
This scoping review was written for policymakers. Focusing on tools developed since 2015 to support responsibility in digital solutions that operate with or without artificial intelligence (D/AI), its asks: 1) what kinds of practice-oriented tools are available?; 2) on what principles do they predominantly rely?; and 3) what are their limitations? Despite a lack of consensus, policymakers can consolidate their role in this dynamic field.
Lehoux, P., Rivard, L., de Oliveira, R. R., Mörch, C. M., & Alami, H. (2022). Tools to foster responsibility in digital solutions that operate with or without artificial intelligence: A scoping review for health and innovation policymakers. International Journal of Medical Informatics.
Ciência Hoje
Intended for the general public, this post (in Portuguese) by Hudson Silva asks “What innovations does the Brazilian health system need?” The author underscores that Responsible Innovation in Health helps identify how an innovation responds to important health challenges while taking the needs of the population and the health system as well as their economic and environmental impacts into account.
Silva, H. (2022). De quais inovações o sistema de saúde brasileiro necessita? Ciência Hoje. Setembro 2022 (CH 391).
Palgrave Macmillan
Written for innovators and entrepreneurs, this ‘how to’ book clarifies the steps leading to the design of responsible innovations in health and to an organization that creates more value for society. It is downloadable through our own website.
Lehoux, P., Rivard, L. et Silva, H.P. (2022). Responsible Innovation in Health. Concepts and tools for sustainable impact. Springer Nature.
Sustainability
Through a multiple case study involving 30 organizations in the province of Québec (Canada) and in the state of São Paulo (Brazil), this paper identifies the contextual dimensions that both contribute to and constrain the emergence of responsibility in food systems. The findings can inform research and policy aiming to design institutional environments that promote a transition towards more responsible food systems.
Pozelli Sabio, R., Lehoux, P. (2022). How does context contribute to and constrain the emergence of responsible innovation in food systems? Results from a multiple case study. Sustainability. 14(13), 7776.
The BMJ
In this editorial, we comment the Goldacre report, the UK’s roadmap towards “better, broader, and safer” use of health data for research and analysis. Among other things, we discuss the high environmental cost of mining data, and point out that it would make sense to reward the development of more responsible, sustainable, and inclusive digital infrastructures.
Lehoux, P. & Rivard, L. (2022). Major public works ahead for a healthy data-centric NHS, The BMJ.
Health Policy and Technology
In this article, we explore the perspectives of entrepreneurs producing innovation in health who have received support from incubators or accelerators. We examine how the benefits vary depending on when and how the responsible health entrepreneurs received this support.
Silva, H. P., Lehoux, P. & Sabio, R. P. (2022). Is there a fit between incubators and ventures producing responsible innovations in health?, Health Policy and Technology.
Health Services Management Research
In this article, we explore the role that healthcare and social service managers can play in developing innovation to address health system challenges. Using the Responsible Innovation in Health (RIH) framework, we analyze 37 interviews we conducted with Canadian and Brazilian innovators. We sought to identify how they implement inclusive design processes, what influences the responsiveness of their innovation to system challenges, and how they consider the level and intensity of care required by their innovation.
Lehoux, P., Silva, H. P., Rocha de Oliveira, R., Sabio, R. P., & Malas, K. (2021). Responsible innovation in health and health system sustainability: Insights from health innovators’ views and practices, Health Services Management Research.
Journal of Product Innovation Management
In this paper, we describe the challenges faced by organizations implementing new business models to develop and disseminate responsible innovations. By documenting the entrepreneurial challenges of 16 Canadian and Brazilian organizations (for-profit and non-profit), we develop an empirical model that clarifies what it means to create economic, social and environmental value.
Lehoux, P., Silva, H. P., Denis, J-L., , Miller, F. A., Pozelli Sabio, R., Mendell, M. (2021). Moving Toward Responsible Value Creation: Business Model Challenges Faced By Organizations Producing Responsible Health Innovations, Journal of Product Innovation Management.
Mémoire SQRI
The brief outlines how Responsible Innovation in Health is a driver of innovation and how it can foster responsible scientific and business activities at the interface of health and economic policies.
Lehoux, P. et al. (2021). Créer de la valeur économique, sociale et environnementale au Québec par l’Innovation Responsable en Santé.
Design Studies
Guided by Tronto’s (1993) ethic of care framework and Responsible Research and Innovation (RRI), this qualitative study focuses on the ways in which health innovation designers reason around care and responsibility and translate these notions into their work. The exploratory findings provide a novel empirical basis for scholars to conceptualize health innovation designers as ‘care-makers’ and to integrate designers within the care relationship alongside caregivers and care-receivers.
Rivard, L., Lehoux, P., Hagemeister, N. (2021). Articulating care and responsibility in design: A study on the reasoning processes guiding health innovators’ ‘care-making’ practices, Design Studies.
Social Science & Medicine
The challenge of novel and high cost health technologies has encouraged the growth of regulatory agencies such as Health Technology Assessment (HTA) organizations and Group Procurement Organizations (GPO). Yet the existence of several agencies in the same polycentric regulatory regime raises questions about whether and how their work can be coordinated. Drawing on a case study of GPOs and HTA agencies across four provinces in Canada, we explore the separate evolution of these agencies, emerging connections between them for non-drug technologies, and the organizational processes and evaluative judgments that underpin coordination efforts.
Miller, A. F., Lehoux, P., Rac, V. E., P. Bytautas, J. P., Krahn, M., Peacock, S. (2020). Modes of coordination for health technology adoption: Health Technology Assessment agencies and Group Procurement Organizations in a polycentric regulatory regime, Social Science & Medicine.
Journal of Responsible Innovation
In the field of Responsible Research and Innovation (RIR), tools have been developed to enable entrepreneurs to integrate RIR principles into their practices. While these tools may include measurable self-assessment indicators, external assessment approaches have so far received little attention. This study addresses this gap by applying the Responsible Innovation in Health (RIH) Tool, which adopts an external assessment approach, to 16 health innovations from Canada and Brazil.
(2020). The responsible innovation in health tool and the need to reconcile formative and summative ends in RRI tools for business, Journal of Responsible Innovation.
BMJ Quality & Safety
Although Do-It-Yourself and open access health innovations can offer interesting solutions for patients with needs that are currently not met by the medical industry, they pose new dilemmas in terms of quality and safety. In this study, the authors seek to better understand the dilemmas raised by two examples of popular innovations. To do so, they gathered the views of health care innovators who are familiar with medical device standards and regulations in order to identify practical issues and develop recommendations for public policy.
Research Policy
Seen as professional intermediaries, procurement offices affect innovation: they shape the valuation of goods and the markets through which they are exchanged. Yet procurement offices seem largely incidental to the innovation efforts of others. In this article, the authors argue that enhancing the capacities of procurement offices can support responsive innovation.
Miller, A. F., Lehoux, P. (2020). The innovation impacts of public procurement offices: The case of healthcare procurement, Research Policy.
Cadernos de Saúde Pública
COVID-19. The speed with which solutions have been developed and made available to the population in Latin America raises an important set of ethical, legal, social, economic, and environmental questions. In this paper we discuss how the perspective of Responsible Innovation in Health (RIH) provides important elements for answering these questions.
Silva, H. P., Oliveira, R.R., Pozelli Sabio, R., Lehoux, P. (2020). Fostering the common good in times of COVID-19: the Responsible Innovation in Health perspective, Cadernos de Saúde Pública.
In Fieri and OBVIA
The In Fieri team, in collaboration with OBVIA, developed a policy brief on AI and digital solutions. Using examples, it describes the four responsible innovation principles and clarifies pre-existing socioeconomic dynamics that condition the current development of these solutions as well as future trajectories. We offer guidance for public decision-makers and developers to help them shift towards a more responsible development of these innovations.
Lehoux, P., Alami, H., Mörch, C., Rivard, L., Oliveira, R.R., Silva, H.P. (2020). Can we innovate responsibly during a pandemic? Artificial intelligence, digital solutions and SARS-Cov-2.
Journal of Health Organization and Management
An important step to ensure the successful integration of AI and avoid unnecessary investments and costly failures, better consideration should be given to: 1) needs and added-value assessment; 2) workplace readiness: stakeholder acceptance and engagement; 3) technology-organization alignment assessment; and 4) business plan: financing and investments. Decision-makers and technology promoters should better address the complexity of AI and understand the systemic challenges raised by its implementation in healthcare organizations and systems.
Alami, H., Lehoux, P., Denis, JL., Motulsky, A., Petitgrand, C., Savoldelli, M., Rouquet, R., Gagnon, MP., Roy, D., Fortin, JP. (2020). Organizational readiness for artificial intelligence in health care: Insights for decision-making and practice. Journal of Health Organization and Management.
Globalization and Health
Most AI-based health applications are developed and implemented in high-income countries, their use in Low- and Middle-Income Countries (LMICs) contexts is recent and there is a lack of robust local evaluations to guide decision-making in low-resource settings. After discussing the potential benefits as well as the risks and challenges raised by AI-based health care, this paper proposes five building blocks to guide the development and implementation of more responsible, sustainable, and inclusive AI health care technologies in LMICs.
Alami, H., Rivard, L., Lehoux, P., Hoffman, S. J., Cadeddu, SBM., Savoldelli, M., Samri, MA., Ag Ahmed, MA., Fleet, R., Fortin, JP. (2020). Artificial intelligence in health care: Laying the Foundation for Responsible, sustainable, and inclusive innovation in low- and middle-income countries. Globalization and Health. 16(1): 52.
International Journal of Health Policy and Management
By confirming key aspects of the RIH Tool’s reliability and applicability, our study brings its development to completion. It can be jointly put into action by innovation stakeholders who want to foster innovations with greater social, economic and environmental value.
Silva, H.P., Lefebvre, A.-A., Rocha, R.O., Lehoux, P. (2020). Fostering Responsible Innovation in Health: An evidence-informed assessment tool for decision-makers, International Journal of Health Policy and Management.
International Journal of Health Policy and Management
Comment inviting scholars to further the discussion on how the value of health innovations should be appraised in view of today’s societal challenges.
Lehoux, P., Silva, H.P. (2020). Transforming Disciplinary Traditions; Comment on “Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling”, International Journal of Health Policy and Management.
BMC Medical Informatics and Decision Making
This article examines how improving the quality of work and well-being of health care providers could help rethinking the implementation of EHRs and also other information technology-based tools and systems, while creating more value for patients, organizations and health systems.
Alami, H., Lehoux, P., Gagnon, MP., Fortin, JP., Fleet, R., Ag Ahmed MA. (2020). Rethinking the electronic health record through the quadruple aim: time to align its value with the health system, BMC Medical Informatics and Decision Making.
Technological Forecasting and Social Change
This article generate methodological insights into the way prospective public deliberative processes can stimulate the public’s moral imagination regarding what may (or may not) happen in the future and what should (or should not) happen in the future.
Lehoux, P., Miller, F.A., Williams-Jones, B. (2020). Anticipatory governance and moral imagination: Methodological insights from a scenario-based public deliberation study, Technological Forecasting and Social Change.
International Journal of Health Policy and Management
Responses to comments on our scoping review that identified the challenges that responsible innovation in health should seek to address.
Lehoux, P., Roncarolo, F., Silva, H.P., Boivin, A., Denis, J.-L., Hébert, R. (2020). Revisiting the relationship between systems of innovation and health systems: A response to recent commentaries, International Journal of Health Policy and Management.
Systèmes alimentaires/Food Systems
This essay aims to clarify why alternative food systems supported by a different Science, Technology and Innovation (STI) approach can contribute to the Sustainable Development Goals (SDG).
Pozelli Sabio, R., Lehoux, P. (2019). How can alternative food systems contribute to the sustainable development goals?, Systèmes alimentaires/Food Systems.
BMJ Innovation
This paper explores how those who design new health technologies (devices, technical aids and information technologies) perceive and address environmental considerations in their practice.
Rivard, L., Lehoux, P., Miller, F.A. (2019). Double burden or single duty to care? Health innovators’ perspectives on environmental considerations in health innovation design, BMJ Innovation.
Healthcare Policy
This paper examines how two complementary perspectives —as a public representative or a health services user— entail different yet mutually challenging ways of appraising health innovations. Policymakers should foster the expression of both personal and collective perspectives.
Lehoux, P. & Proulx S. (2019) Deliberating as a public representative or as a potential user? Two complementary perspectives that should inform health innovation policy, Healthcare Policy.
Journal of Responsible Innovation
By analyzing the practical insights of health innovators on what is and is not responsible innovation in health, this paper demonstrates how they consider both the desirability and feasibility of responsibility features when contemplating their operationalization.
Rivard L., Lehoux P. (2019). When desirability and feasibility go hand in hand: innovators’ perspectives on what is and is not responsible innovation in health, Journal of Responsible Innovation.
Systèmes Alimentaires/Food Systems
This essay clarifies why alternative food systems supported by a different Science, Technology & Innovation approach could contribute to the Sustainable Development Goals (SDGs). These systems are analyzed through the SDGs framework and illustrated with three examples from Québec (Canada), which show how the consolidation of alternative food systems may foster the changes required by the SDGs.
Pozelli Sabio, R., & Lehoux, P. (2019). How can alternative food systems contribute to the sustainable development goals? Systèmes alimentaires/Food systems, 2019(4), 209-218.
International Journal of Technology Assessment in Health Care
This article analyzes how procurement organizations assess the value of medical technologies: how products are solic- ited and evaluated, who is buying, and how buying practices structure opportunities for suppliers.
Miller, F.A., Lehoux, P., Peacock, S., Rac, V.E., Neukomm, J., Barg, C., Bytautas, J., Krahn, M. (2019). How procurement judges the value of medical technologies: A review of healthcare tenders, International Journal of Technology Assessment in Health Care.
Revue d’économie et de management de l’innovation
To generate an empirically-grounded model of why and how responsible innovations are produced, this paper provides a synthesis of 17 qualitative studies describing the development of responsible innovations that have an incidence on the determinants of health.
Lehoux, P., Daudelin, G., Denis, J.-L., Gauthier, P., Hagemeister, N. (2019). Pourquoi et comment sont conçues des innovations responsables? Résultats d’une méta-ethnographie, Revue d’économie et de management de l’innovation.
International Journal of Health Policy and Management
To identify the challenges that responsible innovation in health should seek to address, this papers presents the findings of a synthesis of 254 articles that examined the challenges of health systems in 99 countries.
Lehoux, P., Roncarolo, F., Silva, H.P., Boivin, A., Denis, J.-L., Hébert, R. (2019). What health system challenges should responsible innovation in health address? Insights from an international scoping review, International Journal of Health Policy and Management.
Health Policy and Technology
This paper shows how an international panel of experts contributed to the development of a Responsible Innovation in Health (RIH) screening and assessment Tool.
Silva, H.P., Lehoux, P., Hagemeister, N. (2018). Developing a tool to assess responsibility in health innovation: Results from an international delphi study, Health Policy and Technology.
Sustainability
With the help of empirical examples, this paper explores the relationships Responsible Innovation in Health (RIH) may entertain with the Sustainable Development Goals (SDG).
Lehoux, P., Pacifico H.P., Pozelli Sabio, R., Roncarolo, F. (2018). The Unexplored Contribution of Responsible Innovation in Health to Sustainable Development Goals, Sustainability.
Health Research Policy and Systems
This article introduces an integrative RIH framework drawing on the RRI literature, the international literature on health systems as well as specific bodies of knowledge that shed light on key dimensions of health innovations.
Silva, H.P., Lehoux, P., Miller, F.A., Denis, J.-L. (2018). Introducing responsible innovation in health: a policy-oriented framework, Health Research Policy and Systems.
Social Science & Medicine
Drawing on a prospective public deliberation study, this article offers sociological insights into the ways in which members of the public reason around assistive actions, be they performed by humans, machines or both.
Lehoux, P., Grimard, D. (2018). When robots care: Public deliberations on how technology and humans may support independent living for older adults, Social Science & Medicine.
International Journal of Health Policy and Management
Response to three comments on the article « Providing value to new health technology: the early contribution of entrepreneurs, investors, and regulatory agencies» (Lehoux P., Miller F., Daudelin G, Denis J., 2017).
Lehoux, P., Miller, F.A., Daudelin, G., Denis, J.-L. (2018). Why learning how to chase butterflies matters: A response to recent commentaries, International Journal of Health Policy and Management.
BMC Health Services Research
This article looks at what kind of research was conducted on Health System challenges, where it was performed, in which health sectors and on which populations. It also identifies the types of challenge that were most present and how they varied across countries
Roncarolo, F., Boivin, A., Denis, J.-L., Hébert, R., Lehoux, P. (2017). What do we know about the needs and challenges of health systems? A scoping review of the international literature, BMC Health Services Research.
Public Understanding of Science
This article examines how members of the public conceive of the relationship between responsibility and prospective health technologies.
Lehoux, P., Miller, F.A., Grimard, D., Gauthier, P. (2017). Anticipating health innovations in 2030–2040: Where does responsibility lie for the publics? Public Understanding of Science.
Review of Policy Research
This article examines the rules that characterize economic policy, capital investment, and regulatory approval as well as the way these institutions enable and constrain the development of ventures at an early stage.
Lehoux, P., Daudelin, G., Denis, J.-L., Miller F.A. (2017). A Concurrent Analysis of Three Institutions that Transform Health Technology-Based Ventures: Economic Policy, Capital Investment, and Market Approval, Review of Policy Research.
Critical Public Health
This paper examines how members of the public define the legitimacy of cognitive and behavioural enhancement.
Lehoux, P., Williams-Jones, B., Grimard, D., Proulx, S. (2017). Technologies of the self in public health: insights from public deliberations on cognitive and behavioural enhancement, Critical Public Health.
Éthique, Médecine et Politique Publique
This study uses structuring theory to explore how members of the public anticipate the potential and limitations of prevention in the context of predictive medicine and to clarify the underlying reasoning processes.
Lehoux, P., Cheriet, I., Grimard, D. (2017). Que pense le public de la prévention dans le contexte de la médecine prédictive? Éthique, Médecine et Politique Publique.
Technological Forcasting and Social Change
Building on insights from sociology of expectations and institutions, this paper elicits how specific institutional requirements provide potency to the expectations that pave the health technology development pathway.
Lehoux, P., Miller, F.A., Daudelin, G. (2016). Converting clinical risks into economic value: The role of expectations and institutions in health technology development, Technological Forcasting and Social Change.
PLoS ONE
This study explored interactions with device industry representatives among physicians who use implantable cardiovascular and orthopedic devices to identify whether conflict of interest (COI) is a concern and how it is managed.
Gagliardi, A., Lehoux, P., Ducey, A., Easty, A., Ross, S., Bell, C., Trbovich, P., Urbach, D. (2017). We can’t get along without each other: Qualitative interviews with physicians about device industry representatives, conflict of interest and patient safety, PLoS ONE.
International Journal for Quality in Health Care
This study identified that patients are not engaged in discussions or decisions about implantable medical devices.
Gagliardi, A. R., Lehoux, P., Ducey, A., Easty, A., Ross, S., Bell, C. M., & Urbach, D. R. (2017). Factors constraining patient engagement in implantable medical device discussions and decisions: Interviews with physicians, International Journal for Quality in Health Care.
Patient Involvement in Health Technology Assessment
This chapter provides readers with clear guidance on the ways in which particular qualitative methods can help HTA practitioners to elicit patients’ perspectives, experiences and preferences.
Lehoux, P., Jimenez-Pernett, J., (2017). Making sense of patients’ perspectives, experiences and preferences in HTA (pp.215-224). In Facey, K., Hensen, H.P., Single, A.N.V. (Eds). Patient Involvement in Health Technology Assessment (HTA). Singapore: Springer.
International Journal of Health Policy and Management
The goal of this paper is to clarify how entrepreneurs, investors, and regulatory agencies influence the value of emerging health technologies.
Lehoux, P., Miller, F.A., Daudelin, G., Denis, J.L. (2017). Providing value to new health technology: the early contribution of entrepreneurs, investors, and regulatory agencies, International Journal of Health Policy and Management.
Journal of Responsible Innovation
This article seeks to deepen our understanding of the responsible research and innovation (RRI) approach as it relates to health care systems, where the notion of responsibility is already deeply embedded.
Demers-Payette, O., Lehoux, P., Daudelin, G. (2016). Responsible research and innovation: a productive model for the future of medical innovation, Journal of Responsible Innovation.
Health Services Management Research
This article aims to generate a better understanding of the historical Research & Development dynamics that have contributed to shape today’s medical innovation ecosystem.
Lehoux, P., Roncarolo, F., Rocha Oliveira, R., Silva, H.P. (2016). Medical innovation and the sustainability of health systems: A historical perspective on technological change in health, Health Services Management Research.
BMC Health Services Research
This article looks at a prospective method using multimedia material for public deliberations on health technology design.
Lehoux, P., Jimenez-Pernett, J., Miller, F. A., Williams-Jones, B. (2016). Assessment of a multimedia-based prospective method to support public deliberations on health technology design: participant survey findings and qualitative insights, BMC Health Services Research.
Science & Public Policy
This paper brings forward why capital investors choose to invest in certain health technology-based ventures and not others, and how they influence the innovation process.
Lehoux, P., Miller, F.A., Daudelin, G., Urbach, D.R. (2015). How venture capitalists decide which new medical technologies come to exist, Science & Public Policy.
Research Policy
This paper clarifies why technology developers are pushed to prioritize design features that expedite sales, often to the detriment of design features that would increase the clinical value of their technology.
Lehoux & al. (2014). How do business models and health technology design influence each other? Insights from a longitudinal case study of three academic spin-offs, Research Policy.
The problem of health technology
This book explains how health technology is embedded in broader social and political practices that can be reshaped through appropriate policy initiatives. It was short-listed along 3 others for the 2007 Best Book Award of the British Sociology Association and Sociology of Health & Illness.
Lehoux. P. (2006). The problem of health technology. Policy implications for modern health care systems. New York: Routledge.
Contact
Postal address:
Centre de recherche en santé publique de l’Université de Montréal (CReSP)
P.O. Box 6128, branch Centre-ville
Montreal, QC, CANADA H3C 3J7
Civic address:
Centre de recherche en santé publique de l’Université de Montréal (CReSP)
7101 Parc avenue, Room 3082 (3rd floor)
Montreal, QC, CANADA H3N 1X9
Courriel: pascale.lehoux@umontreal.ca