Alami Hassane, Lehoux Pascale, E Shaw Sara, Niang Marietou, Malas Kathy, Fortin Jean-Paul
Department of Health Management, Evaluation and Policy, University of Montreal, Montreal, QC, Canada.
Center for Public Health Research of the University of Montreal, Montreal, QC, Canada.
Int J Health Policy Manag. 2024;13:8061. doi: 10.34172/ijhpm.8061. Epub 2024 Oct 21.
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.
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.
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 (eg, environmental sustainability); (3) the evolution of health technology assessment (HTA) 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 (eg, venture capital) in the design of federal and provincial innovation policies.
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.
自新冠疫情危机以来,数字健康技术(DHTs)呈指数级增长,并引发了关于其对各级卫生系统影响的诸多问题。由于卫生组织和系统在向更公平、更可持续社会转型的成败中起着核心作用,关注使创新过程和成果与社会价值观保持一致的健康领域责任创新(RIH)概念在研究、政策和实践中越来越受到关注。本研究旨在探讨卫生组织中负责任的数字健康技术开发、采购和/或使用的促进因素和制约因素。
对加拿大一家大型学术健康中心内29名涉及数字健康技术开发、采购和/或使用的利益相关者进行了半结构化访谈。使用RIH框架,通过混合演绎-归纳过程对数据进行了主题分析。
我们的研究结果表明,在数字健康技术的开发、采购和/或使用中对RIH原则的考虑主要取决于组织和系统因素及条件,即:(1)存在一种在其与创新相关的实践和过程中促进RIH的组织文化;(2)物质和财政资源以及某些领域(如环境可持续性)专业知识的可得性;(3)卫生技术评估(HTA)实践的演变,以纳入有效性、安全性和成本之外的其他维度;(4)管理数字健康技术批准和使用的监管和法律框架的范围;以及(5)市场(如风险资本)在联邦和省级创新政策设计中的作用。
本研究提供了关于卫生组织在开发、采购和/或使用负责任的数字健康技术时可能面临的实践、政策和政治问题的见解。它可以帮助学者、从业者、决策者和行业创造条件,以便更好地将RIH原则融入卫生组织和系统。