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      Introducing responsible innovation in health: a policy-oriented framework

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          Abstract

          The scholarship on responsible research and innovation (RRI) aims to align the processes and outcomes of innovation with societal values by involving a broad range of stakeholders from a very early stage. Though this scholarship offers a new lens to consider the challenges new health technologies raise for health systems around the world, there is a need to define the dimensions that specifically characterise responsible innovation in health (RIH). The present article aims to introduce 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. Combining inductive and deductive theory-building strategies and concomitant with the development of a formal tool to assess the responsibility of innovations, we developed a framework that is comprised of nine dimensions organised within five value domains, namely population health, health system, economic, organisational and environmental. RIH provides health and innovation policy-makers with a common framework that supports the development of innovations that can tackle significant system-level challenges, including sustainability and equity.

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          Most cited references62

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          Developing a framework for responsible innovation

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            Green innovation in technology and innovation management - an exploratory literature review

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              Environmental Impacts of the U.S. Health Care System and Effects on Public Health

              The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation’s pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003–2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%), greenhouse gas emissions (10%), smog formation (10%) criteria air pollutants (9%), stratospheric ozone depletion (1%), and carcinogenic and non-carcinogenic air toxics (1–2%). The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors) and demand side (NHE categories), as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000–98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.
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                Author and article information

                Contributors
                hp.silva@umontreal.ca
                (514) 343-7978 , pascale.lehoux@umontreal.ca
                fiona.miller@utoronto.ca
                jean-louis.denis@umontreal.ca
                Journal
                Health Res Policy Syst
                Health Res Policy Syst
                Health Research Policy and Systems
                BioMed Central (London )
                1478-4505
                10 September 2018
                10 September 2018
                2018
                : 16
                : 90
                Affiliations
                [1 ]ISNI 0000 0001 2292 3357, GRID grid.14848.31, Institute of Public Health Research of University of Montreal (IRSPUM), ; Montreal, Canada
                [2 ]ISNI 0000 0001 2292 3357, GRID grid.14848.31, Department of Health Management, Evaluation and Policy, , University of Montreal, ; P.O. Box 6128, Branch Centre-ville, Montreal, Quebec H3C 3J7 Canada
                [3 ]ISNI 0000 0001 2292 3357, GRID grid.14848.31, University of Montreal Chair on Responsible Innovation in Health, Institute of Public Health Research of University of Montreal (IRSPUM), Research Center of the University of Montreal Health Center (CRCHUM), ; P.O. Box 6128, Branch Centre-ville, Montreal, Quebec H3C 3J7 Canada
                [4 ]ISNI 0000 0001 2157 2938, GRID grid.17063.33, Institute of Health Policy, Management and Evaluation, , University of Toronto, ; Toronto, Canada
                [5 ]ISNI 0000 0001 2292 3357, GRID grid.14848.31, Department of Health Management, Evaluation and Policy, School of Public Health, , University of Montreal, ; Montreal, Canada
                [6 ]Canada Research Chair on Governance and Transformation of Health Organizations and Systems, Montreal, Canada
                Author information
                http://orcid.org/0000-0001-9482-1800
                Article
                362
                10.1186/s12961-018-0362-5
                6131953
                30200985
                7f2efedf-b669-47cb-a144-97d4c576b235
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 March 2018
                : 17 August 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;
                Award ID: FDN-143294
                Award Recipient :
                Categories
                Review
                Custom metadata
                © The Author(s) 2018

                Health & Social care
                responsible research and innovation,health technology,health systems,sustainability,health equity

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