Responsible digital solutions and AI

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Over the past decade, digital health solutions and those relying on artificial intelligence (hereafter called “D/AI solutions”) have exponentially grown and expanded research and health care practices in ways that were previously unthinkable. As health care providers and health systems worldwide will be on the frontline tackling the health effects of climate change and growing social and economic disparities, our team aimed to develop a rigorous tool that can measure the degree of responsibility of D/AI solutions by adapting the multidimensional and already validated Responsible Innovation in Health (RIH) Tool.

To do so, we conducted a three-phase mixed method study:

  1. In Phase 1, we performed a scoping review of practice-oriented tools (n=57) developed since 2015 to support the development and use of responsible and ethical D/AI solutions. We extracted from these tools up to 40 principles that were mapped against the RIH Tool to identify issues that are specific to D/AI solutions and were not covered in the RIH Tool. This mapping process led to a preliminary version of the ‘Responsible D/AI Solutions Assessment Tool.’
  2. In Phase 2, an international two-round e-Delphi expert panel rated on a five-level scale the importance, clarity, and appropriateness of the new Tool’s components (i.e., its premises, screening criteria, and assessment attributes).
  3. In Phase 3, two raters independently applied the revised Tool to a sample of D/AI solutions (n=25), interrater reliability was measured, and final minor changes were brought to the Tool.

The results of the scoping review were published (see below) and confirmed the need for a comprehensive, valid, and reliable tool to assess the degree of responsibility of D/AI health solutions. Because regulation remains limited in this rapidly evolving field, we believe that the new tool we developed has the potential to change practice towards more equitable as well as economically and environmentally sustainable digital health care.

Publications of interest to this project:

Project Team Members: Lysanne Rivard

Robson Rocha de Oliveira

Hassane Alami

Pascale Lehoux

Role of social finance in RIH

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This project aims to clarify the conditions under which social finance provides high-impact enterprises with the resources they need to design, develop and commercialize RIH on a larger scale.

This project involves two sequential data collections. First, social finance experts working in Quebec, Ontario, and the State of Sao Paulo will be recruited to participate in semi-structured interviews. The purpose of the interviews will be to clarify the conditions under which social finance provides innovative enterprises with the resources they need to design and commercialize RIH, the impact measures used to assess their social, economic or environmental impacts, and the milestones that are appropriate for monitoring their progress over the investment life cycle.

Approximately 5 participants per geographical region will be recruited on the basis of their expertise in the field of social finance. Inclusion criteria include: 1) five or more years of experience in the field; and 2) involvement in the full life cycle of an investment (file assessment, project management and “exit”). Diversification criteria include the profile of the investment portfolio for which the respondent is responsible (e.g., more social or technological innovations, health or environmental sector) and the degree of responsibility of the position the respondent holds (senior partner, senior advisor, advisor).

Subsequently, more international social finance experts will be invited to participate in a two-round Delphi prioritization exercise that will take place on a secure web-based platform. The study will build on the results of the interviews. First, the experts will be invited to assess, through a series of closed-ended questions, the level of importance of the resources and conditions that will have been identified through the interviews as being particularly conducive to the design, development, and commercialization of RIH. Free-text response fields will allow them to share comments and propose additional resources or conditions they consider important. In Round 2, the experts will receive the results of the previous round and will be asked to comment on the level of feasibility associated with each of the resources and conditions identified and the risk mitigation strategies they consider appropriate.

Up to 75 participants will be recruited on a non-probability basis to participate in both rounds. Inclusion criteria include mastery of the topic, interest and availability to participate in the study. Diversification criteria include gender, geographic location (to cover five continents) and years of experience. The participation of each expert will be confidential, and the composition of the group will not be revealed to participants.

 

Project Lead: Hudson Silva

The BMJ

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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

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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

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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

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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.