Direction of the program. Emerging health technologies require complex skills to operate, often lead to inequity in access and their development is increasingly capital-intensive. Our goal is to conduct programmatic research on the design, financing and commercialization of Responsible Innovation in Health (RIH). Responsible innovations are affordable, relevant and foster the sustainability of healthcare systems by addressing its key challenges, which include responding to the needs of a growing elderly population, supporting chronically ill patients and tackling health disparities. Our research streams rely on advanced qualitative methods to examine: 1) the design of RIH; 2) the emergence and contribution of RIH; and 3) the institutionalization of RIH. Through our KT Lab, we will set up a cooperative online environment to support the production of knowledge syntheses, provide access to a multi-user qualitative database and enable the prototyping and administration of multimedia-based elicitation tools (e.g., using videos and online deliberation).
 

Expertise and collaborations. This Foundation Scheme builds on the Leader’s Canada Research Chair program (2005-2015) through which she conducted increasingly more complex and innovative research. This included clarifying from a health policy standpoint the impact of business models, capital investment and economic policy on technology design processes in academic spin-offs. Since 1998, her team acquired a strong command of the usability, social and ethical issues of various technologies (telemedicine, mobile dialysis units, high-tech homecare, screening tests). This Foundation Scheme mobilizes scholars across Canada, the United States, France, the United Kingdom and Brazil and catalyzes research at the interface of health services research, medicine, engineering, design, ethics, sociology, economics and public policy. To support this Foundation Scheme, the Leader was awarded a University of Montreal Chair that provides seed money for 3 years.
 

Mentoring and training activities. Responsible innovation was the recent focus of high-level policy and academic meetings in the UK, the Netherlands, Brazil and Germany. Both the European Horizon 2020 Program and the American NSF developed funding streams in this area. Building on this momentum, we will establish a high-caliber knowledge production hub that provokes international synergies with talented investigators, graduate students and postdocs. We will exchange knowledge across disciplines and with key stakeholders across the country, including health research organizations, clinical leaders, policymakers and the medical device industry.
 

Expected knowledge advancement. Our integrated research streams will clarify why, how and in what context RIH can contribute to healthcare sustainability. Scholarship in this area is warranted when one considers the capital-intensive nature of R&D and how high-tech services make “choosing wisely” steadily more difficult. This Foundation Scheme is of strategic importance to CIHR, policymakers, entrepreneurs and investors. It can profoundly benefit patients and healthcare providers because it will evidence alternative ways of designing, financing and commercializing technologies. Outcomes include establishing a vibrant community of clinical leaders, technology developers and policymakers skilled and capable of contributing to the scaling up of RIH.

The technologies that enter the health care system often generate usability problems (e.g., underuse, overuse or misuse) and questionable social transformations (e.g., pervasive monitoring, dependence upon specialized expertise, being and living "at risk"). Nevertheless, whether their design -the shape they take, the functions they perform and what users may accomplish through their use- has been well thought out is rarely questioned. The goal of our three-year study is to examine the ways in which a prospective method developed in the Netherlands can enrich current understandings of health innovation design. Our research will focus on three areas where technological opportunities are already emerging and which will alter significantly the moral choices of future generations: enhancement technologies in teenagers, preventive interventions for genetically "at risks" adults, and ageing in a high-tech world. Our team will create plausible scenarios that depict how technical and social changes may affect, within a 20-year timeframe, these three health care areas. We will develop video clips and short stories illustrating each scenario. The three scenarios will then be debated by members of the public in face-to-face focus groups and through an online forum. Our premise is that the use of fiction within deliberative contexts that foster participants' creativity and reflexivity will enable our team to examine a large range of values and usability issues associated to these three thematic areas. As more complex forms of health innovation keep emerging, there is an acute need for user-friendly tools for debating and pondering the direction taken by technological change in health care. Intervening earlier in the development of health technology may not only help reduce undesirable effects, but may also pave the way for the design of more valuable innovations. 

The goal of this five-year research program is to examine, from a health care perspective, the ways in which knowledge, preferences and norms of various stakeholders contribute to the design of health innovations and address health care system challenges. The program builds on one Core Research Project, around which Satellite Studies will be developed throughout the five-year timeframe. The Core Project consists in examining the development of award-winning innovations of three Canadian health technology companies by means of onsite observation of design activities, interviews with designers and executives, interviews and focus groups with external stakeholders (R&D funders, health care providers, patient representatives, journalists, etc.) and document analysis. By bridging two perspectives that rarely cross-fertilize each other (the industry and the health care system) this research program will inform health innovation design and policy, research on knowledge transfer and qualitative research methods.