Pascale Lehoux

Pascale Lehoux
Université de Montréal | UdeM · Department of Health Management, Evaluation and Policy

About

213
Publications
42,658
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
5,073
Citations
Citations since 2017
69 Research Items
2641 Citations
20172018201920202021202220230100200300400500600
20172018201920202021202220230100200300400500600
20172018201920202021202220230100200300400500600
20172018201920202021202220230100200300400500600
Introduction
The research program that I’m leading at the University of Montreal is called In Fieri and focuses on Responsible Innovation in Health (RIH), from the design on new solutions to their commercialization.

Publications

Publications (213)
Article
Background: Digital health solutions that operate with or without artificial intelligence (D/AI) raise several responsibility challenges. Though many frameworks and tools have been developed, determining what principles should be translated into practice remains under debate. This scoping review aims to provide policymakers with a rigorous body of...
Article
Full-text available
Virtual care spread rapidly at the outbreak of the COVID-19 pandemic. Restricting in-person contact contributed to reducing the spread of infection and saved lives. However, the benefits of virtual care were not evenly distributed within and across social groups, and existing inequalities became exacerbated for those unable to fully access to, or b...
Article
Full-text available
Organizations and practices that contribute to the resolution of major societal challenges are key to achieving a transition towards sustainable and resilient food systems. Previous research identified contextual elements that affect the emergence of organizations and practices with responsibility characteristics, but how this process unfolds remai...
Article
Full-text available
Objectives While Incubators and Accelerators (I/As) may help startups grow and survive, the benefits incubatees derive from I/As remains under debate. This is especially true for ventures in the health sector that face specific challenges and responsibility issues. The aim of this study is to explore when and how I/As supported 16 Canadian and Braz...
Book
This book pursues two objectives. The first is to introduce the field of Responsible Innovation in Health (RIH) by clarifying its theoretical foundations and the practical approaches that enable the design and production of responsible medical devices, health and social care interventions, digital tools and solutions based on Artificial Intelligenc...
Article
Full-text available
Although healthcare managers make increasingly difficult decisions about health innovations, the way they may interact with innovators to foster health system sustainability remains underexplored. Drawing on the Responsible Innovation in Health (RIH) framework, this paper analyses interviews ( n=37) with Canadian and Brazilian innovators to identif...
Article
Full-text available
The COVID-19 pandemic has had a major impact on health and social service systems (HSSS) worldwide. It has put tremendous pressure on these systems, threatening access, continuity, and the quality of patient care and services. In Quebec (Canada), the delivery of care and services has radically changed in a short period of time. During the pandemic,...
Article
Full-text available
Responsible Research and Innovation (RRI) seeks to steer innovation towards important societal challenges and, by doing so, calls for entrepreneurial activities that create economic, social, and environmental value. Nonetheless, little is known about the way different types of organization can produce responsible products and services and the chall...
Article
Full-text available
The magnitude of the COVID-19 pandemic challenged societies around our globalized world. To contain the spread of the virus, unprecedented and drastic measures and policies were put in place by governments to manage an exceptional health care situation while maintaining other essential services. The responses of many governments showed a lack of pr...
Article
Full-text available
Background: Responsible innovation in health (RIH) emphasizes the importance of developing technologies that are responsive to system-level challenges and support equitable and sustainable healthcare. To help decision-makers identify whether an innovation fulfills RIH requirements, we developed and validated an evidence-informed assessment tool co...
Article
Full-text available
Purpose: Artificial intelligence (AI) raises many expectations regarding its ability to profoundly transform health care delivery. There is an abundant literature on the technical performance of AI applications in many clinical fields (e.g. radiology, ophthalmology). This article aims to bring forward the importance of studying organizational readi...
Article
This article explores how health innovation designers articulate care and responsibility when designing new health technologies. Towards this end, we draw on Tronto’s ethic of care framework and Responsible Research and Innovation (RRI) scholarship to analyse interviews with Canadian health innovators (n ¼ 31). Our findings clarify how respondents:...
Article
Full-text available
Responsible Research and Innovation (RRI) scholars have explored how businesses perceive the goals and processes of RRI and have developed tools to enable entrepreneurs to integrate such principles into their practices. While these tools often adopt a formative approach and may include measurable self-assessment indicators, external assessment appr...
Article
Background: Open do-it- yourself (DIY) health innovations raise new dilemmas for patient-oriented and service-oriented scholars and healthcare providers. Our study aimed to generate practical insights into quality and safety issues to patient care raised by two volunteer-run, open DIY solutions: Nightscout Project (patient-driven, open-source softw...
Article
Interest in public procurement's role in innovation has been reinforced by the directional turn in innovation policy, which highlights the social purpose of innovation. Procurement-induced innovation may often be a by-product of the pursuit of other policy goals, especially in sectors that are highly dependent on innovation, such as healthcare. Yet...
Article
Full-text available
While the transition toward digitalized health care and service delivery challenges many publicly and privately funded health systems, patients are already producing a phenomenal amount of data on their health and lifestyle through their personal use of mobile technologies. To extract value from such user-generated data, a new insurance model is em...
Article
Full-text available
Artificial intelligence (AI) is seen as a strategic lever to improve access, quality, and efficiency of care and services and to build learning and value-based health systems. Many studies have examined the technical performance of AI within an experimental context. These studies provide limited insights into the issues that its use in a real-world...
Article
Full-text available
Several solutions have been proposed to address Covid-19, including tests for screening and diagnostic confirmation, non-pharmacological interventions to reduce the speed of virus transmission, and technologies to treat patients. In addition to issues related to the effectiveness and safety of these solutions, the speed with which they have been de...
Article
Full-text available
The World Health Organization and other institutions are considering Artificial Intelligence (AI) as a technology that can potentially address some health system gaps, especially the reduction of global health inequalities in low- and middle-income countries (LMICs). However, because most AI-based health applications are developed and implemented i...
Poster
Full-text available
To identify the degree of responsibility of innovations at an early stage, we developed and validated The In Fieri Assessment Tool for RIH, which supports an evidence-informed judgment through a three-step process: screening, assessment and rating.
Technical Report
Full-text available
A policy brief for public decision-makers and developers of AI and digital solutions: "As de confinement begins, the potential for artificial intelligence (AI) and digital solutions to accelerate the fight against COVID-19 is increasingly debated. Despite promises and hopes, one may wonder whether the required conditions for innovating responsibl...
Technical Report
Full-text available
Note à l’intention des décideurs publics et développeurs de solutions fondées sur l’IA et le numérique : "Alors que le déconfinement s’amorce, le potentiel de l’intelligence artificielle (IA) et des outils numériques pour accélérer la lutte contre la COVID-19 est de plus en plus débattu. En dépit des promesses et des espoirs, une question urgente...
Preprint
UNSTRUCTURED While the transition toward digitalized health care and service delivery challenges many publicly and privately funded health systems, patients are already producing a phenomenal amount of data on their health and lifestyle through their personal use of mobile technologies. To extract value from such user-generated data, a new insuranc...
Article
Full-text available
Electronic health records (EHRs) are considered as a powerful lever for enabling value-based health systems. However, many challenges to their use persist and some of their unintended negative impacts are increasingly well documented, including the deterioration of work conditions and quality, and increased dissatisfaction of health care providers....
Article
The fields of Responsible Research and Innovation (RRI) and participatory foresight seek to establish, and to include publics within, anticipatory governance mechanisms. While scenario-based methods can bring to the publics’ attention the ethical challenges associated to existing technologies, there has been little empirical research examining how,...
Preprint
UNSTRUCTURED Artificial intelligence (AI) is seen as a strategic lever to improve access, quality, and efficiency of care and services and to build learning and value-based health systems. Many studies have examined the technical performance of AI within an experimental context. These studies provide limited insights into the issues that its use in...
Article
Objectives: The healthcare sector lags behind other industries in efforts to reduce its environmental footprint. This study aims to better understand how those who design new health technologies (devices, technical aids and information technologies) perceive and address environmental considerations in their practice. Methods: We conducted in-depth...
Article
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). To this end, alternative food systems are analyzed in the light of the SDG framework and their potential contributions illustrated through three examples from Q...
Article
Full-text available
Grutters et al show that economic assessments can inform the development of new health technologies at an early stage. This is an important contribution to health services and policy research, which implies a "shift away" from the more traditional forms of academic health economic modeling. Because transforming established disciplinary traditions i...
Article
Full-text available
Few studies have considered the creation of health technology organizations where the entrepreneurs seize opportunities, create their entrepreneurial organization and provide it with legitimacy, and examined the triggers, constraints and pressures involved in this process. To study the emergence of such firms, we performed semistructured interviews...
Article
Full-text available
We were very glad to read the six commentaries about our scoping review on the needs and challenges of health systems that Responsible Innovation in Health (RIH) could address. The commentators offered great suggestions to further research on RIH and health systems. We provide clarifications to their queries and explain why revisiting the relations...
Article
While the conceptual foundations of Responsible Research and Innovation (RRI) were consolidated in the past decades, the practice of RRI remains poorly understood. The goal of our study was to gather the practical insights of professionals who design, develop and commercialize health innovations. We invited Canadian engineers, industrial designers,...
Article
Full-text available
While public involvement in health policy is gaining traction around the world, deciding whether practitioners of public involvement should encourage participants to deliberate from a personal or a collective perspective remains an object of contention. Drawing on an empirical study, the aim of this article is to generate methodological insights in...
Article
Full-text available
[ENGLISH FOLLOWS] Bien que le concept d’innovation responsable (IR) gagne en popularité, aucune synthèse d’études empiriques n’existe pour informer son développement. Cet article présente les résultats d’une méta-ethnographie dont l’objectif était de modéliser pourquoi et comment différentes IR ayant une incidence sur les déterminants de la santé a...
Article
Full-text available
Background: In 2016, the Canadian government legalized medical assistance in dying (MAiD) for adults with terminal illness. The objective of this study was to explore the information needs of health care professionals and members of the public regarding MAiD. Methods: This was a qualitative study involving a 1-day face-to-face forum followed by...
Article
Objectives Procurement's important role in healthcare decision making has encouraged criticism and calls for greater collaboration with health technology assessment (HTA), and necessitates detailed analysis of how procurement approaches the decision task. Methods We reviewed tender documents that solicit medical technologies for patient care in Ca...
Article
Full-text available
Background: While responsible innovation in health (RIH) suggests that health innovations could be purposefully designed to better support health systems, little is known about the system-level challenges that it should address. The goal of this paper is thus to document what is known about health systems’ demand for innovations. Methods: We search...
Article
Full-text available
Responsible Innovation in Health (RIH) represents an emerging Science, Technology and Innovation (STI) approach that could support not only the Sustainable Development Goal (SDG) "Good health and well-being" but also other SDGs. Since few studies have conceptualized the relationships between RIH and the SDGs, our goal was to inductively develop a f...
Article
Full-text available
Objectives:Health care innovation and technologies can improve patient outcomes, but policies and regulations established to protect the public interest may become barriers to improvement of health care delivery. We conducted a scoping review to identify policy and regulatory barriers to, and facilitators of, successful innovation and adoption of h...
Article
Full-text available
Objectives. The way new health technologies are being developed and brought to market undermines the sustainability of health systems around the world and limits the emergence of innovations that could generate greater system-level benefits. While Responsible Research and Innovation (RRI) offers relevant principles to address this policy problem, t...
Article
Full-text available
Abstract A growing number of announcements on new and innovative medical devices are reported each year by economic actors. However, very few new technologies are successfully acquired and adopted by healthcare actors. To examine how economic and healthcare system actors perceive entrepreneurs’ strategies employed to respond to and address healthca...
Article
Full-text available
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...
Article
Full-text available
Background Patient and public engagement is growing, but evaluative efforts remain limited. Reviews looking at evaluation tools for patient engagement in individual decision making do exist, but no similar articles in research and health systems have been published. Objective Systematically review and appraise evaluation tools for patient and publ...
Article
Given growing initiatives incentivizing academic researchers to engage in 'entrepreneurial' activities, this article examines how these academic entrepreneurs claim value in their entrepreneurial engagements, and navigate concerns related to conflicts of interest. Using data from qualitative interviews with twenty-four academic entrepreneurs in Can...
Article
Full-text available
Background: Little research has examined how physicians choose medical devices for treating individual patients to reveal if interventions are needed to support decision-making and reduce device-associated morbidity and mortality. This study explored factors that influence choice of implantable device from among available options. Methods: A des...
Article
Full-text available
Objectives: Medical devices are ubiquitous in modern medical care. However, little is known about the epidemiology of medical devices in the healthcare marketplace, including the rate at which medical devices are subject to recalls or other advisories. We sought to study the epidemiology of medical devices in Canada, focusing on device recalls. In...
Article
Full-text available
Background While there is an extensive literature on Health System (HS) strengthening and on the performance of specific HSs, there are few exhaustive syntheses of the challenges HSs are facing worldwide. This paper reports the findings of a scoping review aiming to classify the challenges of HSs investigated in the scientific literature. Specifica...
Article
Full-text available
Considering that public engagement is pivotal to the mission of Responsible Research and Innovation, this article’s aim is to examine how members of the public conceive of the relationship between responsibility and prospective health technologies. We organized four face-to-face deliberative workshops and an online forum wherein participants were i...
Article
Full-text available
Background Postmarket surveillance of medical devices is reliant on physician reporting of adverse medical device events (AMDEs). Little is known about factors that influence whether and how physicians report AMDEs, an essential step in developing behaviour change interventions. This study explored factors that influence AMDE reporting. Methods Qu...
Article
Résumé La médecine prédictive, qui s’appuie sur les avancées en génomique, a le potentiel de contribuer au développement de nouvelles interventions préventives en santé publique. Cette approche soulève toutefois plusieurs enjeux éthiques et sociaux et la participation du public est essentielle. Cette étude s’appuie sur la théorie de la structuratio...
Chapter
Qualitative research methods have been developed several decades ago and have been applied since then to further knowledge in many social scientific disciplines. Numerous qualitative research communities have been actively sharing their expertise and insights in fields that are closely related to HTA such as sociology of health and illness, healthc...
Article
Full-text available
Drawing on institutional theory, this article articulates qualitative insights from a program of research on Canadian health technology-based ventures to examine 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...
Article
Full-text available
Objectives Physician relationships with device industry representatives have not been previously assessed. 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. Design A descr...
Data
COREQ checklist for reporting qualitative research. (DOCX)
Data
Data on role of device industry representatives. (DOCX)
Article
Full-text available
The aim of this paper is to examine how members of the public define the legitimacy of cognitive and behavioural enhancement. Our study involved a two-step multimedia-based deliberative intervention in which participants of different age groups pondered the desirability of a fictional enhancement technology: a sweater made of ‘smart’ textiles that...
Article
Objective Patient engagement (PE) is warranted when treatment risks and outcomes are uncertain, as is the case for higher risk medical devices. Previous research found that patients were not engaged in discussions or decisions about implantable medical devices. This study explored physician views about engaging patients in such discussions. Design...
Article
Full-text available
Background: New technologies constitute an important cost-driver in healthcare, but the dynamics that lead to their emergence remains poorly understood from a health policy standpoint. The goal of this paper is to clarify how entrepreneurs, investors, and regulatory agencies influence the value of emerging health technologies. Methods: Our 5-year q...
Article
Few studies have examined the process by which health technology innovators must socially construct their firm and share their ideas with economic and health system actors. To fill this gap, we intended to provide insights into the differences characterising the health technology startup (HTS) among other startups and test a conceptual model by cha...
Article
The ability to handle clinical and business risks is critical to an academic spin-off that seeks to develop a new medical technology. The milestones it has to meet to materialize its innovation are objects of speculation for those who finance its operations, and also for stakeholders who comment publicly on its progress. Such future-oriented expect...
Article
Full-text available
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. We empirically flesh out the RRI framework developed by Stilgoe et al. by drawing on the content of three mixed focus groups on health care syst...
Article
Full-text available
New medical technology challenges the sustainability of healthcare systems in several countries. Drawing on secondary sources of data, the aim of this article is to generate a better understanding of the historical Research & Development dynamics that have contributed to shape today's medical innovation ecosystem. We describe key technological achi...
Article
Full-text available
Background Using a combination of videos and online short stories, we conducted four face-to-face deliberative workshops in Montreal (Quebec, Canada) with members of the public who later joined additional participants in an online forum to discuss the social and ethical implications of prospective technologies. This paper presents the participants’...
Article
Full-text available
Introduction: Some cardiovascular devices are licensed based on limited evidence, potentially exposing patients to devices that are not safe or effective. Research is needed to ascertain if the same is true of other types of medical devices. Knee arthroplasty is a widely-used surgical procedure yet implant failures are not uncommon. The purpose of...
Data
Web sites searched for HTAs. (DOCX)
Data
Data extracted from primary studies and references. (DOCX)
Article
Full-text available
Background End-of-life policies are hotly debated in many countries, with international evidence frequently used to support or oppose legal reforms. Existing reviews are limited by their focus on specific practices or selected jurisdictions. The objective is to review international time trends in end-of-life practices. Methods We conducted a syste...
Article
End-of-life policies are hotly debated in many countries, with international evidence frequently used to support or oppose legal reforms. Existing reviews are limited by their focus on specific practices or selected jurisdictions. The objective is to review international time trends in end-of-life practices. We conducted a systematic review of empi...