Societal impact and ethical healthcare innovation

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With the rise in popularity of #techforgood movement and social enterprises it’s not uncommon to hear innovators speaking about how they are taking an ethical approach or their tool is based on ethical principles. Its easy to say we’re taking an ethical approach but more difficult for different stakeholders in a healthcare system to agree what this means and especially be clear on the prioritisation of their principles.

The 2019 post “An ethical approach to innovation” outlined a first attempt to try and capture what we can understand to be essential components of ethical innovation:

• Co-development. An innovation addresses an unmet need and is co-developed by all impacted as equal partners.
• Outcomes based. An innovation should be developed to address an unmet need measuring effectiveness against the outcomes as one part of the success measure.
• Privacy. Any use of data and information captured respects the privacy preferences of the individuals involved.
• Honesty and transparency. The innovation function should be honest and transparent - not actual specific workings but the principals.
• Matches values of users and professionals. Innovations are often developed because there is a good idea that potentially solves a problem. However there also needs to be consideration of how an innovation aligns to values of healthcare systems, professions and people.
• Sustainability of the innovation and system it is intended. Profit is not unethical after all we want employees and innovators to earn a living and be able to live healthy lifestyles. Additionally users need to have confidence that innovations will continue to exist and be supported - a revenue stream helps both of these.
• Inclusiveness. Innovations should aim to be inclusive not exclusive from the outset this approach should underpin the co-develop to ensure the seldom heard voices are engaged.

Under the sustainability aspect the following was provided:

Sustainability of the innovation and system it is intended. Profit is not unethical after all we want employees and innovators to earn a living and be able to live healthy lifestyles. Additionally users need to have confidence that innovations will continue to exist and be supported - a revenue stream helps both of these. The right metrics need to be selected to measure the success of an innovation or users fear change, for example over 150 products have been launched and quickly closed by Google. If profit maximisation is the only motive it most likely isn't a good match to the values of healthcare professionals and could result in unethical practice such as selling on information to maximise profit. However we do want innovations to be sustainable and supported so they are reliable and of high quality. Similarly if the innovation upends part of the system what happens to those people and how are you supporting it to change? That's not to say disruption is a bad thing but when it endangers people and quality of life what's the mitigation process? Also in a climate change crisis innovations should mitigate the environmental impact.

As outlined above a sustainable solution is essential and part of being sustainable is having a financial return. However the above doesn’t appropriately acknowledge the importance of social and societal impact within the context of ethical innovation. A tool being developed for health purposes already has a societal impact most likely to an individual or an organisation (and perhaps also on the health care system). But is this sufficient or should we expect more from ethical innovators? A social enterprise could reinvest profits into product R&D which improves patient care - is this not a societal impact?

Beyond transactional

Providing a service or a product in return for revenue is necessary for sustainability but also risks being categorised as transactional and paying lip service to an ethical approach. However how can organisations do more and remain sustainable organisations?

Organisations may wish to look at how they can support one of the various initiatives being championed by the healthcare service this might include:

• Social prescribing - for example donating use of a room for a community activity such as a coffee morning or yoga class.
• Community anchor - invest in the skills and education of the community the organisation sits within e.g. by supporting disadvantaged families to gain experience and so be more able to build their confidence and skills.
• Green - invest in research and development to reduce carbon footprint and improve recycling of products

It's not uncommon for manufacturers and suppliers to be distrusted by healthcare professionals and patients. They risk being criticised for profiting from healthcare provision. Without knowing the full deatils of a business the line between a sustainable solution and profiteering can be grey and open to interpretation. But, as outlined above, organisations can put ethical innovation including incorporating social impact as part of their business as usual without needing to invest huge amounts of resources.

Ethical innovation means having parity of importance for social impact and finacial return developing organisations that are sustainable and reliable but also support the society and community they reside within.

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