Liability washing is as bad for healthcare innovation as green washing is for sustainability. Here’s how to stop it.

While Apple CEO Tim Cook believes the future lies in responsible innovation, management scholars warned of a liability-washing trend almost a decade ago. Unfortunately, time proved them right. In recent months, generative AI tools like ChatGPT have become the latest technology to raise concerns about liability scrubbing.

Just like sustainability efforts overshadowed by greenwashing before the establishment of standards and norms (such as the ISO 14001 environmental management standards), responsible innovation (RI) is under threat from responsibility washing.

Just as greenwashing creates a misleading appearance of environmental responsibility for a product or organization, responsibility washing creates the impression of RI without making obvious efforts to address important social responsibility issues such as health equity, affordability economy and sustainability.

RI aims to reduce the negative impacts of innovations on users and society by transforming the way innovations are developed. But the lack of a standard definition of RI, practical tools or clear evaluation criteria and methods can lead to an innovation being discredited, intentionally or unintentionally.

New health technologies raise complex economic, social and environmental risks and harms as well as concerns for clinical safety and efficacy. That’s why our research team of RI experts tackles liability scrubbing in this area.

How does responsible innovation apply to the healthcare sector?

Readers may ask: Why does the healthcare sector need RE? Healthcare innovations are highly regulated to limit risk and harm. Their purpose is to save lives and make people feel better. Good technologies are developed with doctors and patients to best meet their needs. Aren’t they already responsible?

In 2015, our team of Canadian and Brazilian researchers set out to better understand how RE applies to the healthcare sector in both mature and emerging economies. This included:

• conduct a comprehensive research review;
• interviewing more than 85 experts in fields such as entrepreneurship, engineering, industrial design, and health technology assessment;
• conducting a four-year case study with small and medium-sized enterprises, e
• implement a collaborative process with experts to derive practical guidance.

This research led to the Responsible Innovation in Health (RIH) framework, which aims to foster high-quality and safe health care innovations that also: strengthen health system equity, deliver more value to users, use fewer resources, are positive for health environmentally and economically viable.

RIH brings together five areas of value, each defined by a specific goal and attributes (or elements) of responsibility that go beyond standards of clinical safety and efficacy: population health value, health system value, economic value, organizational and environmental value.

In addition to clearly defining RE for healthcare, our team developed a tool that informs design decisions and an evaluation tool that measures the degree of ownership of a healthcare innovation.

The RIH Design Brief is a practical tool for innovators that explains how to integrate RIH’s nine attributes of responsibility throughout the innovation lifecycle: conception, design, development, commercialization and end-of-life disposal.

The RIH assessment tool then measures the extent to which each accountability attribute is met. This tool has been validated by international experts and has been confirmed reliable through an evaluation of the inter-rater agreement.

Both the design brief and the assessment tool are based on four-level rating scales for each attribute, where A represents a high level of responsibility and D indicates that there are no particular signs of responsibility.

For example, let’s take a closer look at the scales of inclusiveness and eco-responsibility, two issues rarely addressed by health technology assessments.

Inclusiveness is measured by assessing whether the innovation team has formally consulted with a diverse group of people who may be affected by the technology and explained how that group’s input was integrated into the project. Formal methods include both consultation (such as surveys) and engagement methods (such as roundtables).

Eco-responsibility is measured by examining the number of key life cycle stages where the innovation team has applied eco-responsible practices, including the sourcing, production, distribution, use and disposal of materials prime.

Building a path of responsible healthcare innovation

By integrating RIH attributes during the ideation, design and development phases of an innovation, innovators can ensure that the key economic, social and environmental responsibility issues raised by their healthcare innovation are identified and measurably addressed.

It’s a complex process, so the RIH Design Brief offers practical guidance with an original tool for design thinking called the Responsible Design Compass. A multidisciplinary toolbox also indicates where innovators can work to achieve RIH goals using existing tools, such as FDA human factors engineering, IDEO photojournal or B Corps impact assessment.

Once the innovation is completed and ready for use, policy makers, healthcare executives, investors, technology transfer offices, philanthropic foundations and patient groups can apply the RIH assessment tool to inform decisions investment, purchase or implementation.

RIH’s goal is to prevent liability washing by setting a new path for responsible healthcare innovation. It provides the tools and practical guidance for innovators to be accountable to users and society from concept through to end-of-life disposal.