Article Text

Download PDFPDF
Original research
Double burden or single duty to care? Health innovators’ perspectives on environmental considerations in health innovation design
  1. Lysanne Rivard1,
  2. Pascale Lehoux1,2,
  3. Fiona A Miller3
  1. 1 Institute of Public Health Research, Universite de Montreal, Montreal, Quebec, Canada
  2. 2 Department of Health Management, Evaluation and Policy, Universite de Montreal, Montreal, Quebec, Canada
  3. 3 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Pascale Lehoux, Department of Health Management, Evaluation and Policy, Universite de Montreal, Montreal, Quebec H3C 3J7, Canada; pascale.lehoux{at}


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 interviews with engineers, industrial designers, entrepreneurs and clinicians (n=31) involved in the design, development and distribution of health innovations in Quebec and Ontario (Canada). A qualitative thematic data analysis identified similarities and variations across respondents’ viewpoints.

Results Innovators’ views emphasise the following: (1) the double burden of supporting patient care and reducing the environmental impact of healthcare; (2) systemic challenges to integrating environmental considerations in health innovation design, development and use and (3) solutions to foster the development of environmental-friendly health innovations. Although innovators tend to prioritise patient care over the environment, they also call for public policies that can transform these two imperatives into a single duty to care.

Conclusions Health innovators are uniquely positioned to tackle challenges and develop creative solutions. Policymakers and regulators should, however, actively steer the healthcare industry towards a more sustainable modus operandi by giving full attention to environmental considerations in health innovation design.

  • responsible innovation
  • sustainable innovation
  • environmental health
  • innovation policy
  • health policy

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors LR and PL contributed substantially to the design of the study and to the first draft of the manuscript. LR was responsible for collecting and analysing data. LR, PL and FAM contributed to the interpretation of the findings, revised critically preliminary versions of the manuscript and contributed important intellectual content. All authors reviewed, edited and approved the final version.

  • Funding This research was funded by the Canadian Institutes of Health Research (CIHR; #FDN-143294). Our research group infrastructure is supported by the Fonds de la recherche en santé du Québec (FRQ-S).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.