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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Toward Equitable Innovation
in Health and Medicine

A Framework

_____

Committee on Creating a Framework
for Emerging Science, Technology, and
Innovation in Health and Medicine

Board on Health Sciences Policy

Health and Medicine Division

Consensus Study Report


Image

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by grants between the National Academy of Sciences and the Gordon and Betty Moore Foundation through grant #8938.01, the Greenwall Foundation, the Public Interest Technology Infrastructure Fund through subgrant #01705-2022-09-01, the Robert Wood Johnson Foundation through grant #79541, Schmidt Futures, and Qualcomm Inc. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-70761-9
International Standard Book Number-10: 0-309-70761-7
Digital Object Identifier: https://doi.org/10.17226/27184

This publication is available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward equitable innovation in health and medicine: A framework. Washington, DC: The National Academies Press. https://doi.org/10.17226/27184.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

Rapid Expert Consultations published by the National Academies of Sciences, Engineering, and Medicine are authored by subject-matter experts on narrowly focused topics that can be supported by a body of evidence. The discussions contained in rapid expert consultations are considered those of the authors and do not contain policy recommendations. Rapid expert consultations are reviewed by the institution before release.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×

COMMITTEE ON CREATING A FRAMEWORK FOR EMERGING SCIENCE, TECHNOLOGY, AND INNOVATION IN HEALTH AND MEDICINE1

KEITH WAILOO (Co-Chair), Henry Putnam University Professor of History and Public Affairs, Princeton University, New Jersey

KEITH YAMAMOTO (Co-Chair), Vice Chancellor for Science Policy and Strategy; Director, UCSF Precision Medicine; Professor Emeritus, Cellular and Molecular Pharmacology, University of California, San Francisco

AMY ABERNETHY, President, Product Development and Chief Medical Officer, Verily, San Francisco, California

DAVID ASCH, Senior Vice Dean for Strategic Initiatives at the Perelman School of Medicine and the John Morgan Professor at the Perelman School and the Wharton School at the University of Pennsylvania

OLVEEN CARRASQUILLO, Professor of Medicine and Public Health Sciences, University of Miami, Florida

AMITABH CHANDRA, Ethel Zimmerman Wiener Professor of Public Policy and Henry and Allison McCance Professor of Business Administration, Harvard University, Massachusetts

R. ALTA CHARO, Principal, Alta Charo Consulting LLC and Warren P. Knowles Professor Emerita of Law & Bioethics, University of Wisconsin–Madison

HANA EL-SAMAD, Senior Vice President and Director of Science Integration, Innovation and Insights and Founding Principal Investigator, Altos Labs, California

MICHELE BRATCHER GOODWIN, Linda D. & Timothy J. O’Neill Professor of Constitutional Law and Global Health Policy, Georgetown Law School, Washington, DC

ANTHONY RYAN HATCH, Professor of Science in Society, African American Studies, Environmental Studies, and Sociology, Wesleyan University, Connecticut

JIANYING HU, IBM Fellow, Director of HCLS Research, and Global Science Leader, AI for Healthcare, IBM Research, New York

LISA I. IEZZONI, Professor of Medicine, Harvard Medical School, Massachusetts

ALEX JOHN LONDON, Clara L. West Professor of Ethics and Philosophy, Carnegie Mellon University, Pennsylvania

DEBRA MATHEWS, Associate Director for Research and Programs, Berman Institute of Bioethics and Associate Professor of Genetic Medicine, Johns Hopkins University, Maryland

SHOBITA PARTHASARATHY, Professor of Public Policy and Professor of Women’s and Gender Studies, University of Michigan

TIMOTHY M. PERSONS, Partner, PricewaterhouseCoopers LLP, Washington, DC

ARTI RAI, Elvin R. Latty Professor of Law, Duke University, North Carolina

KAUSHIK SUNDER RAJAN, Professor of Anthropology and Social Sciences, The University of Chicago, Illinois

KRYSTAL TSOSIE, Assistant Professor, Arizona State University and Co-founder, Native BioData Consortium, Arizona

___________________

1 NOTE: See Appendix E, Disclosure of Unavoidable Conflicts of Interest.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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NAM Fellows

ANDREW A. GONZALEZ, Gilbert S. Omenn Fellow and Assistant Professor of Surgery, Indiana University

STEVEN LIN, James C. Puffer, American Board of Family Medicine Fellow and Clinical Associate Professor, Stanford University, California

Study Staff

KATHERINE BOWMAN, Study Director, Board on Health Sciences Policy

ANDREW BREMER, Program Officer, Board on Life Science

MELISSA LAITNER, Special Assistant to the President, National Academy of Medicine

CELYNNE BALATBAT, Associate Program Officer, National Academy of Medicine

MICHAEL BERRIOS, Research Associate, Board on Health Sciences Policy

VICTORIA CHEGE, Senior Program Assistant, Board on Health Sciences Policy

CHRISTIE BELL, Finance Business Partner, Board on Health Sciences Policy

CLARE STROUD, Senior Director, Board on Health Sciences Policy

KIMBER BOGARD, Deputy Executive Officer, Programs, National Academy of Medicine

Consultants

RONA BRIERE, Senior Editor, Briere Associates, Inc.

LEE A. BLEVINS ZAJAC, Editorial Assistant, Briere Associates, Inc.

ALLIE BOMAN, Editorial Assistant, Briere Associates, Inc.

JOHN HAWKINS, Editorial Assistant, Briere Associates, Inc.

ANNE JOHNSON, Founder and Lead Science Writer, Creative Science Writing, LLC

PEAK SEN CHUA, Consultant, National Academy of Medicine

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×

Reviewers


This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

We thank the following individuals for their review of this report:

RODOLPHE BARRANGOU, North Carolina State University

RODERIC L. PETTIGREW, Texas A&M University

TANZEEM CHOUDHURY, Cornell Tech

ROBERT COOK-DEEGAN, Arizona State University

J. NWANDO OLAYIWOLA, Humana, Inc.

JENNY REARDON, University of California, Santa Cruz

MICHELLE M. MELLO, Stanford University

BHAVEN N. SAMPAT, Columbia University

BOB KOCHER, Venrock and Stanford University

DAVID WINICKOFF, Organisation for Economic Co-operation and Development (OECD)

TANIA SIMONCELLI, Chan Zuckerberg Initiative

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by ELISABETH BELMONT, MaineHealth, and ERIC LARSON, University of Washington. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Acknowledgments


The committee would like to express its sincere gratitude to the speakers, panelists, respondents to the call for input, and others who shared their views with the committee, as well as to Alexis Walker and Michael McGovern for authoring commissioned papers presented in Appendixes of this report.

The committee is also grateful for the contributions of Rona Briere, senior editor, Allie Boman, Lee A. Blevins Zajac, and John Hawkins, editorial assistants, Anne Johnson, science writer, and Peek Sen Chua, consultant, along with Christopher Lao-Scott, senior librarian of the National Academies Research Center, for his crucial assistance with fact checking.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2023. Toward Equitable Innovation in Health and Medicine: A Framework. Washington, DC: The National Academies Press. doi: 10.17226/27184.
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Advances in biomedical science, data science, engineering, and technology are leading to high-pace innovation with potential to transform health and medicine. These innovations simultaneously raise important ethical and social issues, including how to fairly distribute their benefits and risks. The National Academies of Sciences, Engineering, and Medicine, in collaboration with the National Academy of Medicine, established the Committee on Creating a Framework for Emerging Science, Technology, and Innovation in Health and Medicine to provide leadership and engage broad communities in developing a framework for aligning the development and use of transformative technologies with ethical and equitable principles. The committees resulting report describes a governance framework for decisions throughout the innovation life cycle to advance equitable innovation and support an ecosystem that is more responsive to the needs of a broader range of individuals and is better able to recognize and address inequities as they arise.

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