HTA responsiveness to today's challenges to health systems: a responsible innovation in health perspective.

Introduction: Though Health Technology Assessment (HTA) has steadily grown over the past decades, less attention has been paid to the way HTA may prove more responsive to the broader economic, social, and environmental challenges that health systems are facing today. In view of climate change, chronic diseases, an aging population, inequalities, and workforce issues, the HTA community's unique set of skills nonetheless holds great potential to help decision-makers strengthen many publicly funded health systems around the world.

Methods: This article adopts an integrated system-wide perspective guided by the Responsible Innovation in Health (RIH) framework to explore how the HTA community may not only adapt to the speed of innovation but also consider its direction.

Results: Because RIH aims to steer innovation toward a more sustainable pathway, it can help HTA agencies anticipate decision-makers' informational needs regarding four systemic challenges: (1) equitable access; (2) workforce issues; (3) accountable policy trade-offs; and (4) environmental sustainability. We clarify how key elements of the RIH framework may be used by HTA agencies to: (1) supplement their evaluation process; (2) align their priority-setting or strategic planning activities with their health system challenges; or (3) inform the production of early HTAs, horizon scans, or reports that are broader in scope than a single technology review.

Conclusions: The article concludes with three practical implications that were identified by the Institut National d'Excellence en Santé et Services Sociaux (INESSS) (Québec, Canada) and may inspire other HTA agencies.