{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T20:46:56Z","timestamp":1769633216902,"version":"3.49.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["NRP77, 407740_187356\/1"],"award-info":[{"award-number":["NRP77, 407740_187356\/1"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:p>Spurred by recent advances in machine learning and electronic hardware, digital health promises to profoundly transform medicine. At the same time, however, it raises conspicuous ethical and regulatory issues. This has led to a growing number of calls for responsible digital health. Based on stakeholder engagement methods, this paper sets out to identify core impediments hindering responsible digital health in Switzerland. We developed a participatory research methodology to access stakeholders' fragmented knowledge of digital health, engaging 46 digital health stakeholders over a period of five months (December 2020\u2013April 2021). We identified ineffective stakeholder collaboration, lack of ethical awareness among digital health innovators, and lack of relevant regulation as core impediments to responsible digital health. The stakeholders' accounts indicate that ethical concerns may considerably slow the pace of digital health innovation \u2013 implying that responsible innovation is a core catalyst for the progress of digital health overall.<\/jats:p>","DOI":"10.3389\/fdgth.2023.1069410","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T06:08:55Z","timestamp":1675663735000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":30,"title":["Stuck in translation: Stakeholder perspectives on impediments to responsible digital health"],"prefix":"10.3389","volume":"5","author":[{"given":"Constantin","family":"Landers","sequence":"first","affiliation":[]},{"given":"Effy","family":"Vayena","sequence":"additional","affiliation":[]},{"given":"Julia","family":"Amann","sequence":"additional","affiliation":[]},{"given":"Alessandro","family":"Blasimme","sequence":"additional","affiliation":[]}],"member":"1965","published-online":{"date-parts":[[2023,2,6]]},"reference":[{"key":"B1","article-title":"Digital health trends 2021: innovation, evidence, regulation and adoption","volume":"2021","author":"Aitkin","year":"2021","journal-title":"IQVIA Inst"},{"key":"B2","volume-title":"Artificial intelligence and machine learning (AI\/ML)-enabled medical devices","year":"2022"},{"key":"B3","doi-asserted-by":"publisher","first-page":"66","DOI":"10.2471\/BLT.17.197426","article-title":"Policy implications of big data in the health sector","volume":"96","author":"Vayena","year":"2018","journal-title":"Bull W H O"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-04831-4_13","article-title":"The use of digital health technology and social media to support breast screening","author":"Robinson","year":"2015","journal-title":"Digital Mammography"},{"key":"B5","doi-asserted-by":"publisher","first-page":"38","DOI":"10.21037\/mhealth.2017.08.07","article-title":"Digital health is a cultural transformation of traditional healthcare","volume":"3","author":"Mesk\u00f3","year":"2017","journal-title":"mHealth"},{"key":"B6","volume-title":"Digital health","year":"2022"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fdgth.2020.536203","article-title":"Five crucial challenges in digital health","volume":"2","author":"Cummins","year":"2020","journal-title":"Front Digit Health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10796-021-10142-8","article-title":"Responsible artificial intelligence as a secret ingredient for digital health: bibliometric analysis, insights, and research directions","author":"Fosso Wamba","year":"2021","journal-title":"Inf Syst Front"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10796-021-10146-4","article-title":"Responsible AI for digital health: a synthesis and a research agenda","author":"Trocin","year":"2021","journal-title":"Inf Syst Front"},{"key":"B10","doi-asserted-by":"publisher","first-page":"127","DOI":"10.3389\/fdgth.2021.725088","article-title":"The sociotechnical ethics of digital health: a critique and extension of approaches from bioethics","volume":"3","author":"Shaw","year":"2021","journal-title":"Front Digit Health"},{"key":"B11","article-title":"The Ethics of AI in Biomedical Research, Patient Care, and Public Health","volume-title":"The Oxford Handbook of Ethics of AI","author":"Blasimme","year":"2020"},{"key":"B12","doi-asserted-by":"publisher","first-page":"w14571-w","DOI":"10.4414\/smw.2018.14571","article-title":"Digital health: meeting the ethical and policy challenges","volume":"148","author":"Vayena","year":"2018","journal-title":"Swiss Med Wkly"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e1002689","DOI":"10.1371\/journal.pmed.1002689","article-title":"Machine learning in medicine: addressing ethical challenges","volume":"15","author":"Vayena","year":"2018","journal-title":"PLoS Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"113172","DOI":"10.1016\/j.socscimed.2020.113172","article-title":"The ethics of AI in health care: a mapping review","volume":"260","author":"Morley","year":"2020","journal-title":"Soc Sci Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"91","DOI":"10.3389\/fdgth.2021.697072","article-title":"Digital mental health for young people: a scoping review of ethical promises and challenges","volume":"3","author":"Wies","year":"2021","journal-title":"Front Digit Health"},{"key":"B16","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1038\/s41746-020-00314-2","article-title":"Challenges for the evaluation of digital health solutions\u2014a call for innovative evidence generation approaches","volume":"3","author":"Guo","year":"2020","journal-title":"npj Digit Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12916-019-1377-7","article-title":"Building the case for actionable ethics in digital health research supported by artificial intelligence","volume":"17","author":"Nebeker","year":"2019","journal-title":"BMC Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fdgth.2021.841477","article-title":"Editorial: responsible digital health","volume":"3","author":"Ahmadpour","year":"2022","journal-title":"Front Digit Health"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/su11195433","article-title":"Responsible for responsibility? A study of digital e-health startups","volume":"11","author":"Oftedal","year":"2019","journal-title":"Sustainability (Switzerland)"},{"key":"B20","doi-asserted-by":"publisher","first-page":"690417","DOI":"10.3389\/fdgth.2021.690417","article-title":"From general principles to procedural values: responsible digital health meets public health ethics","volume":"3","author":"Nyrup","year":"2021","journal-title":"Front Digit Health"},{"key":"B21","first-page":"326","author":"Tsekleves","year":"2021"},{"key":"B22","year":""},{"key":"B23","unstructured":"KosteraT\n            ThranberendT\n            SchwenkU"},{"key":"B24","author":"Holler","year":""},{"key":"B25","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s12910-017-0167-z","article-title":"The ECOUTER methodology for stakeholder engagement in translational research","volume":"18","author":"Murtagh","year":"2017","journal-title":"BMC Med Ethics"},{"key":"B26","first-page":"1","article-title":"Mind-mapping: a tool for eliciting and representing knowledge held by diverse informants","volume":"52","author":"Meier","year":"2007","journal-title":"Soc Res Update"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.8786.1","article-title":"Digital methodology to implement the ECOUTER engagement process","volume":"5","author":"Wilson","year":"2016","journal-title":"F1000Res"},{"key":"B28","author":"Nyrup","year":""},{"key":"B29","doi-asserted-by":"publisher","first-page":"e11254-e","DOI":"10.2196\/11254","article-title":"Elements of trust in digital health systems:\u00a0scoping review","volume":"20","author":"Adjekum","year":"2018","journal-title":"J Med Internet Res"},{"key":"B30","doi-asserted-by":"crossref","DOI":"10.4337\/9781788975063.00008","article-title":"Responsible Innovation in Digital Health","author":"Iakovleva","year":"2019","journal-title":"Responsible innovation in digital health"},{"key":"B31","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1038\/s42256-021-00386-z","article-title":"Regulating AI in medicine in the United States and Europe","volume":"3","author":"Vokinger","year":"2021","journal-title":"Nat Mach Intell"},{"key":"B32","volume-title":"Digital health innovation action plan","year":"2017"},{"key":"B33","unstructured":"DiamondM"},{"key":"B34","year":""},{"key":"B35","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1038\/s41431-019-0386-5","article-title":"The GDPR and the research exemption: considerations on the necessary safeguards for research biobanks","volume":"27","author":"Staunton","year":"2019","journal-title":"Eur J Hum Genet"},{"key":"B36","volume-title":"Ethics guidelines for trustworty artificial intelligence","year":"2019"},{"key":"B37","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1038\/s42256-019-0055-y","article-title":"Establishing the rules for building trustworthy AI","volume":"1","author":"Floridi","year":"2019","journal-title":"Nat Mach Intell"},{"key":"B38","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s13347-019-00354-x","article-title":"Translating principles into practices of digital ethics: five risks of being unethical","volume":"32","author":"Floridi","year":"2019","journal-title":"Philos Technol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1007\/s13347-022-00557-9","article-title":"The ethics of AI ethics. A constructive critique","volume":"35","author":"Heilinger","year":"2022","journal-title":"Philos Technol"},{"key":"B40","volume-title":"Laying down harmonised rules on artificial intelligence (Artificial Intelligence Act) and amending certain union legislative acts","author":"Commission","year":"2021"},{"key":"B41","author":"Vasella","year":""},{"key":"B42","volume-title":"K\u00fcnstliche Intelligenz: Handlungsbedarf im Schweizer Recht.","author":"Braun Binder","year":"2021"},{"key":"B43","volume-title":"Herausforderungen der k\u00fcnstlichen Intelligenz: Bericht der interdepartementalen Arbeitsgruppe \u00ab K\u00fcnstliche Intelligenz \u00bb an den Bundesrat","year":"2019"},{"key":"B44","author":"Swiss Federal","year":""}],"container-title":["Frontiers in Digital Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2023.1069410\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T06:09:05Z","timestamp":1675663745000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2023.1069410\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,6]]},"references-count":44,"alternative-id":["10.3389\/fdgth.2023.1069410"],"URL":"https:\/\/doi.org\/10.3389\/fdgth.2023.1069410","relation":{},"ISSN":["2673-253X"],"issn-type":[{"value":"2673-253X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,6]]},"article-number":"1069410"}}