Enabling health technology innovation in Canada: Barriers and facilitators in policy and regulatory processes

OBJECTIVES: Health care innovation and technologies can improve patient outcomes, but policies and regulations established to protect the public interest may become barriers to improvement of health care delivery. We conducted a scoping review to identify policy and regulatory barriers to, and facilitators of, successful innovation and adoption of health technologies (excluding pharmaceutical and information technologies) in Canada. METHODS: The review followed Arksey and O'Malley's methodology to assess the breadth and depth of literature on this topic and drew upon published and grey literature from 2000-2016. Four reviewers independently screened citations for inclusion. RESULTS: Sixty- seven full- text documents were extracted to collect facilitators and barriers to health technology innovation and adoption. The extraction table was themed using content analysis, and reanalyzed, resulting in facilitators and barriers under six broad themes: development, assessment, implementation, Canadian policy context, partnerships and resources. CONCLUSION: This scoping review identified current barriers and highlights numerous facilitators to create a responsive regulatory and policy environment that encourages and supports effective co-creation of innovations to optimize patient and economic outcomes while emphasizing the importance of sustainability of health technologies.