Over my career the vital but unappreciated link between ethics and innovation has become apparent to me.  Some workplace scenarios require rigorous ethics training, others allow workplace ethical frameworks to be centered around the profession in relation to their professional membership, and others are driven by regulations and standards. In different ways people are trained and supervised under an ethical construct, knowing that certain issues will create a loss of employment or the revoking of a privilege to practice.  Where do innovators fit?Canadians take pride in our country's global reputation as an ethical leader with a strong rule of law and a commitment to diversity and inclusion.  Our reputation has made us an attractive place to invest and drawn talented people from across the globe who have chosen to study and work in Canada. Canadians generally value that diversity of thought leads to strong innovation.This identity has also enabled us to attract opportunities that require diversity and ethical business dealings- like clinical trials that need good public health infrastructure, a professional class of administrators and access to a diverse patient population.Our health system is in need of innovation; today's disruption is evidence of that. Yet, when it comes to ethics in health care innovation there seems to be a growing schism between an ethical framework and the technology surrounding data, digital health and patient interaction.   While technology continues to speed ahead, it is not clear that our ethical framework models are keeping pace. Many of the upcoming challenges like digital identity, AI, genetic treatments, and even stronger roles and players for alternate payers to government like insurance companies, will increasingly require a form of social license and a trade-off from citizens who will need to be reassured that the technologies are accompanied by a consistent set of rules and ethical protections.An Accenture survey in 2020 found that healthcare organizations need to become more collaborative in creating new digital healthcare experiences – ensuring customers feel engaged, important and informed. A breakdown of stats showed that 85% of executives believe that technology has become an inextricable part of the human experience. Further, 45% of those polled said that rapid advancements in new technologies and scientific innovations are positioned to disrupt their industry. Take this disruption a step further – it's imperative that with the advancements we've made during the pandemic in healthcare – healthcare recipients and providers need to redesign our existing framework to minimize the high-stakes in innovation and “get it right” by incorporating ethical thinking from the gate.The concept of public trust is going to become increasingly important as private and public sector healthcare continues to converge. Especially as we further understand the genome, computational power and the exciting things happening in healthcare, we have an obligation to re-earn public trust and social license.Public trust, however, will instead be further disrupted as we move toward a consumer-focused interoperable model. To this point, we have entrusted the government to hold personal information on our behalf, as we have held trust in banks to hold our money, and health agencies to hold our health information – but data integration needs will require our personal accountability to reconcile with doctors' offices, hospitals and other institutions having access to our data.As the private sector engages more in the health system, such as through pharmacies and insurance companies, having a bigger slice of my data – we need to start thinking about how the private and public sector will work together in lockstep on ethical guidelines while spearheading collaboration and strong data integration. For example, I can get some blood tests done by a private lab, pick up medication and get vaccinated at a retail pharmacy and receive wellness packages from an insurance company. Now my 1-2% of health data held by a private company will easily grow to 20-30%.  As these innovations unfold, will our public trust framework be challenged?When thinking about the salient points of ethical healthcare in Canada, two things come to mind: how do we serve all equally in our healthcare system and ensure that technology doesn't further divide? And how does the system we stand for reflect diversity and equity?We can see the importance of equity in our healthcare system as we begin to create meaningful conversations around who gets vaccines first. These useful discussions have brought forward the need to integrate more technology, tracking and information integration into the public health care system to promote equitable outcomes.If we move toward this hyper-integrated model and inevitably are bound for disruption, we must think of how we can protect this system ethically and the boundaries in place for this interoperable model. A public system funded by taxpayers is not enough to ensure success. We must deliver healthcare together, designing with innovation for a rapidly evolving citizen experience, yet adhering to a more dynamic framework for ethical outcomes.  One that allows for multiple players yet ensures equality and access, as we envisioned in the Canada Health Act.Shannon McDonald is managing director, health and social services lead – Canada for Accenture.