Canada’s health-care system is under massive strain. It faces the combined challenges of aging demographics, population growth, and design built for episodic care in a pre-computer age.
The result is overextended and overcrowded hospitals and increasingly lengthy wait times. Canadians are also paying far more for less. From 1997 to 2017, the consumer price index rose 43.7 per cent; health-care costs rose 173.6 per cent. Last year, we spent $242 billion on health care. That’s $663 million a day.
In 2017, the Commonwealth Fund released a report that compared health-care systems in 11 developed countries. Canada ranked ninth
Canada spends more on health care than almost every comparable country with universal care, but it ranks near the bottom with respect to critical quality and accessibility measures. In 2017, the Commonwealth Fund released a report that compared health-care systems in 11 developed countries. Canada ranked ninth, ahead of only France and the United States.
However, four breakthrough technologies that are converging rapidly offer Canada a remarkable opportunity to transform its health-care system, dramatically increasing its quality and accessibility while exponentially decreasing its cost of care. Importantly, these technologies can also significantly enhance Canada’s health-care professionals and employees’ effectiveness in tackling their tough daily challenges.
1. Mobile health — inexpensive, ubiquitous communication and monitoring through the mobile web;
2. Robotic and process automation — automating major parts of the system’s back office, as well as targeted core processes;
3. Artificial intelligence — using data to generate low-cost highly accurate health predictions; and
4. Genetics – developing personalized medicines and treatments.
Canada could use these technologies to transform health care. In a public system, the government must play a leadership role in creating the conditions for success such that the four breakthrough technologies can be adopted. While we are seeing the development of pockets of excellence (incubating health-care ventures in Toronto’s Biomedical Zone, the Value-Based Innovation Program of Ontario’s Office of the Chief Health Innovation Strategist, and accelerating innovation adoption through Vancouver’s Pacific Health Innovation Exchange) much more could be done at a more rapid pace.
To achieve the full opportunity Canada’s governments at all levels could consider options including:
1. Setting an ambitious, “moonshot” goal: declaring a goal to become the top-ranked system globally on quality, accessibility, and efficiency within 10 years, for instance, could bring focus, urgency, and a sense of competition to this work.
2. Investing in diverse people and partnerships: Imagine putting Canada’s world-class technology entrepreneurs and founders in management and boardrooms of health-care institutions, while providers could form transformational partnerships with top university computer science, engineering, and design departments.
3. Training and investing in next generation of digital health-care professionals. The future will bring shortages of professionals with expertise in breakthrough technologies, all of whom will be crucial to transforming the system. Real investments could be made to educate new professionals in these areas and to upgrade the digital skills and technology tools for today’s doctors, nurses, and health-care employees.
4. Creating strong financial incentives to invest in and adopt technology. Institutions could be challenged and rewarded with large prizes to reach specific goals, such as achieving the lowest wait times in the country or realizing the best outcomes in the world on surgical readmittance. Their innovations could then be shared.
5. Increasing technology experimentation in non-traditional ways. Hospital systems and provinces could be encouraged to start “disruptive labs” to pursue process and other innovations, circumventing the typical bureaucracy. Changes in policy and procurement rules could be explored to spur Canadian-based health-care startups and scale-ups to address problems in the system. Successful companies and teams could be supported through a government-sponsored VC-like allocation system managed by the private sector.
6. Opening access to health data. A national effort to standardize, anonymize, and liberate the wealth of data in our health system could help achieve two critical outcomes: non-profits, academics, and journalists could use the data to rate and research health-care inputs, actions, and results, while private-sector technology firms could leverage the data to deliver truly disruptive ventures.
7. Concentrating resources to build areas of excellence. Innovation excellence requires concentration and scale. The government could place much larger informed technology “bets” in logical locations across Canada. When they pay off, the lessons and solutions can be replicated in additional institutions.
8. Exporting health-care products and services internationally. Innovation and productivity leaders typically export their products and services globally or otherwise serve international customers. Dubai’s world-class health-care city attracts customers from all over the world. Vancouver, Toronto or Montreal could adopt this model, drawing global investment, technology, and customers to Canada, provided that doing so doesn’t distract from reducing wait times and increasing quality of care for Canadians.
Canada is at a crossroads. It can either be a leader of the health-care economy or a follower. The time to seize the opportunity is now.