If a thousand-mile journey begins with a single step, then the journey to innovate health-care systems in Canada has already begun.
But there is much ground left to cover, according to participants in a Future of Health virtual presentation Tuesday, co-hosted by CityAge and Communitech. The event, which drew an audience from coast to coast in Canada and from some points in the United States, was to promote conversation among health sector leaders, researchers, funders and tech entrepreneurs, as to how technological innovation can solve the problems facing the health-care system.
Although there have been first steps, there are many more to be taken, said Dr. Robert Bell, former Ontario deputy minister of health and long-term care, and former CEO of Toronto’s University Health Network, in his opening remarks.
Recapping from his May Globe and Mail opinion piece on the ways health care can be fixed, Bell ranged widely, highlighting such points as:
With 15 per cent of Canadians not having a family doctor, there is a demonstrated need to broaden the definition of who can provide primary care;
There needs to be urgency in rolling out the electronic referral and consultation technology that now exists;
Surgical delays could be reduced through creating community surgical centres, rather than cramming hospitals;
Mental health therapy needs to be included in Canada’s universal health-care system;
Implementing pharmacare is a vital issue;
The work of personal support workers needs to be treated as essential;
Seniors need community care that caters to the whole self, with an emphasis on naturally occurring retirement communities, rather than institutional care facilities; and
The urgent need to fix the long-term care system. With a compound growth rate in demand of 5.4 per cent over the next 10 years, the need for home care and long-term care will peak in 2032, only a decade away.
Throughout, Bell emphasized the need to get better data on the need and how it is being met. In every sector, from gathering information on rare diseases to rationalizing health-care delivery, data was an essential stimulant for change.
The first panel weighed in on many of the issues, with Canada’s fragmented health-care system — where rules may vary among provinces — being top of mind. The panel included: Brian Courtney, Chief Medical Officer of medical device maker Conavi Medical, and a cardiologist at Sunnybrook Hospital; Alan Forster, Executive VP and Chief Innovation and Quality Officer at The Ottawa Hospital; and Jennifer Sheils, VP and CIO of New Brunswick’s Horizon Health Network, with Globe and Mail health columnist Andre Picard as moderator.
Forster kicked off the discussion by noting that the health-care system tends to be “provider centric” which can dominate discussions that should focus on the needs of patients and patient outcomes.
Forster said patients and their families can be challenged by the various agencies that they must navigate to get the care they need. Silos exist between provinces, and often even within communities, where one hospital or health-care agency may not share information with another.
He said capital investment is needed both at the front end, to encourage innovation, and at the back end, to reward the innovators, and that data is vital for making medtech investment decisions.
Shiels noted that it can be difficult for agencies, dependent on government funding, to make a case for long-term solutions, but noted that the Atlantic provinces are in their second year of the Coordinated Accessible National Health Network (CAN Health Network), with the aim of getting the eight health organizations in Atlantic Canada to solve common problems.
Motivating clinicians to embrace digital health solutions is vital to the CAN Health Network’s future, Shiels said.
Panelists welcomed Picard’s question about the need for more R&D being done in hospitals, with Shiels urging hospitals to consider themselves to be “living labs,” with their doors open to industry. Forster agreed, saying that health leaders need to create pathways for industry so tech entrepreneurs can find solutions.
Courtney cited the varying approaches by universities and hospitals to managing the intellectual property of digital innovators. He urged national leaders to energize the medtech field by making the approval process easier, saying it takes three times as long to meet FDA and Health Canada requirements than it does to meet FDA requirements alone. The tendency, he said, is that medtech advances wind up being rolled out in other countries, even if developed in Canada. He noted, as an example, that Canadian clinicians were implanting metal stents for up to seven years longer than necessary, when improved, drug-coated stents were in use elsewhere.
A final panel stressed these pain points, with contributions from: Jodi Abbott, President and CEO of Edmonton’s University Hospital Foundation; Balaji Gopalan, CEO and Co-Founder of Toronto-based digital health solution provider MedStack; and Amir Hayeri, CEO of Vancouver-based predictive health-tech firm Bio Conscious Tech, chaired by The Logic health writer David Reevely.
Asked by Reevely what good tech emerged from the pandemic, Gopalan suggested very little new tech appeared. What did happen, he said, was the rapid rollout of tech already in development. Telecare, for instance, had already been in development. As society emerges from the pandemic (which panelists agreed isn’t a certainty), there have been shifts back to traditional medicine, but virtual care, self-monitoring and better home care will survive, he said.
Abbott noted that the Edmonton hospital created 60 virtual beds, using data and tech to break out of the traditional thinking about what a hospital is. The virtual beds led to a 51 per cent reduction in ER visits, and Alberta Health is considering rolling the virtual-bed model out across the province.
Hayeri offered that high-risk patients are more likely to accept new tech solutions, since they readily accept the value proposition for doing so. This acceptance opens doors for med-tech innovators by providing more data for analysis. Hayeri said the toughest sell, possibly surprisingly, are the large insurers. His company found that small and medium clinics and medical practices were most likely to embrace the new: “Their appetite for new tech is much greater.”
Hayeri lauded the potential for predictive health care promised by tech innovation. He proposed that “health care is really sick care.” The health-care system tracks the very young and the very old, but does little with “the healthy middle” and that group — the Fitbit users and others — are generating data that can predict problems through changes in their regular patterns of living. The healthy middle is where the future is, he suggested.
Potential private-sector partners wishing to know more or get involved in Future of Health events should contact Joel Semeniuk, VP of Corporate Growth & Innovation at Communitech, at firstname.lastname@example.org.