National Post

Canada needs a health-care moonshot — and now is the time

- AHMED NASIR , DANTE MORRA AND JOHN KELLEHER

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 precompute­r 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.

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.

Howe ver, f our 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. They are: Mobile health — inexpensiv­e, ubiquitous communicat­ion and monitoring through the mobile web;

Robotic and process automation — automating major parts of the system’s back office, as well as targeted core processes;

Artificial intelligen­ce — using data to generate lowcost highly accurate health prediction­s; and

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:

Setting an ambitious, “moonshot” goal: declaring a goal to become the topranked system globally on quality, accessibil­ity, and efficiency within 10 years, for instance, could bring focus, urgency, and a sense of competitio­n to this work.

Investing in diverse people and partnershi­ps: Imagine putting Canada’s world-class technology entreprene­urs and founders in management and boardrooms of health- care i nstitution­s, while providers could form transforma­tional partnershi­ps with top university computer science, engineerin­g, and design department­s.

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.

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.

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.

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 privatesec­tor technology firms could leverage the data to deliver truly disruptive ventures.

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.

Exporting health-care products and services internatio­nally. Innovation and productivi­ty leaders typically export their products and services globally or otherwise serve i nternation­al customers. Dubai’s worldclass 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.

National Post Ahmed Nasir is senior advisor, innovation, and Dante Morra is the chief of medical staff, both at Trillium Health Partners. John Kelleher is a partner at McKinsey & Company and co- chair of NEXT Canada.

LAST YEAR, WE SPENT $242 BILLION ON HEALTH CARE. THAT’S $663 MILLION A DAY.

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