The federal Advisory Panel on Healthcare Innovation released its report “Unleashing Innovation: Excellent Healthcare for Canada” on July 17, 2015 – a report that CARP and many other Canadians will welcome as an honest but necessary assessment of Canada’s healthcare system. After a year of consultations and discussions with various organizations, stakeholders, academics and experts, the Panel released its report that highlights opportunities and recommendations to reform and reinvigorate Canada’s lagging healthcare system.
The Advisory Panel on Healthcare Innovation was created by Canada’s Health Minister, the Honourable Rona Ambrose, with a mandate to identify the five most promising areas of innovation in Canada and internationally that could sustainably reduce growth in health spending while improving the quality and accessibility of care. The Panel was also requested to provide recommendations on how the federal government could support those identified areas of innovation. CARP made a submission in 2014 to the Panel, calling for a full system re-design of the healthcare system to provide a comprehensive 360 degrees of care and treat Canadians as “healthcare citizens” – with the right to expect timely and appropriate care and equal treatment regardless of age, income, or postal code.
The realities of our current fragmented, complex healthcare system
The Panel heard from Canadians that many are concerned about the state of their health care system and see the need for fundamental change in how the healthcare is organized, financed, and delivered. Among the many challenges, the report identified the fragmented, complex, and difficult-to-navigate nature of the healthcare system as well as the lack of patient-centered care as some of the major shortfalls of the current healthcare system, – shortfalls that CARP has also identified in its submission to the Panel and its original One Patient paper.
According to the report, “Healthcare remains disjointed, with poor coordination and alignment within and across the various professions, acute and chronic care institutions and community care” and patients are increasingly seeing themselves as “partners in their own care and are less willing to accept poor customer service, including communication gaps and outdated communication technology, long-waiting times, and poorly integrated services.” The report plainly states that “so long as the system is organized around providers and so long as those providers are paid out of separate funding envelopes, patient-centred care will be easy to announce and difficult to achieve.”
The panel did not merely identify challenges without providing solutions like so many reports do. It provided concrete solutions and recommendations, including testing new forms of payment that are organized and financed around the patient’s needs, scaling-up and spreading best practices of inter-professional care across systems, and support a pan-Canadian multi-sectorial collaboration on a pan-Canadian pay commission to help decision-makers evaluate professional roles, payments, and prices. It also recommended incentives at the system level for improved patient engagement, digital health solutions like virtual care, and patient-access and co-ownership of their own personal health records coupled with adequate privacy protection.
Barriers to scaling up and spreading innovation
There are many pockets of innovation across the country improving care but the report found major barriers that prevent innovative ideas from being scaled up and spread across the country. The Panel’s report attributes many of these barriers to the federal government’s lack of leadership and lack of dedicated funds to drive innovation and healthcare reform:
“The panel observes that federal spending power has evolved into quite a lot of spending and not much power.”
“There has been a lack of federal leadership and collaboration with the provinces. The existing provincial/territorial collaboration has been positive but it is suboptimal, costly, limited in scope, and lack of long-term working capital. Federal engagement and leadership could accelerate healthcare innovation via their ability to fund long-term, mobilize resources to help scale-up systematically and efficiently, help develop a national vision for reform.”
The fragmented nature of the system was also found as a barrier. It not only leads to poor patient experience but it also acts as a structural barrier to scaling up and spreading innovation. As a result, among other recommendations, the Panel recommends two key enabling actions: a new fund and new agency.