By Peter Lindfield, published in the Telegraph-Journal 15th May 2012
In countries around the world, no public good or government program has undergone as much radical change over the last 100 years as health care. Treatments, pharmaceutical products and medical devices have become dramatically more effective while the scope and scale of knowledge in the field has increased exponentially. In Canada, more than a million people list health care as their occupation. Canada is a recognized world leader in health research accounting for more than $6 billion in research budgets.
From a financial standpoint, health care has become the most intractable social program. In the face of increasing fiscal pressures, provincial governments have placed a spotlight on the need to contain the rising costs of health care. The Canadian public and their governments annually spend more than $180 billion on health care and much of this expenditure is under provincial jurisdiction.
The current fiscal challenges and the price of economic recovery effectively limit the availability of health care dollars. The fiscal crisis provides an opportunity to reshape current health care systems by reducing the growth rate of health care costs, while increasing productivity and improving health outcomes.
Yet even though health care innovation has been a priority on the agendas of every provincial government over the last ten years, little headway has been made. This drive to innovation has occurred under the rubric of alternative service delivery, supply chain re-engineering and process improvement, but change has been largely incremental.
In the face of the mounting challenges, why has more radical and transformative change not taken hold in the health care field? Change is clearly needed. The future demand from an aging population, rising expectations to meet current patient needs and the escalating costs of technology and pharmaceutical products have each conspired to ratchet up budgetary pressures.
One of the reasons that change is so difficult is that the number of stakeholders and players is enormous. The roster of team players includes health education and research institutions, such as universities and research hospitals; health and life sciences companies, including firms in industries such as pharmaceuticals, biotechnology, medical devices and medical informatics; health and health care non-governmental organizations and professionals; and government departments, including those that manage finance, health and innovation portfolios. There is no question that there is sufficient capacity in Canada’s health care system to manage our health care challenges.
Another reason that health care has become resistant to monumental change is that, for more than ten years, health care professionals have been immersed in a work environment where endless change has been the norm. Workshops, seminars, conferences, forums, consultations and town halls have produced a professionally uncertain workplace where everything is top priority. Without the proper alignment and integration of innovation goals to ensure that all members of the health organization work in harmony, productivity inevitably suffers.
There are such a large number of opportunities to reshape health care that strategic collaboration is a critical success factor. Aligning the incentives of the critical stakeholders in the health care orbit would go a long way to improving the prospects for innovation to take hold.
Health care innovation can be a potent enabler of better health and health care. For this innovation to be successful will require new technologies, new skills and capabilities, new ways of working and the establishment of an innovation culture. Since Canada possesses hundreds of thousands of different points of care, transformative progress will require the support of the public, the commitment of clinicians, and the creativity and political will to support this transformation.