A coast-to-coast consultation on health innovation

The era when Canadians could be confident their health care system is among the best in the world is “drawing to a close,” says Dr. David Naylor, chair of the federal government’s new Advisory Panel on Healthcare Innovation.

Naylor, former president of the University of Toronto, and his seven colleagues are charged with identifying five areas of innovation in Canada and internationally that can reduce the growth of health care spending while improving quality and accessibility. The panel is to deliver its final report by June 2015.

Naylor spoke to CMAJ about the panel’s work so far and what he hopes it will achieve.

CMAJ: What have you been hearing in your consultations?

Naylor: More people are focused now on value for money than was the case in the past. … There are many fabulous ideas and initiatives germinating in the system, and a big part of our challenge is to figure out how to evaluate rigorously and then scale those innovations across the country.

CMAJ: Has anything surprised you so far?

Naylor: One thing that has surprised me … is that the system has not changed dramatically in the last 15 or 20 years. There have certainly been experiments … but we have the challenge in Canada of an architecture that worked beautifully for the first 20-plus years of medicare … and then over the last 20 or 30 years has been struggling.

CMAJ: Where do you see international practices coming into play?

Naylor: Health care systems have both a genotype and a phenotype and one has to be wary of simply assuming you can import something from afar, but I will say that the Canadian propensity to learn from international experience may have been stunted by a tendency to look south with ambivalence, and perhaps some spurious self-congratulation about our arrangements.

“Anything we can do to accelerate evaluation, dialogue, dissemination and adoption would be a good thing,” says Dr. David Naylor, chair of the Advisory Panel on Healthcare Innovation.

Image courtesy of Health Canada

CMAJ: What do you hope to get from public consultation that differs from the surveys and town halls and fact-finding that has already gone on?

Naylor: I think we are going to get Canadians coast to coast in their own words talking about their health care experiences and how they see the system. That qualitative input will have a salience that no survey can capture.

CMAJ: Isn’t the issue here a lack of action and resources, or is it truly a lack of information about evidence-based innovation?

Naylor: The question will be what can we do on a pan-Canadian basis to change that culture, if indeed that’s the issue. … Anything we can do to accelerate evaluation, dialogue, dissemination and adoption would be a good thing.

CMAJ: What do you hope the result of this entire panel process will be?

Naylor: Our emphasis is going to be on both the levers that are primarily within the hands of the federal government and those elements of governance and decision support that are in the hands of pan-Canadian agencies. ... I hope that we’re able to offer some valued input … so that they are more supportive of a health care culture that will be not only innovative but responsive to innovation wherever it can be found.