Like most provinces in Canada, Nova Scotia spends about 40 per cent of its budget on health care. This year the provincial health department’s budget is $4.37 billion(1) . That’s over $1 million a day.
Yet our health care system is ailing with overcrowded emergency rooms, lengthy wait times, and over 50,000(2). Nova Scotians on a provincial list looking for a family doctor.
As our population ages, health care costs are projected to grow well beyond sustainable levels. So what can be done to improve a situation that has, at times, been called a “crisis” by patients and clinicians?
Nova Scotia’s Health Minister Randy Delorey said recently, in an interview with The Star Halifax, “… better health care is not always defined by throwing more money at it. You need to make sure that where you are investing the money are the right areas that are going to provide results.”
Healthcare Solutions 2020 – Health Care Innovation Project
Rather than attempting to manage an unsustainable health care system by cutting spending, BioNova – Nova Scotia’s health and life sciences association – is proposing a different approach to support the system; one that facilitates the adoption of new medical technologies. Working in partnership with MEDEC, the association of Canadian medical technology companies, BioNova is spearheading Healthcare Solutions 2020, a health care innovation project for Atlantic Canada. The project is led by a committee of Canadian health care innovators from both industry and government.
Paul Bradley is managing the health care innovation project. As a former vice president of strategic affairs at Johnson & Johnson Medical Products and the past chair of MEDEC, he is pleased to have assembled such an accomplished and diverse committee. “Having committee members who are embedded in our health care system and those representing the private sector brings a unique blend of perspectives,” says Bradley.
This committee will map out an approach to empower the region’s health care system to adopt new medical technologies and transform it into an economic driver. “Adopting made-in-Nova-Scotia innovations has the potential to both increase the quality of our health care and manage our costs,” says Scott Moffitt, Managing Director of BioNova.
Potential of Our Health and Life Sciences Sector
As a sector, health is a booming industry world-wide. The Canadian Venture Capital & Private Equity Association recently posted that Nova Scotia’s investment scene is also heating up, attracting $38 million in venture capital in the first quarter of 2018.
Nova Scotia’s world-class research facilities and incubator programs are already galvanizing a cluster of health and life science companies. Unfortunately, as long as the health care system is seen as a cost, and as Paul Bradley, Healthcare Solutions 2020 Project Manager long as administrators fail to be early adopters of home-grown innovation, this region will fail to realize the economic potential of the global health revolution.
Barriers to Adoption of Innovation
There are multiple barriers affecting the adoption of new medical technologies into Canada’s 13 individual provincial and territorial health care systems, from siloed budgets among hospitals and home care services to a procurement process that is price-based.
When it comes to the adoption of new medical technologies, Paul Bradly sees a broader, value-based process as the way forward. He describes a scenario of a company developing a new computer navigation technology for surgery that would enable the surgeon to use minimally invasive incisions. “It may mean spending more of the operating room’s budget, but with fewer days in hospital and a shorter rehab, the savings are significant,” he says. “Yet, because the hospital’s budget is separate from the home care budget, it makes it tough to reconcile the value delivered by the new technology.”
Yet, procurement is only one piece of the puzzle. Private sector innovation often enters the health care system through government funded pilot projects. Unfortunately, once companies emerge from these pilot programs they often face the commercialization valley of death. Even if the pilot has a good outcome, there is no clear process to scale it and bring the new technology to market. This approach is not serving our health care system well.
Moving Towards Value-Based Health Care
To strengthen Nova Scotia’s health and life science sector there needs to be stronger links between the research performed here, the companies that start here, and the public system that provides the majority of health services. “When companies move beyond the pilot stage, not only does it have a positive impact on the economy, but patients gain access to breakthrough technologies that improve their quality of life,” says Bradley.
The Healthcare Solutions 2020 committee envisions a value-based health care system that breaks down the budget silos and improves data collection so product or service performance is tied to patient outcomes. The committee is also reviewing what other jurisdictions have done to support the adoption of health care innovation, including:
̵ creating a single point of entry for companies to pitch their technology,
̵ establishing the position of a Chief Health Innovation Strategist, a role that would facilitate connections between health care buyers and innovative vendors, and
̵ developing policies that support industry taking the lead in developing innovative solutions to defined public health problems.
“Our purpose is to create a roadmap that supports innovation adoption and better recognizes total benefits to health care,” says Bradley.
Health Care Can Be an Economic Driver
Healthcare Solutions 2020 is about economic growth as well. By establishing a system that encourages local innovation adoption, startup companies gain access to clinical users, engage and learn from a first customer and receive international validation when the companies home jurisdiction adopts the technology – all of this is in addition to helping the healthcare system. “It’s going to take all of us working together to build a health system that works and that is sustainable into the future,” says Moffitt.
1 Nova Scotia Department of Health and Wellness budget 2018-2019
2 Nova Scotians on a provincial list looking for a family doctor. http://www.nshealth.ca/need-family-practice-data