What’s your waiting-for-healthcare story?
Almost every Canadian has one. Maybe it was at the height of the winter flu season in a packed emergency room, or a walk-in clinic where many turn to because they lack a primary care physician. Or getting a referral to a specialist, only to find out that your appointment is in six months.
Mine was an ER wait that ended up being an overnight in the department, thanks to a potential postpartum hemorrhage.
I had a week-old newborn at home and I was really scared, though luckily I also understand the triage system, and remembered to grab my phone charger before hurrying out the door.
Stories like this have become part of everyday life in Canada’s healthcare system. They also point to a deeper issue. The challenge is not only how care is delivered, but how solutions move through the system.
A new report from the Council of Canadian Innovators (CCI) reveals a structural problem inside Canada’s healthcare system.
It’s the way governments buy technology and manage health data.
Released this week, Care at Scale: Public Buying, Data and Better Health Care for Canadians outlines six policy change recommendations aimed at fixing those barriers, focusing on procurement rules, interoperability standards, and access to health data.
Despite the countless stories we tell about ER or specialist waits, deferred care, and Band-Aid solutions that don’t address preventative care, Canadians still value a universal healthcare system.
A 2025 survey conducted by Abacus Data for the Canadian Medical Association (CMA) found that 89% of respondents believe “improving access to our universal health system should also be a key priority in building a stronger country.”
I didn’t pay thousands to deliver my baby, and millions of us aren’t navigating the bureaucracy of a U.S.-style insurance system.
But we can certainly acknowledge a broken system. Doctors, nurses, and a diverse range of healthcare professionals can all attest to doing more with less, and constantly dancing around burnout. In the words of as-seen-on-TV ads, there’s got to be a better way.
And it’s right there.
Hospitals across Canada are experimenting with digital tools designed to reduce paperwork, improve patient scheduling, and connect fragmented care systems. Many of them work, yet those same tools often never spread beyond the hospital or clinic where they were first tested.
When provinces and health authorities make smarter purchases that prioritize interoperability, patient outcomes improve.
As the report explains, “When properly procured and scaled, they reduce duplication, improve workflow efficiency, enable preventative care and unlock system-wide gains.”
Add the priority to ‘Buy Canadian,’ building and supporting a stronger domestic health tech sector, and you have a win-win way of improving a system that Canadians still hold sacred.
If innovation struggles to scale inside a $400-billion public system, what does that say about the country’s ability to scale innovation more broadly?
Canada’s healthcare strain and why promising innovations stall
“Everyone who’s interacted with the health care system in recent years really appreciates, whether as a patient, whether as a caregiver, or going to support family or friends…is aware that the system is under a lot of strain,” CCI’s Laurent Carbonneau said in the online launch of the report.
Canada spends heavily on healthcare. The Canadian Institute for Health Information expects the final figure for 2025 to reach $399 billion, or $9,626 per Canadian. The system, however, continues to face shortages of family doctors, rising wait times, and hospital capacity issues.
In 2023, a CIHI report found that 17% of Canadian adults reported not having a regular healthcare provider.
Specialist wait times have increased, the CCI explains, to 30 weeks in 2025, up by 2.3 weeks from 2024. And hospitals are dealing with capacity issues, their rooms full of patients who would be better served by a different level of care.
All this spending has not translated into better outcomes, the CCI reports. How effective healthcare spending is, not how much is really being spent, is at the root of Canadian healthcare’s sustainability.
The system’s core challenge is productivity.
Canada has a large ecosystem of companies building digital tools for healthcare providers. These technologies range from electronic health records and scheduling platforms to AI-assisted clinical tools.
According to the report, digital health solutions often prove their value during pilot projects but struggle to move into procurement contracts.
“It’s very easy to get stuck in pilot hell,” said Carbonneau.
“You have pilots that get going, do quite well, and then get wound down because there’s no pathway for them to actually turn into a bigger contract.”
A product may work in practice but still struggle to become part of the system.
The economic stakes behind healthcare innovation
As part of the report’s release, the CCI hosted a panel discussion unpacking the broader economic stakes behind healthcare policy and investment.
Carbonneau framed the issue in terms of how modern economies create value.
“We live in a data and intangibles-driven economy,” Carbonneau said. “Intangibles represent 90% of the value of the S&P 500.”
In that context, health data, intellectual property, and digital platforms are economic assets.
“Foreign incumbents use their data advantage and IP advantage to lock domestic challengers out,” he explained. “That means less growth for Canada and less control over our healthcare data and also less relevant products and services.”
The lack of Canadian health data in this scenario means that solutions might not be as effective or relevant, he added.
“If you want to have productivity growth, if you want to have economic sovereignty, the key is how do you scale companies that are innovating here in Canada,” said Carbonneau.
In turn, panelists argued that Canada’s healthcare system has struggled to create a domestic market for those innovations.
Mike Cook, CEO of digital identity and access technology company IDENTOS, said many Canadian healthtech companies prove their technology through pilots but struggle to grow inside the system they were built for.
“We haven’t developed a market,” Cook said. “We haven’t created a pedestal by which they can stand on and call it a market and recognize the economic benefits to the nation by actually having a strong sector.”
Echoing Carbonneau’s ‘pilot hell’ comments, he added that these companies are getting “piloted to death.”
“They’re dying on the vine,” said Cook. “They’re getting sold for pieces to multinational companies.”
The result, he added, is that technology built to solve Canadian healthcare problems often ends up owned elsewhere.
“All this wonderful IP… from the hearts of Canadians, trying to solve a problem for other Canadians and their families, is going out the door to foreign nationals and being sold back to us.”
Other panelists pointed out that the stakes go beyond the technology sector.
Dr. Andrew Bond, senior vice president and medical director at insurer GreenShield, said the structure of the healthcare system itself limits how care can evolve.
“Most patients would see me at most four times a year,” Dr. Bond said. “You cannot keep people healthy in any version of a service or a system that sees people three to four times a year.”
Health is an everyday issue, he said, and we need the tools in hand to keep all Canadians healthy, while being supported in doing so. Digital tools, remote monitoring, and better data sharing could help fill those gaps between visits, but only if the system can adopt them more broadly.
“Until we make that shift, we’re fighting a battle that we cannot win,” said Dr. Bond.
Shane Sabatino, chief people officer at WELL Health Technologies, said industry leaders are eager to work with governments to move past the pilot stage, and support Canadian-made solutions, all with a sense of urgency.
He pointed to AI scribe technology as an example, where companies from around the world are able to come to Canada and embed themselves in our ecosystem.
“We can’t just have ‘Buy Canadian’ as a slogan,” he said.
Echoing this urgency, Todd Foote, director of sales for telehealth/virtual care company Fonemed, emphasized the increasing demand for mental health services, an aging demographic, and loss of services in rural and Indigenous communities.
“We need to use technology to help enhance and support these,” he said.
Policy decisions shape the market
Healthcare innovation is often framed as a technology challenge, but the real issue is policy.
“It’s a market, but it’s a market that’s extremely bounded by policy decisions that we have a lot of control over,” Carbonneau said. “So better public buying can make a big difference in how we provide care.”
The report paints a picture of a future where procurement decisions are treated as strategic policy choices rather than purely administrative processes.
“They are structural,” the report notes. “How governments buy shapes market structure, determines which firms scale, influences where intellectual property (IP) resides and affects whether economic value generated by our public system accrues at home or abroad.”
Six changes aimed at unlocking innovation
The report outlines six recommendations intended to remove structural barriers to healthcare innovation, leading to better care.
The first focuses on procurement criteria. Many healthcare systems still prioritize the lowest upfront cost when purchasing technology. Procurement should instead evaluate long-term value, including interoperability, security, lifecycle costs, and productivity improvements.
Carbonneau jokingly illustrated the issue with a familiar Canadian example.
“For all the folks in Ottawa, we have a great LRT system that was built by the lowest bidder,” he said during the panel.
Most importantly, this recommended procurement criteria should be under a ‘Buy Canadian’ framework.
“This is, for us, kind of the heart of the matter,” Carbonneau explained. “If we’re not looking at integrating buying from domestic innovators as a priority, we’re missing the mark.”
The second recommendation calls for clear, more predictable pathways from pilot projects to procurement contracts. Without those pathways, technologies that demonstrate value during trials often disappear before they can scale.
Remember “pilot hell” and “piloted to death”?
The report calls for clear criteria on what success looks like for these pilots. We’re talking clear timelines, pre-approved contracting pathways, and standardized evaluations.
That predictability would allow Canadian companies to offer “credible reference customers,” helping them compete on a global scale.
The report’s third recommendation focuses on creating a national market for digital health, allowing provinces and health authorities to adopt procurement outcomes from other jurisdictions.
This practice, commonly dubbed “piggybacking,” would allow organizations to reuse existing procurement processes rather than starting from scratch each time.
“Other organizations should be able to essentially say, ‘I’ll have what he’s having,’ and buy into that,” Carbonneau said.
The fourth recommendation looks at the system-wide value of digital health tools.
Better scheduling, remote monitoring, or improved workflows (all attainable through digital tools) can reduce hospital visits, administrative work, and duplicated tests. And when Canadians are empowered to take proactive steps in their health, and are supported in doing so, system strain goes down.
The recommendation calls for procurement models that recognize these broader efficiencies. If a technology reduces labour hours, prevents admissions, or improves productivity, those savings should count in the evaluation of the bid.
Adopting international standards for data portability and interoperability is the fifth recommendation.
Healthcare systems in Canada often store patient data in formats that cannot easily connect with other systems. That makes it difficult for new technologies or applications to access the information they need to function.
Adopting the HL7 Fast Healthcare Interoperability Resources standard would allow patient records to move securely between providers, platforms, and provinces.
When data moves between systems, new companies can build tools that work across the healthcare system rather than inside isolated platforms. This increases competition and allows patients and providers to choose better digital tools.
The report’s final recommendation would give Canadian innovators access to aggregated, de-personalized health data, a critical input for building digital health tools. Without access to relevant datasets, companies cannot develop or test solutions effectively.
Using Canadian data also ensures that digital tools reflect the realities of Canada’s healthcare system and population, rather than relying on technologies developed for other countries.
In practical terms, the recommendation calls for health data to be treated as national infrastructure, and make high-quality datasets available in ways that support innovation while protecting patient privacy.
The bigger lesson for Canada’s innovation economy
Innovation rarely spreads on its own. Systems need structures that allow successful ideas to move from experimentation into everyday operations.
Healthcare provides a clear example.
Digital tools already exist that could help clinicians manage patient information more effectively and reduce administrative workload. But fragmented procurement systems and limited interoperability slow that adoption.
Improving healthcare in the coming decades will require modernization, not just funding and goodwill.
“Preserving Medicare in the 21st century will require not only compassion and funding, but modernization and productivity,” the report states.
Sitting in that ER next to my husband in 2023, exhausted, hormonal, and constantly texting my mother who was at home with our newborn, it was pretty clear that the system was, and still is, overwhelmed. The nurses and doctors were absolute angels, despite the challenges.
Every Canadian has a waiting-for-healthcare story, and these won’t disappear overnight, even with large-scale changes. But smarter procurement, better data access, and systems designed to scale innovation could help ensure fewer Canadians have to tell them.
Final shots
- Canada already has a robust digital health innovation sector. The challenge is adoption.
- Procurement rules, interoperability standards, and access to data determine whether innovations stay stuck in pilot projects or become part of Canada’s healthcare sector.
- Innovation scales when institutions are designed to adopt it. Without that structure, even promising technologies struggle to move beyond the testing phase.
