Rethinking the Way We Deliver Care
How HealthCareCAN is Helping to Address Critical System Challenges
Catherine Gaulton (HIROC CEO) and Paul-Émile Cloutier (HealthCareCAN President and CEO) offer their perspective on the health sector’s most pressing issues, and what organizations like HealthCareCAN are doing to overcome the challenges.
Conversations like this one help to raise awareness on how best we as a healthcare community can turn the corner on patient safety. HIROC’s partnerships are critical to realizing change and help all of us live our vision of partnering to create the safest healthcare system.
Catherine Gaulton: At HIROC, we are very much aware that health human resource shortages and cyber threats are dominant concerns for healthcare organizations in Canada. HIROC’s upcoming strategic plan focuses on how we can best support our Subscribers in these areas. On the health human resources front, this includes a focus on appropriately managing risk while still allowing healthcare leaders and providers to be innovative in their approach – essentially how to balance the impact of risk. I’m sure health human resources and cyber are also a focus for HealthCareCAN. We’d appreciate hearing your thoughts.
Paul-Émile Cloutier: As the national organization representing hospitals, health research institutes and healthcare organizations, I repeatedly hear health leaders from our member institutions say that human resources is the number one challenge facing healthcare organizations right across Canada today.
As the COVID-19 pandemic has dragged on, it has been Health Care Workers (HCWs) who have sustained the response, often at a cost to their own personal health and wellness. Many HCWs delayed retirement plans, students stepped in, and thousands of retirees returned to the workforce to support their colleagues. This caused a temporary increase in our workforce numbers, however, as workers move (or return) to retirement, and others choose to leave healthcare, we will be relying on a diminished, beleaguered workforce that is facing increased public demands, risking an exponential rise in stress, burnout and mental illness.
The issue of cybersecurity in healthcare is another area where the pandemic has wreaked havoc since hospitals and health research institutes house data that is extremely valuable. Criminals know that if they deny access to this data – or the digital systems that enable modern healthcare – the risk to patient safety means the likelihood of a payout is high.
Surgeries rescheduled or cancelled, missed chemotherapy appointments, diagnostic tools rendered useless, emergency rooms only able to offer the most basic care. That’s the reality of a modern healthcare cyberattack and it’s happening more frequently across Canada.
Cybercriminals also know that the Canadian health system is woefully under-resourced in terms of providing time and opportunities for overworked staff to access cybersecurity training. It’s a perfect storm of vulnerability and opportunity.
Catherine: At HIROC we are listening and acting on these issues as they arise. We know that sharing knowledge is key and speaks to how a reciprocal of shared-focus entities can drive action. We are hearing that these issues speak to the need for responsiveness at national and local levels. Could you please tell us how HealthCareCAN is helping to address these challenges?
Paul-Émile: Anticipating the worsening HCW crisis across the country, in 2021 HealthCareCAN worked with senior People and Culture leaders from our member healthcare organizations across Canada to form the Health Human Resources Advisory Committee (HHRAC).
HHRAC is working to strengthen ties between health employers, policymakers, educators, and researchers to develop pragmatic, focused and cohesive pan-Canadian strategies to provide insight and solutions to current and pending issues.
The HHRAC has identified the top three priorities for the federal government to engage in as a partner:
- Ensuring an adequate supply of HHR with the competencies, skills, and diversity required to sustain and evolve our healthcare system and equitably serve the diverse population and needs of Canada.
- Support the health, wellness, safety, and resilience of our workforce with a pan-Canadian mental health strategy, tools, and resources for HCWs.
- Promote equity, diversity, inclusion, and reconciliation in our health system by addressing systemic discrimination, removing barriers, and developing talent within equity-seeking and underserved communities so that we reflect and serve all communities in Canada.
We take every opportunity to raise this challenge with policymakers, politicians, media, other stakeholders and groups. With our efforts and those of others, I believe that governments are seized with the importance of the challenge and the risks to patient care if nothing is done.
On the cybersecurity issue, we are strongly advocating for increased capital investment in healthcare to a minimum of 0.6 percent of Gross Domestic Product (GDP) aligning Canada with the OECD, action to address the HHR shortages in the system, and that the federal government adopt a more aggressive stance internationally regarding the scourge of ransomware.
HealthCareCAN and the CIO Strategy Council have also launched a new project with support from Public Safety Canada’s Cyber Security Cooperation Program to develop a new set of standards to support cyber resiliency in Canada’s healthcare system, and help address growing cybersecurity threats in the healthcare field.
Development of the new standard is being informed by expert input and guidance from healthcare Chief Information Officers (CIOs) and Chief Information and Security Officers (CISOs) from Canada’s five regions. Initial input and discussion took place at two virtual focus group sessions in early March and provided a healthcare perspective on cybersecurity issues and challenges.
The CIO Strategy Council will refine the guidance from the input received during the facilitated focus groups to develop a detailed report to enable standards development and progress review. Once complete, the CIO Strategy Council will develop the National Standard of Canada with their technical committee on cybersecurity, accredited by the Standards Council of Canada.
Catherine: From HIROC’s perspective, having healthcare and partner organizations come together and learn from each other on the most difficult issues is key. Would you agree?
Paul-Émile: Absolutely. This is a tremendously important point, and one driven home by the COVID-19 pandemic. Technologies and our understanding of health are constantly changing and presenting new opportunities and avenues to explore. Our members are adapting, evolving and redefining what quality care means in order to chart the best paths forward and better serve their communities. As a result, there are a lot of incredible innovations happening here in Canada that could be adapted and implemented in hospitals all over the world.
But while there is a strong consensus among our members that breaking down geographical silos is vital to identifying these best practices, Canada is a geographically massive country, making it challenging to collaborate and network with counterparts across the country, let internationally.
This is why, for our members, one of the most important services we offer is the opportunity for health leaders to network and share knowledge with colleagues and counterparts, both nationally and internationally.
Catherine: During these times we are having to decide which innovations from the pandemic we wish to keep, and which we don’t. This is also a time when we need so much from our leaders. Is there any advice you would provide from your position as CEO of HealthCareCAN?
Paul-Émile: First, I would like to thank all of our health leaders and their teams for their courage, tenacity and leadership during a period full of enormous frustration and monumental challenges that they have faced during the last two years. As one of our member CEOs who is head of a major health research institute said to me, “Let’s not go back to normal, because things are not normal.”
We need our leaders to tell us what was a success, and what was a failure. Let’s learn from this by reviewing the scope of practice challenges, models of care, scale and spread, and looking at a system that has better sharing of data and analytics.
Also, on behalf of our members, we must ensure that healthcare organizations have the necessary resources to continue dealing with the COVID-19 pandemic while also providing other vital health services, such as surgical interventions and other treatments put off due to pandemic demands.
That also means ensuring health research institutions have the support they need to continue to make breakthroughs that innovate the delivery of care, protect people from disease and improve health outcomes for all.
So, we as a nation must set our sights on how to shore up Canada’s health system for future challenges, HealthCareCAN is advocating specifically for:
- Strengthened support for health research and innovation: Federal investment in health research pales in comparison to what is invested in many other OECD countries. Canada’s jurisdictional divides and regulatory landscape discourage partnerships and global investment.
- A national health workforce planning strategy: Canada does not have enough healthcare workers to meet present, let alone future, demand in the health system. Healthcare is a people business and we urgently need a pan-Canadian approach to health human resources planning.
- Support for better aging: Canada must develop a pan-Canadian approach to improve health and social services for older adults, ensuring they align with their needs and wishes.
- Modernization of Canada’s healthcare system: The federal government must better support health sector infrastructure, including digital infrastructure and cybersecurity, to streamline the health system, support virtual care, and improve access and health outcomes.
- Ensuring funding for the healthcare system: There is growing concern about the future sustainability of healthcare in Canada. Will there be enough money to provide care to patients?
- Rethinking the way we deliver care: COVID-19 has exposed the system's flaws and gaps and clearly shown that the way we delivered care is no longer satisfactory. A rethink of the entire health system is therefore critical, and we need to find a better way of interconnecting its various components.