Health systems in developed countries face escalating challenges, including rising costs, workforce crises, safety concerns and persistent inequities. Despite widespread recognition of the need for transformation, progress has been slow and fragmented. The Canadian experience underscores this reality: a decade after the federal health minister's Advisory Panel on Healthcare Innovation released its landmark report, many of its key recommendations - including a $1-billion innovation fund and a national healthcare innovation agency - remain unfulfilled. During this period, system pressures have intensified, compounded by the COVID-19 pandemic and growing financial constraints. At the same time, digital technologies, particularly artificial intelligence, offer unprecedented opportunities to redesign care delivery, though adoption has been patchy and uncoordinated. This commentary argues that health systems must embed innovation into their core mission, linking transformation with economic development through clinician- and patient-driven solutions, commercialization, procurement reform and sustained national strategies to ensure that healthcare becomes both sustainable and socially generative.
Progress on the report of the Advisory Panel on Healthcare Innovation (2015) for Canada is limited. While Manns et al. (2025) advocate for a national innovation agency and fund, their analysis underemphasizes the catalytic role of health data infrastructure as the foundation of an innovation engine. Consequently, Canada has not cultivated the strategic infrastructure necessary to enable spread and scale. This commentary argues that pan-Canadian health data ecosystems are foundational to scaling innovation. By prioritizing data liquidity, real-world evidence generation and data stewardship, Canada can transform its "perpetual pilot projects" into a learning health system that accelerates the scale and spread of value-based innovations.
In 2023, federal, provincial and territorial governments created Health Workforce Canada with a mandate to transform health workforce planning. Strategic initiatives focus on convening networks, advancing data, catalyzing modelling and forecasting and sharing promising practices. Early successes feature extensive collaboration and co-creation, data dashboards to assist planners and decision makers, an early microsimulation modelling tool to enable working with imprecise data and an artificial intelligence-powered Digital Front Door to enhance access to quality health workforce information and support informed decision making. Early efforts are having a positive impact on health workforce planning, data accessibility and catalyzing innovation and transformation.
According to Manns et al. (2025), Canada struggles to turn good ideas into routine care because functions for evidence, funding, procurement and delivery are fragmented. In the UK, these functions are, in part, connected within a tax-funded service free at the point of use. This commentary maps the architecture, linking research translation, independent assessment, regulation, procurement, adoption support and data and explains how evidence moves into practice through principles aligned with the nonadoption, abandonment, scale-up, spread and sustainability framework, which addresses nonadoption, abandonment, the challenges of scale-up, spread and sustainability. Two worked examples, placental growth factor testing and stroke imaging artificial intelligence, show that national assessment, adoption support and procurement enabled rapid adoption at a national scale. Practical implications for Canada include a single repeatable pathway from promising evidence to routine use, conditional adoption with evidence generation, national frameworks that reduce transaction costs, investment in implementation capability and secure data environments for real-world evaluation.
It is valuable to reflect on what progress the federal, provincial and territorial governments have made on implementing the Advisory Panel on Healthcare Innovation Report's recommendations. The recommendations offered by Manns et al. (2025) are a good starting point but are too modest. New entities need assurances of independence from federal, provincial and territorial governments; scale system interventions; ability to influence provincial and territorial health system funding policies including physician remuneration models; and capacity to integrate with regional priorities. To pursue the sought innovations, political will for reforming the structure of pan-Canadian healthcare organizations is needed.
