Abstract:
The healthcare system in Canada is under immense pressure. ER closures, doctor shortages, long waitlists, rising costs, the demands of an aging population, burnout among health professionals—these issues and more are making it difficult for Canadians to access timely, high-quality healthcare and threatening the sustainability of Canada’s universal public healthcare system. From primary care to long-term care, researchers are working alongside health service providers, patients, caregivers, and community partners to tackle issues and transform healthcare in Canada.

Summary of Conversations

A discussion on transforming healthcare through evidence highlighted the necessity of collaborative and impact-focused research. Multiple success stories demonstrated the power of deeply engaging patients and the public to drive systemic change. One large-scale initiative, which identified a major primary care access gap, led to the creation and legislative adoption of a national care standard. Other community-led research successfully developed anti-stigma care toolkits for a specific population and their clinicians. A third program repurposed long-term care facilities to create community hubs offering vital social support and navigation services, proving effective in combating social isolation and is now scaling nationally. The conversation also stressed that the ongoing “biological revolution” enhanced by AI will drastically alter future medical care. A major theme was the need to re-engineer primary care, moving beyond physician-centric models to address profound workforce shortages and systemic funding gaps.

Take Away Messages/Current Status of Challenges

• Profound Primary Care Workforce Crisis: The system is struggling with an escalating shortage of primary care physicians (estimated at 23,000 and growing due to mass retirements), which cannot be solved by simply increasing training, demanding a complete operational restructure of care delivery.
• Gap in Implementation Science: There is a critical knowledge deficit not on what needs to be done (e.g., using interprofessional teams), but how to implement these models effectively, including determining optimal team composition, necessary staff ratios, and clearly defined professional roles.
• Severe Underfunding of Systems Research: The national investment in health services and systems research is deemed “woefully insufficient,” falling far short of the necessary level needed to drive major health system transformation and sustained innovation.
• Persistence of Stigma in Healthcare: Community-based research reveals that patients, such as those with chronic infectious diseases, continue to experience judgment and stigma from clinicians who lack basic current medical knowledge, compromising the quality and safety of their care.
• Social Barriers to Aging in Place: The main obstacles preventing seniors from successfully aging in their homes are overwhelmingly social and psychosocial—including inadequate support for transportation, nutrition, and especially, the epidemic of social isolation and loneliness—rather than purely clinical medical needs.
• Unrecognized Value of Caregiving: The immense contribution of informal caregivers, who save the system nearly $100 billion annually, remains largely uncompensated and unsupported by current government policies, contributing to burnout and a lack of system resilience.
• Sustaining and Scaling Successful Pilots: A major systemic barrier is the inability to transition proven, research-backed pilot projects and innovations into sustained, system-wide practices, preventing local successes from achieving national impact.
• Equity and Inclusion Challenges in Engagement: Genuine, equitable patient and community engagement is difficult, requiring explicit strategies to ensure the table is inclusive, marginalized voices are amplified, and community members are adequately compensated for their crucial input.

Recommendations/Next Steps

• Fund a National Innovation Strategy: Urgent creation of a cohesive, comprehensive national strategy focused on innovation and quality improvement, explicitly encompassing both social and technological strategies, not just basic scientific research.
• Adopt Research-Based National Standards: Governments must formally legislate and adopt standards of care developed through extensive public and patient engagement, using these criteria to measure performance and hold the healthcare system accountable to citizens.
• Re-engineer Primary Care with Interprofessional Teams: Redefine the care model away from a focus on the doctor to a “first contact practitioner” approach, leveraging nurse practitioners, pharmacists, and other allied health professionals to address the profound workforce deficit.
• Prioritize Collective and Mission-Focused Investment: Research funding must shift toward a collaborative and collective impact model, dedicating a significant portion of resources to mission-focused initiatives aimed at solving grand challenges and achieving measurable societal impact.
• Scale Community-Leveraged Support Models: Successful community programs that utilize existing infrastructure, such as long-term care facilities, as hubs for social support, navigation, and crisis awareness should be rapidly expanded provincially and pan-Canadially.
• Deepen Peer and Community-Led Research Integration: Researchers must ensure that community members, including Peer Research Associates, are meaningfully involved at all stages of the research process to co-create relevant knowledge, build trust, and develop practical tools for both users and clinicians.
• Embed Technology for Scaling Social Innovation: Invest in digital health companions, data infrastructure, and AI technologies to support, scale, and learn from social innovation strategies, enabling predictive capabilities and streamlined navigation support for users and caregivers.
• Develop a Caregiving Policy Framework: Utilize research on the economic impact and needs of caregivers to immediately establish a national caregiving strategy that provides tangible financial support (e.g., a caregiver allowance) and ensures better working conditions and pay for care providers.