For decades, Toronto has served as the hub of health care innovation not only for the province of Ontario but for all of Canada and its now 35.2 million people. From the first use of insulin to treat diabetes to the invention of the electronic wheelchair to the first computer program to measure how much radiation patients receive during radiation therapy, health care entrepreneurs in Toronto have found innovative solutions to the most vexing patient jobs to be done.

Today, patients are counting on the next generation of health care entrepreneurs in Toronto to lead the provincial health care system out of its current quandary—the growing gap between the escalating health care needs of its residents and the limited ability of the government to pay for additional services to meet those needs.

“The most significant challenge we face is achieving a sustainable health care system. One that’s economically sustainable but also delivers on its value proposition for the people of Ontario,” says Anne Snowdon, academic chair of the International Centre for Health Innovation at the Ivey Business School at Western University in Toronto.

The job to be done for the health care system in Ontario, which is overseen by the Ontario Ministry of Health and Long Term Care, is expanding access and improving care for a highly diverse and geographically dispersed population, and do so despite the policy and financial barriers inherent in the health care system itself. Experts here say they believe disruptive innovation to be the solution to the dilemma with Toronto and the model for the rest of the country.

What Toronto has that most major metropolitan areas in North America lack is a strong and growing infrastructure that supports innovations in health care delivery and finance—from idea to working model to commercialization to adoption. That same infrastructure also fosters collaboration among entrepreneurs, academia, researchers, business and government to produce innovative products, services and processes used by the provincial health care system to care for Ontario’s 13.5 million people, of whom 5.6 million, or 41%, live in the Toronto census metropolitan area.

Total health care spending in Ontario inched up just 1.7% in 2013 to $79.7 billion from $78.5 billion in 2012. The public funding component of that total, financed by taxes on residents of Ontario, crept up at the same rate to $54 billion last year.

Part of the infrastructure is the Ontario Centres of Excellence. Funded by the provincial government, the not-for-profit OCE serves as the “bridge” that connects universities, colleges, research hospitals and industry to bring innovative health care solutions to market. Most recently, the Toronto-based OCE announced the AdvancingHealth Program, which will award as many as 10 grants of up to $250,000 each to fund demonstration projects that target unmet public health care needs in the province. The grants are scheduled to be awarded in February 2015.

Separately, the Canadian government in August provided $68.1 million over five years to five commercialization centers to help take the results of health sciences research to market. Three of the five centers are in Ontario.

The government of Ontario knows — as does the national government of Canada — that demographic changes like an aging population and rising rates of chronic medical diseases will only increase the demands on provincial health care systems at a time of continuing limited resources.

In 2012, the ministers of health from Canada’s 10 provinces and three territories formed the Health Care Innovation Working Group to generate ideas to increase the capacity of the Canadian health care system to better meet the needs of the country’s citizens. In its first report, released in July 2012, the group made a number of recommendations, including encouraging the provinces and territories to collaborate on the development of clinical practice guidelines and the development of team-based patient care models. In July 2013, the group extended its mandate for another three years.

In June of this year, Canadian Health Minister Rona Ambrose launched a national advisory panel on health care innovation that’s charged with fostering innovations that improve the quality of health care services in the country while maintaining the cost-effectiveness of the current single-payer system. The panel is chaired by physician David Naylor, M.D., immediate past president of the University of Toronto.

“Health care innovation is essential to ensure the future sustainability and quality of health care for Canadians,” Ambrose said in a statement announcing the panel, noting that simply spending more money “is not the solution.”

“If you look at the cluster in Toronto of medical and health research, pharmaceuticals, information communication technology [ICT], leading universities plus a government that is willing to invest in health care, in research, in ICT, I do think that Toronto can be a global leader in integrating new treatments, new technologies and new models of care,” says Matthew Mendelsohn, founding director of the Mowat Centre, a public policy think tank in the School of Public Policy at the University of Toronto.

In January 2013, the Fraser Institute, a public policy research and educational organization, released a report comparing Canada’s 10 provinces on health care value. Ontario finished second only to Quebec, receiving high scores in such measures as clinical performance, cost and access to resources.

Look for Ontario to maintain its high standing as the next generation of health care entrepreneurs in Toronto rises to meet the new health care challenges in the province and throughout Canada.

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