A Country of Firsts
Canada’s healthcare ecosystem boasts a lot of “firsts”. In 1922, Drs. Frederick Banting and Charles Best were the first to discover insulin. In 1949,Wilfred Bigelow and John Callaghan were the first to discover the use of electrical stimulation to pace the heart. And in 1968, Canada became the first international subsidiary of Medtronic, now one of the world’s largest medical technology, services, and solutions companies.
Medtronic came from humble beginnings — it was first established in 1949 as a medical device repair shop in co-founder Earl Bakken’s garage. After a power outage in Minneapolis in 1957 caused the death of a paediatric patient reliant on a pacemaker plugged into the wall, heart surgeon Dr.Walter Lillehei asked Earl Bakken to create the first battery powered transistorized pacemaker.
That collaboration between Medtronic and a physician would be the first of many to produce meaningful innovations that would impact millions of patient lives around the world. In Canada, this includes numerous collaborations with doctors on devices such as spinal implants, insertable cardiac monitors, and cryoablation technologies.
Collaborating on Research
Although Canada represents only 2% of the global market for medical devices, it punches above its weight in terms of research. And for good reason. Canada has a concentrated tertiary medical system, world- leading centres of excellence in evidence-based population health, and world-class research capabilities.
It’s not surprising, then, that in 2017, Medtronic had over 28 clinical trials underway in Canada and a significant number of its global trials involve a Canadian site.
One of the most significant trials funded by Medtronic Canada was a clinical trial at the University of Ottawa Heart Institute, which ultimately showed that cardiac resynchronization therapy produced a 30% survival improvement for certain patients with heart failure. Announced in 2010, the results of that trial have since benefited thousands of patients.
A New Kind of Collaboration
Medtronic sees its role as more than developing the cardiac pacemakers, insulin pumps, and other leading-edge devices for which it’s known. Medtronic is collaborating with health system leaders to apply its expertise in technology and innovation to help transform healthcare systems struggling to remain sustainable in the face of rising costs, clinical pressures, and aging populations.
That’s why in 2013, Medtronic created its Integrated Health Solutions (IHS) business that moves beyond devices to focus on system-level services and solutions. Today, Medtronic IHS helps hospitals and health systems align value across the care continuum by delivering more efficient and improved care to patients.
In Ontario, IHS worked with Brampton Civic Hospital’s Diabetes Education Centre to find solutions to increase the number of new patient visits, boost capacity for classes, and decrease the number of no-shows. Working with IHS, the centre was able to realize 2,600 hours of process efficiencies, freeing up time to conduct 33% more patient visits, while reducing wait times from up to two months, to less than 3 weeks.
Similarly, the New Brunswick Heart Centre leveraged Medtronic’s deep clinical and operational expertise and, within six months, increased operating room capacity by 14% and reduced average wait times by 44% from about 4 months to 2 months (i.e., from 118 to 66 days).
“If you think of the system itself as a patient suffering from sustainability challenges
and burnout,” says Neil Fraser, president of Medtronic Canada, “what we’re trying to do is address an illness that can be helped through technology, innovation, and collaboration. This is consistent with our mission of alleviating pain, restoring health, and extending life because there’s a lot of pain in the system. And there’s also a lot we can do in the areas where we have expertise to continue to help the Canadian healthcare system improve.”
To that end, Medtronic is working with the healthcare system to improve access to medical technologies through a value-based approach, which promises to deliver better outcomes for patients at a lower cost to the system by focusing on value rather than volume. This involves collaborating with hospitals on patient pathways, with clinicians and researchers
on clinical trials, and with health organizations and ministries on removing obstacles to value-based healthcare.
Value-based Healthcare in Canada
According to the Economist Intelligence Unit’s global study of country readiness for value- based healthcare, Canada was rated “moderate”, with only two countries rated higher. Canada’s universal coverage of medical and hospital care and its experimentation with bundled payment contributed to this rating.
Looking to the future of Medtronic and the healthcare system, Fraser says,“So many things are changing as a result of technology and the social networks that are available. We
are involved in areas such as artificial intelligence, robotics, and personalized medicine — and also patient voice.We’re increasingly incorporating patient-reported outcomes and experiences into the way we measure the success of our products and the impact of changing healthcare policy on patient outcomes.”
Medtronic understands that to benefit from transformative innovations, it must also make healthcare more sustainable.The future of value-based healthcare will hinge on collaboration between industry, physicians, health system leaders, and patients.
And whether ideas are sparked in someone’s garage in Kelowna, or in a high-tech imaging suite in Toronto, the next major breakthrough in healthcare may come from yet another Canadian.
