By:
Allison Sekuler, PhD
Co-Chair, OHA Research and Innovation Committee
President & Chief Scientist, Baycrest Academy for Research and Education at Baycrest Centre for Geriatric Care
President & Chief Scientist, Centre for Aging + Brain Health Innovation
Lehana Thabane, PhD
Co-Chair, OHA Research and Innovation Committee
Vice-President Research, St. Joseph's Healthcare Hamilton
Scientific Director, Research Institute of St. Joe's Hamilton
We recently experienced the challenges of Ontario's health care system in a very personal way. A loved one in their twenties collapsed at home and was rushed to one of Ontario's hospitals, where they were diagnosed with a massive pulmonary embolism. They received excellent care, but under incredibly difficult circumstances. For 36 hours, they struggled to breathe, contemplating their mortality while being poked and prodded behind a flimsy curtain on a too-small stretcher in the emergency room (ER). And yet, they were among the lucky ones. Others waited on stretchers in the hallway, enduring even longer delays before securing a hospital bed.
Eventually, our loved one was moved to a shared room in an orthopedic surgery ward—far from pulmonary specialists. But in today's hospitals, a bed is a bed, and any bed is welcome. When their discharge day arrived, it was delayed because there weren't enough staff available to complete the final required EKG. Their greatest concern was not for themselves, but for the countless others still waiting in ER hallways on stretchers, hoping to get better and for a room.
Rising Health Care Demand
A recent report by the Ontario Hospital Association (OHA) on Projected Patterns of Illness, developed in collaboration with the University of Toronto's Dalla Lana School of Public Health, highlights that Ontario's population will grow by 36 per cent by 2040, with the largest increase in individuals aged 65 and older, the group with the highest health care demands. This cohort has the greatest incidence of major illness, with 66 per cent living with three or more chronic conditions. But the report also states that major illnesses will become more prevalent in younger adults. This foreshadows the higher likelihood of similar cases to the one we recently experienced becoming more commonplace across the lifespan.
Of course, addressing the challenges faced by Ontario's hospitals will take more than just a few extra beds or imaging staff. Given the severe constraints on funding and staffing, Ontario's health care system has morphed into a “sick-care" system. As such, the system needs to be re-invented with a greater focus on community engagement centred on those with lived experience, proactive wellness and prevention, and early detection. Hospital-based research and innovation must play a central role in that re-invention: driving change, improving patient outcomes, enhancing productivity, and strengthening our health system as a whole.
Hospital-Based Research Bridges Discovery and Patient Care
The OHA has long recognized that hospital-based research is distinct in its ability to bridge scientific discovery with frontline patient care. Embedded within the health care environment, hospital research makes the rapid translation of new knowledge into practice possible. It is where clinical challenges meet scientific inquiry, leading to innovations that directly benefit patients, families, and the broader community. More than just discovery, hospital research ensures that new ideas move swiftly from theory to real-world impact, transforming care at every level.
Hospital-based research operates at the very heart of patient care. Our laboratories are located in the same places where people receive treatment, providing researchers with unparalleled access to real-life clinical challenges, patient perspectives, and immediate feedback from frontline health care providers. This fosters a more collaborative, interactive, and integrated approach to research, ensuring that the focus remains squarely on patient outcomes.
At the heart of this integration is a simple, but profound, truth: research is care. Every clinical trial conducted, every innovative solution or device tested, and every new approach validated contributes to better care for Ontarians. Whether it is understanding the mechanisms of disease, developing new treatments, improving diagnostic techniques, enhancing health care practices and patient experiences, improving hospital services and efficiencies, advancing new approaches for virtual care and remote monitoring, or training the next generation of professionals, hospital-based research ensures that our health care system remains responsive, resilient, and forward-thinking. Hospital-enabled research in Ontario is critical to ensuring control over our own health destiny. However, we must expand our vision of what hospital-based research entails.
Expanding the Vision for Hospital-Based Research
To truly serve all Ontarians, research needs to extend beyond academic hospitals to include community hospitals, family doctors, inter-professional clinicians, long-term care facilities, and especially patients, families, and caregivers. Innovation should not be siloed within large research centres but should be embedded throughout the continuum of care. This requires us to rethink not only our model of care, but how we also fund hospital-based research across the spectrum to facilitate integration and foster evidence-based practice.
Ontario is uniquely positioned to lead this transformation. Our hospitals work collaboratively, leveraging a spirit of partnership to develop "made-in-Ontario" solutions that address the needs of our population and beyond. Artificial intelligence (AI), remote monitoring, and big data approaches offer unprecedented opportunities to expand personalized medicine, including precision aging—an imperative, given the province's growing population and shifting demographics. We can and should be making use of modern research tools and technologies to accomplish for all areas of health what precision medicine has done for cancer. By harnessing these tools, we can tailor health care interventions to individual needs, improving efficiency and effectiveness across the system. This is the hallmark of a learning health care system—one that continuously learns and improves through data collection, analysis, and feedback to enhance patient outcomes and quality of care.
Embracing Innovation and Partnerships for a Healthier Future
By fostering a culture where research is seamlessly integrated into care, we can ensure that our health care system remains at the forefront of innovation. This means advocating for sustained investment to address the bottlenecks in care, strengthening collaborations across sectors, and building the required infrastructure by recruiting more clinical researchers and supporting a thriving research and innovation ecosystem to drive sustainability. Such investments will pay off not only by improving care, but also by enhancing productivity, job creation, and economic growth. Investment in hospital-based research today is critical to ensure that Ontario has the capacity to develop homegrown solutions, reducing dependence on external systems and enabling health care sovereignty, security, and sustainability.
Members of the OHA's Health Research and Innovation Committee are committed to supporting hospitals in embedding research and innovation into all of their operations and expanding the reach and impact of research. By working together, we can move from ideas to impact—safeguarding Ontario's position as a global leader in health care innovation and delivering exceptional and timely care to all who need it.
Nobody wants to find themselves—or their loved ones—in the position of being rushed to an Ontario hospital in need of life-saving care only to face long waits and limited resources. By working together, embracing innovation, and embedding research into the fabric of our health care system, we can ensure a future where every Ontarian receives the care they need, when they need it, in a system that is built not just to treat illness or alleviate suffering, but to promote wellness and longevity.