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Congratulations are in order for the research team behind Ontario’s latest study on improving access to joint replacement surgery. Their work, featured recently in the news (Faster surgeries | Watch), highlights how single-entry referral systems and team-based care models can dramatically reduce surgical wait times. According to the simulation results, coordinated approaches could reduce the number of patients exceeding wait-time targets to nearly zero—a truly remarkable step forward for health system planning in Canada.
But as we celebrate this progress, it’s worth pausing to consider another, often overlooked dimension: surgical utilization. As the study notes, even at hospitals leading the way on access reforms, operating rooms often run at only 65–75% utilization. The problem isn’t lack of demand—hundreds of patients still wait in pain for essential surgeries. Nor is it due to limited staff, as these numbers persist even in fully staffed surgical departments. The underlying challenge is inefficiency in the way surgeries are scheduled, planned, and managed.
Efforts like single-entry referral pathways, centralized intake, and multidisciplinary assessment clinics are crucial for leveling the playing field. By smoothing out variations in referral processes and ensuring every patient gets timely, appropriate care, these innovations tackle a major root cause of long wait lists: inequitable access.
But referral models alone can’t address the physical realities of surgical capacity. Every surgical minute left unused is time another patient spends waiting. In Canada, we invest billions in surgical infrastructure and highly trained teams. When our ORs run at 65–75% utilization, we are not just wasting public dollars—we are leaving health on the table.
The reality is stark: even with better referral models, true transformation depends on whether hospitals can actually do more with what they already have. The bottleneck is no longer just about who gets in the door, but how efficiently those doors open and close.
What drives this utilization gap? It’s a complex interplay:
Studies have shown that for every percentage point increase in OR utilization, health systems can complete hundreds of additional surgeries annually—without added infrastructure. In a system where every week matters for patients with mobility-limiting conditions, even small improvements pay outsize dividends.
Ontario’s experiment with single-entry referral is a vital proof of concept. But what if we went a step further? Imagine pairing coordinated intake with intelligent, AI-driven scheduling that matches every patient, surgeon, and resource to the optimal slot—every time.
This is the approach we advocate at Sifio Health. Digital twin technology allows hospitals to simulate and optimize surgical schedules, predict bottlenecks before they happen, and ensure that every available resource—be it an OR, a team, or a specialized tool—is put to best use. By integrating data from referral to discharge, we can close the loop between who needs surgery, who delivers it, and how effectively our system runs day-to-day.
The lesson from this new Ontario study is clear: system-level innovation works. But to unlock the full potential of surgical care in Canada, we must look beyond access models and tackle utilization head-on. It’s not enough to open the front door wider—we must make sure the whole house runs efficiently.
Policymakers, clinicians, and technology innovators need to work together to break down the silos between intake, scheduling, and delivery. Only by aligning coordinated care models with smart utilization strategies can we truly transform access to surgery—moving from waitlists to wellness, from bottlenecks to breakthroughs.
Let’s keep this important conversation going. How can we further align innovations in coordinated care and OR utilization to maximize the value of our surgical infrastructure? What barriers still stand in the way, and what new partnerships or technologies could help close the gap?
Canada is poised for surgical transformation. The next step is ours to take.
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