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Canada’s hospitals are admired around the world for their dedication, quality, and resilience. Yet, beneath these strengths, a persistent challenge threatens to slow our progress: the gap between innovation and actual change at the point of care. In April 2025, the CD Howe Institute released a landmark report, “Enhancing Innovation in Canadian Hospitals: The Obstacles and the Solutions – C.D. Howe Institute” offering a candid diagnosis of what’s holding hospitals back—and, more importantly, what can move us forward. For health technology companies and hospital leaders, this report offers not just a critique but a blueprint for action.
The report opens with a pressing reality: despite Canada’s world-class clinicians, state-of-the-art facilities, and well-intentioned investments, our hospitals remain trapped in a cycle of incremental change. The COVID-19 pandemic exposed and amplified these bottlenecks. Wait times are as long as ever, staff shortages are worsening, and patients too often feel the pinch of a system operating at its breaking point. While hospitals have squeezed out efficiency gains through new models for outpatient surgery and shorter inpatient stays, these improvements have not resolved chronic overload.
What’s preventing Canadian hospitals from innovating at scale? The CD Howe report identifies several deeply rooted obstacles. One of the most persistent is budget fragmentation. In Canada’s system, funding often flows through rigid, department-specific channels. When a department invests in an innovation—say, an advanced surgical scheduling tool—the benefits may be realized elsewhere, such as in a reduced need for overtime in another department or better bed availability on another ward. This disconnect between who pays and who benefits leads to fiscal hesitation. Promising pilot projects can flounder after their initial phase because hospitals lack structured pathways to support ongoing, system-wide adoption.
Data and analytics infrastructure present another roadblock. Many hospitals are stuck in a patchwork of information systems that don’t communicate well with each other. This makes it difficult to generate the real-time insights required for nimble, evidence-based decision making. Even as more organizations adopt remote monitoring or automation, a lack of interoperability and analytic capacity limits their ability to coordinate improvements across the continuum of care.
The report also draws attention to a leadership vacuum. Innovation, by its nature, disrupts the status quo. In Canadian healthcare, there is often no single entity with both the authority and the mandate to drive successful pilots into widespread practice—across departments, across hospitals, or across provinces. Hospitals operate within complex webs of governance, which can stall good ideas before they reach their full potential.
Cultural inertia further complicates the picture. Even when leadership and clinicians are enthusiastic, entrenched processes and a fear of operational risk can stall or derail innovation efforts. Change management expertise is in short supply, and, without it, even the best new tools or workflows can fail to gain traction. Staff shortages, burnout, and capacity constraints—now daily realities—mean there is often little time or energy left for meaningful experimentation or transformation.
Yet the CD Howe report is not a tale of despair. Its authors outline practical, system-level solutions. They call for reforms in procurement and funding so that hospitals can support pilots with clear, cross-sector evaluation and full-cost accounting. They recommend building robust knowledge-sharing networks, so that successful models do not remain siloed within single sites. They argue for the creation of agencies or institutional roles that would take responsibility for scaling up what works, and for a stronger focus on building cultures that reward measured risk-taking and effective change management.
Where does SurgiTwin fit within this vision? SurgiTwin is a digital twin platform engineered specifically for surgical departments. By simulating workflows in real time and using artificial intelligence to forecast resource needs, SurgiTwin enables hospitals to unlock hidden capacity within their existing resources. This means more surgeries can be performed, bottlenecks are proactively addressed, and staff can operate in a more predictable, less stressful environment.
SurgiTwin is designed to tackle precisely the barriers outlined by the CD Howe report. First, it addresses budget fragmentation by making its value visible and measurable. Hospitals that deploy SurgiTwin can quantify improvements in operating room utilization, reductions in overtime, and increases in throughput. By generating clear data, SurgiTwin helps hospital administrators make a strong case for sustaining and expanding digital solutions beyond the pilot stage. This approach also helps align the interests of different departments, since the benefits of optimized scheduling are shared broadly across perioperative and downstream units.
On the analytics front, SurgiTwin serves as a bridge. Its platform integrates seamlessly with existing electronic health record systems, aggregating disparate data streams and transforming them into actionable intelligence. The resulting insights support better decision-making in real time, and lay the groundwork for system-level coordination—exactly the kind of digital backbone that Canadian health innovation policy has long sought to build.
Perhaps most importantly, SurgiTwin empowers local leadership while supporting system-level scalability. By proving value in one hospital or department, the model can be adapted and extended regionally or provincially. This scalability is central to the CD Howe report’s recommendation that Canada create new institutional roles to take responsibility for spreading innovation. SurgiTwin’s transparent metrics and evidence-based outcomes give these bodies the tools they need to make investment decisions and report on progress.
Cultural change cannot beunderestimated. SurgiTwin is not a black-box technology. Its successfuldeployments engage clinical and administrative teams from the outset, embeddinganalytics and decision-support into daily workflows. Staff are invited to experimentwith new approaches in a risk-free digital environment before they’re rolledout in practice, which helps address the risk-aversion and inertia the reportdescribes. This collaborative, hands-on approach builds trust and speedsadoption.
Finally, in a time when every hour of staff time matters, SurgiTwin delivers efficiency withoutdemanding more from already overburdened teams. By smoothing surgical flow andremoving unnecessary delays, the platform allows staff to focus on care rather thancrisis management. In real-world pilots, hospitals have found that the gains inproductivity and morale quickly offset the cost of adoption.
Canada’s hospitals are at acrossroads. Incremental improvements can no longer meet the growing demandsplaced on our health system. The CD Howe Institute’s latest report providesboth a clear-eyed diagnosis of the barriers and a hopeful prescription forchange. At Sifio Health, we believe SurgiTwin is a prime example of the kind ofpractical, system-level innovation Canada needs—one that aligns with policyrecommendations, empowers clinicians, delivers measurable results, and scalesfor impact.
The future of Canadianhospital innovation will be written not just in policy reports, but in thedaily actions of those who are willing to champion, adopt, and expand solutionsthat work. SurgiTwin stands ready to help hospitals break through old barriersand build a new era of resilience, efficiency, and patient-centered care.
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