Issuu

Policy Brief

Advancing Future-Ready Health Care in Ontario Lead Partner Advancing Future-Ready Health Care in Ontario

Supporting Partner Advancing Future-Ready Health Care in Ontario

Introduction Healthy communities are the foundation of a strong and productive economy. Health care is one of Canada’s largest and most dynamic industries. employing approximately three million Canadians, including over

~3M

500,000+

$170B+

500,000 new jobs in the last decade generating Generated in annual Canadians employed New jobs created in the , and 2 across the sector real 2 GDP last decade1 1

more than $170 billion in annual real GDP.

As populations age and health care needs become more complex, investments in health system performance increasingly drive economic competitiveness, workforce participation, and long-term prosperity. Ontario has taken important steps to strengthen its health care system. Through its Primary Care Action Plan, expanded scopes of practice for health care professionals, streamlined credential recognition pathways, investments in digital health, and efforts to connect more Ontarians to primary care, the province is both improving access and modernizing delivery. Notwithstanding this progress, the pressures persist, such as growing workforce shortages, increasing demand for care, barriers to access, and an aging population. Emergency departments remain strained and subject to closure, with patients routinely waiting over 17 hours to receive care;3 millions still lack regular access to primary care; and fragmented systems make it harder for patients and providers to navigate care efficiently.

This policy brief in collaboration with our partners Pfizer and GSK, outlines three foundations for a future-ready health care system:

Data for Impact Leveraging interoperable data to improve decision-making, patient outcomes, and system performance.

Innovating the Supply Chain Modernizing procurement to prioritize value, innovation, and long-term sustainability.

Health Equity and Access to Care Expanding community-based and team-based models that improve access while reducing pressure on hospitals and emergency departments.

Through coordinated planning, cross-sector collaboration, and strategic investments in innovation, Ontario can create a future-ready health care system that delivers better outcomes for patients and supports economic prosperity for decades to come.

The case for reform is stronger and more urgent than ever. Ontario must create a more connected, innovative, and sustainable health care system that is future-ready; one that moves beyond incremental improvements and advances a coordinated strategy to strengthen data interoperability, modernize procurement, and expand community-based care.

Introduction

Advancing Future-Ready Health Care in Ontario

Data for Impact Advancing Interoperability in Canada

Ontario has recognized the importance of digital health transformation with steps to modernize its collection, sharing and use of health information. Despite these investments, health care data remains fragmented across providers, organizations, and systems, limiting improvement in patient outcomes and system performance.

$2.4B Potential annual savings for Canada through health data infrastructure investments

Data for Impact

The next phase of Ontario’s digital health journey should focus not simply on digitization, but on interoperability: ensuring that information can move securely and seamlessly between patients, providers, and care settings. Achieving this objective through Bill S-5, the Connected Care for Canadians Act, and provincial systems such as Ontario’s new primary care medical record system, would strengthen public health monitoring, improve care coordination, reduce administrative burden, and support a more personalized and preventative model of care. Comprehensive and secure digital infrastructure enables the prevention, detection, and monitoring of disease outbreaks while providing timely information that supports evidence-based decision-making. Investments in health data infrastructure also has the potential to save Canada up to $2.4 billion every year.4

Yet, the value of these systems extends beyond efficiencies. By identifying populations and regions at greater risk of poor health outcomes, health data can support more targeted and equitable interventions. During the COVID-19 pandemic, for example, public health data in Toronto revealed higher infection rates in certain neighbourhoods, particularly those with higher proportions of Black, Indigenous, and racialized residents.5 These insights enabled the city to collaborate with community sector partners, faith groups, landlords, and local businesses to make public health information more accessible and relevant.

Advancing Future-Ready Health Care in Ontario

New evidence highlights opportunities to improve vaccine access in Canada.

Spotlight

Timely Access Matters For 75 years, Pfizer Canada has worked to help improve the health and well-being of Canadians through the discovery, development, and delivery of innovative medicines and vaccines. Vaccination is one of the most effective public health tools available to help prevent serious infectious diseases, including pneumococcal disease and respiratory syncytial virus (RSV). Along with improving health outcomes, vaccines also provide economic benefits to our society.

Did you know that… • Adult vaccines bring $2.5 billion of value annually to Canada, including $514 million in health care savings (reduced emergency room visits and hospitalizations) and $1.9 billion in economic benefits (increased productivity and reduced absenteeism).6 • Vaccination is widely recognized as the most cost-effective public health intervention, with a 341 per cent return on investment on every $1 invested in adult vaccination in Canada.7

Data for Impact

IQVIA, a global health care data, analytics, technology, and clinical research company, recently published a first-of-its-kind report which analyzed how long Canadians wait to access publicly funded vaccine programs and how aligned these programs are with expert committee recommendations.8 This study examined 29 different routine vaccine formulations across seven vaccine-preventable diseases from the past 25 years and found the following: 1. Canadians wait over 2 years (788 days) from Health Canada approval to access the first publicly funded routine vaccine program. 2. Significant variations across provincial programs and suboptimal alignment with current vaccine committee recommendations. The study also identified successes that can help shape future policies: 1. Quebec (557 days) and Alberta (612 days) median time to public vaccine programs was significantly shorter than the national average. 2. The first RSV programs were implemented just 296 days after Health Canada approval, demonstrating that rapid access is achievable. Robust, real-world data are the foundation for improved health systems. The study demonstrates that timely and accelerated access to vaccines, involving collaboration across multiple stakeholders, is essential to equitable health outcomes for all Canadians. Pfizer recognizes the sustained efforts of the Public Health Agency of Canada(PHAC), federal and provincial decision-makers, procurement agencies, and expert advisory committees to provide Canadians with publicly funded vaccine programs. Industry stakeholders encourage governments to continue to work together to support the interim National Immunization Strategy objective of ensuring all Canadians have timely and equitable access to all expert committee-recommended vaccines, which will help ensure our population and economies are as strong and resilient as possible.9

Advancing Future-Ready Health Care in Ontario

Nova Scotia is a leader in health data interoperability. In 2024, the province mandated data sharing between the Ministry of Health and health care providers, enabling residents’ right to access and manage their Electronic Medical Records (EMRs). Inspired by ‘digital front door’ models in Denmark and Estonia, the initiative gives patients a single platform to communicate with care teams.

By harmonizing hundreds of millions of datapoints, YourHealthNS empowers clinicians, benefits patients while protecting their privacy, and maintains a human-centred, preventative standard of care (see Figure 1). With more than 680,000 downloads, physicians report that patients are benefiting from easier access to their health information.10

Figure 1: Nova Scotia’s Health Data Interoperability Ecosystem Governance Across All Layers Privacy | Cybersecurity | Patient Consent | Data Governance Standards

Healthcare Providers Hospital systems Primary care clinics Community pharmacies

Interoperability Layer Corepoint integration engine Fast healthcare interoperability resources (FHIR) Data translation, exchange, and integration

Medical laboratories Emergency medical services (EMS) Community-based care

Users & Applications YourHealthNS patient portal One person one record (OPOR) Public health analytics

Provincial Health Data Platform Microsoft Azure cloud infrastructure Unified longitudinal health record Secure data storage, analytics, reporting, and information sharing

Health system planning Research and innovation

Key Outcome A single, interoperable provincial health record accessible by patients, providers, and planners.

Source: Nova Scotia Health improves access to healthcare with data and digital innovation - Kainos

Data for Impact

Advancing Future-Ready Health Care in Ontario

While Nova Scotia demonstrates what is possible when governments, providers, and industry align around a common digital health strategy, the broader Canadian health system continues to face significant interoperability challenges. Although 9 in 10 health care providers in Canada believe that securely sharing electronic health information would improve patient safety and quality of care, only 4 in 10 can do so.11 In addition, despite the economic savings attached to interoperable data, almost 4 in 5 providers (78 per cent)12 reported experiencing at least one barrier that either limited or prevented them from sharing patient information through a digital health system, and only just over half (52 per cent)13 of all health care providers who had access to any form of patient clinical information used a digital health system to send or share that information to providers outside of their main practice setting.

Data for Impact

Canada’s immunization program and delivery systems illustrates the consequences of fragmented health data interoperability and access. The current patchwork approach makes it difficult for providers, patients, and jurisdictions to access vaccination histories and coordinate public health responses.14In Ontario, these gaps lead to suboptimal resource allocation, inventory management, and budget planning for the public health ecosystem overall.

Advancing Future-Ready Health Care in Ontario

Case Study 1

Estonia – A Global Benchmark for Data Interoperability Estonia is the gold standard in Electronic Medical Record (EMR) connectivity, achieving a 99.1 per cent national interoperability rate.15 The country operates a nationwide, interoperable eHealth system that links hospitals, primary care, pharmacies, and social services through a secure national infrastructure and digital identity.16 Its success is rooted in a collaborative approach to digital health, partnering with industry stakeholders such as Helmes to build core infrastructure and registries instead of single-provider deployments, while scaling reusable solutions for patient portals, e-prescribing, clinician workspaces, AI-assisted data-quality tools, and consent management. This is part of the Ministry of Social Affairs’ strategy, which oversees architecture, standards, and governance; builds a robust domestic IT sector in collaboration with universities and start-ups; consistently drives innovation; and demonstrates how a coordinated strategy can create a highly connected, patient-centered health ecosystem.

Advancing Future-Ready Health Care in Ontario

The challenges observed in immunization programs and health care delivery are symptomatic of larger issues in Canada and Ontario’s health information infrastructure, governance, and data-sharing environment. Not only is there a lack of trust in existing systems, but gaps in infrastructure, education, and digital literacy result in the siloing of valuable health data. Many other factors make integration difficult: a lack of standardized data collection, central accountability and a coordinated strategy; vendorcontrolled systems; unclear data ownership; and varying levels of system understanding among health care professionals and patients.

Data for Impact

Ontario must move beyond data guardianship to data stewardship, implementing data standards at points of care. With a patient-centric framework that enables data mobility, supports a personalized medicine journey, and improves public and clinical understanding of the benefits of data sharing, the province can strengthen public health surveillance, support more personalized care, reduce administrative burden, and improve health system performance.

Advancing Future-Ready Health Care in Ontario

Recommendations

Government Provincial

Federal

Industry

Accelerate investments in a comprehensive provincial health data strategy that supports interoperability and standardized reporting with privacy-by-design standards, while ensuring alignment with national strategies. The strategy should include the following: • A central interoperability authority via an existing Ministry or Agency (e.g., Ministry of Health, Ontario Health). • Public integration across public health networks in collaboration with industry and academia. • Repository for longitudinal patient records.

Establish data standardization and ownership agreements in alignment with federal, provincial, and territorial governments, industry, academia, clinicians, and care networks.

Review and evaluate current incentives for digital adoption and adjust to reflect ongoing opportunities and challenges faced in the workforce.

Invest in disease surveillance infrastructure to better track vaccine-preventable diseases and emerging threats.

Establish a national immunization information system and harmonized vaccine schedule through the Public Health Agency of Canada (PHAC), integrated with provincial/territorial EMRs and digital health systems, to support equitable access, program delivery, provider decision-making, and public health surveillance.

Leverage AI and emerging technologies to improve data collection (e.g., VITAL) and reduce administrative burden, with cybersecurity, consent, privacy, and transparency provisions incorporated.

Data for Impact

Advancing Future-Ready Health Care in Ontario

Innovating the Supply Chain

Procurement for a Healthier Ontario Procurement decisions play a critical role in shaping patient access to medicines, vaccines, and medical technologies, while delivering broader economic benefits and health system savings.

$17B/year

Spent on health products, largely through hospitals and frontline care delivery making it Ontario’s single largest procurement category

~50%

of total provincial procurement spending is driven through hospitals and frontline care delivery

Innovating the Supply Chain

Ontario’s procurement ecosystem alone spends $17 billion annually on health products, largely through hospitals and frontline care delivery, making it one of the province’s largest procurement categories and accounting for nearly half of total provincial procurement spending.17 18 Given its scale, health procurement is a powerful driver of economic growth, fostering resilient supply chains across local, provincial, and global markets. Moreover, ensuring that businesses, including small and medium enterprises (SMEs) can compete for public health contracts, encourages innovation, and supports a modern health care system where Ontarians have access to the most effective medicines, vaccines, and medical technologies. Vaccines illustrate procurement’s potential to improve both health outcomes and provide economic benefits.

Adult immunization programs generate an estimated $2.5 billion in annual value for Canada, including $514 million in health system savings, and $1.9 billion in productivity gains.19 Moreover, for every dollar invested in adult vaccination, there is more than three times (341 per cent) value returned in health and economic benefits,20 such as a reduction in productivity losses from absenteeism, caregiving disruptions, and long-term complications, and increased presenteeism in the workforce. Historically, health procurement in Canada has relied on models that prioritize the lowest price. While price-based procurement is easier to implement and can provide short-term savings, it does not recognize the overall value of health products. It can also increase supply disruptions, undermine the creation of a sustainable life sciences sector, and limit new, innovative therapies from reaching patients.

Advancing Future-Ready Health Care in Ontario

Many international jurisdictions have shifted procurement for complex biohealth technologies and products to a Value-Based Procurement (VBP) framework. This approach focuses on patient outcomes rather than price, aligning with broader societal goals, involving a range of stakeholders, and addressing inefficiencies to deliver long-term savings (see Figure 2).21 VBP frequently involves the use of Most Economically Advantageous Tender (MEAT) criteria, which evaluate factors beyond price, including clinical efficacy, safety, quality of life and societal impact, patient convenience, economic value, and the level of innovation the product provides to determine the best overall value to patients and health care systems.

Closer to home, British Columbia (B.C.) offers a compelling Canadian example of VBP that included MEAT criteria to procure pneumococcal vaccines. In 2025, the province decided to assign 75 per cent of the total evaluation points for their pneumococcal immunization program tender to non-price criteria, including disease coverage, expert committee recommendations, supply reliability, and applicability across multiple populations. VBP resulted in B.C. having the simplest program in Canada (one vaccine across all populations), long term budget certainty, and the broadest pediatric protection in Canada (24 per cent broader protection than the vaccine used in other provinces).23

Figure 2: Procurement Cycles – Traditional versus Value-Based Transactional procurement (status quo)

Buyer issues RFP

Vendors bid for contract

Vendors are selected, often based on lowest cost

Collaborative, value-based procurement

Buyer engages in market sounding with vendors

Buyer develops competitive RFP based on insights from vendors

Buyer issues RFP

Vendors bid for contract

Vendors are selected based on highest overall value

Source: Power of the Purchase Order - OCC

Spain provides one example of VBP in action. In 2016, Hospital Sant Pau in Catalonia awarded a four-year, €10 million contract for implantable cardioverter defibrillator (ICD) services using a competitive dialogue process focused on patient and hospital outcomes. This contract resulted in a 10 per cent drop in outpatient visits, a 10 per cent reduction in complications, and increased collaboration along the care pathway.22

Innovating the Supply Chain

Advancing Future-Ready Health Care in Ontario

Case Study 2

Sweden – Value-Based Procurement in Health Care Sweden’s experience demonstrates VBP’s potential at scale. Since 2009, outcomesbased procurement for knee and hip replacements (including bundled payments and patient choice of provider) has reduced sick leave by 17 per cent, lowered resource utilization, decreased surgery-related length of stay, and cut payer costs by 20 per cent per patient. Most importantly, it improved patient outcomes, exemplifying how outcome-driven procurement can generate both clinical and economic value.24

Advancing Future-Ready Health Care in Ontario

Uneven vaccine procurement has measurable economic costs. Delays in access risk leaving up to $685 million in annual economic and health system savings unrealized through health system inefficiencies, based on a 10 per cent adult vaccine uptake 25, underscoring the value of building strong procurement models to support better patient outcomes. Ontario’s current procurement approach also discourages businesses from competing for public contracts, which limits competition and innovation.26 For example, according to the Auditor General, competition for major Ontario infrastructure contracts has weakened significantly in recent years, with the average number of interested bidders for Infrastructure Ontario procurements falling by 50 per cent, from five proponents in 2014 to 2.5 proponents between 2020 and 2023.27 A continued emphasis on cost, combined with misaligned timelines and budgets, limited expertise in procuring complex health solutions, and insufficient outcome measurement frameworks, undermines patient safety and fails to fully capture system value. Consequently, procurement decisions overlook broader benefits for patients, providers, suppliers, payers, and society, despite their importance to overall health system performance.28 Procurement challenges are compounded by broader structural and financial pressures within Ontario’s hospital sector. Limited resources can restrict hospitals’ ability to adopt VBP models and invest in innovations that improve efficiency and patient outcomes. According to the Financial Accountability Office (FAO), Ontario had the lowest age-standardized per capita provincial funding for hospitals in 2023, at $1,967, compared to the Canadian average of $2,098.29

Innovating the Supply Chain

This funding gap highlights the need for sustained investment in hospital infrastructure, workforce capacity, and health technologies to meet the demands of a growing and ageing population (see Figure 3). Figure 3: Age-Standardized Per Capita Provincial Funding for Hospitals in 2023 Dollars per Person, Adjusted for Population Age

Despite growing international evidence supporting the benefits of VBP, Canada and Ontario continue to rely largely on price-driven tendering for complex health medicines and technologies, notably vaccines and medical devices. Although this approach can streamline procurement and reduce upfront costs, it often fails to account for broader measures of value, including patient outcomes, system sustainability, supply-chain resilience, and market competition.

3,000 2,500

Canada Average: 2,098

2,000 1,500 1,000

1,967

1,980

2,057

2,245

2,253

2,338

2,406

2,440

2,563

2,715

500 0

Source: FAO analysis of CIHI: National Health Expenditure Trends, 2025: Data Tables – Series E1

Beyond fiscal and operational constraints, economic and trade uncertainty are affecting Ontario’s procurement environment. The Ontario Chamber’s 2026 Ontario Economic Report found that only 23 per cent of businesses are confident in the province’s economic outlook, while 65 per cent expect tariffs, trade policies, and broader economic uncertainty to have negative impacts on their operations.30 As businesses adapt through supplier diversification, price increases, cost absorption, and workforce reductions, there is a growing need for procurement policies that provide certainty, clarity, and predictability, while still delivering quality care to patients.

Advancing Future-Ready Health Care in Ontario

While the Buy Ontario Act, 2025 and 2025 Buy Canadian Policy aim to support domestic growth and supply chain resilience, these policies need to reflect that life sciences innovation such as pharmaceuticals, vaccines, and medical technologies and devices are complex commodities and require procurement frameworks that acknowledge their dependence on globally integrated supply chains.31 This should be done to avoid unintended consequences on patient outcomes, competition, and innovation.

Innovating the Supply Chain

Procurement is not merely a purchasing function; it is also a strategic lever for improving health system performance. By embedding value, outcomes, innovation, and supply chain resilience into procurement decisions, Ontario can move beyond short-term cost containment and build a future-ready health care system that delivers lasting benefits for patients, providers, the public, and the economy.

Advancing Future-Ready Health Care in Ontario

Spotlight

Shifting the Prevention Paradigm from Cost to Investment Vaccination is one of the most effective tools available to support the health of Ontarians and can be an important contributor to the country’s economic prosperity. And yet, government investment in public health remains proportionally low relative to the overall health care spend in Ontario.32 Consequently, even where the National Advisory Committee on Immunization (NACI) strongly recommends vaccines for adults, there remain gaps in access to them through public funding. For example, Ontario limits public funding of the shingles vaccine to adults aged 65-70, despite the strong NACI recommendation to vaccinate people over 50 and immunocompromised patients over 18.33 In addition to protecting health and improving health care system resiliency, there is growing evidence that immunization can also boost productivity. A recent report by Signal49 (formerly operating as the Conference Board of Canada) estimated that expanding access to shingles vaccination for Ontarians aged 50 years and older could generate $1.76 in health and productivity benefits for every dollar invested by the Ontario government. In addition to reducing health care costs, the analysis estimated $620 million in productivity gains.34 As Ontario - and Canada - navigate ongoing geoeconomic uncertainty, shifting trade relationships, and international conflict, maintaining a healthy and productive population is increasingly important to economic resilience. Expanding access to adult vaccination can improve population health, strengthen health system resilience, and support workforce participation, caregiving, and volunteerism. As such, immunization is a strategic, longterm investment in the province’s health and economic prosperity.

Innovating the Supply Chain

Figure 8: Net Productivity Gains and Returns on Investment Across Canada for Canadians 50 Years and Older

Territories 2.00 $7M

Atlantic Canada QC 1.63 $305M

BC 1.71 $225M

1.57 $96M

Prairies 1.63 $278M

ON 1.76 ROI

$620M

Net productivity gains

Source: The Value of Shingles Vaccination - Signal49 Figure reproduced with permission from Signal49

Advancing Future-Ready Health Care in Ontario

Recommendations

Government Provincial

Federal

Industry

Incorporate a procurement framework that prioritizes clinical outcomes, reliability, interoperability, and system readiness. This includes: • Maintaining and expanding multi‑supplier frameworks for critical medical devices and diagnostics to ensure continuity of supply and support system‑wide resilience. • Recognizing local assembly, customization, integration, and servicing as legitimate value‑added activity, regardless of where components originate.

Adopt VBP, where applicable, across the public sector through both legislative (e.g., pilot programs) and practical means by defining procurement objectives to include lifecycle costs, innovation, economic development, supply chain resilience, and other long-term outcomes. This includes the following: • Communicate a clear definition of VBP, guidelines, and successful examples to ensure alignment across the public and private sectors. • Distinguish between simple commodities and complex purchases and tailor the procurement process to the complexity of the purchases. • Adopt a collaborative procurement model for complex purchases that engages with vendors to understand the technical landscape and define objectives before issuing Request for Proposals (RFPs).

Improve access to procurement for small and local businesses by centralizing information, reducing administrative barriers, and supporting municipalities in taking similar steps.

Innovating the Supply Chain

Advancing Future-Ready Health Care in Ontario

Recommendations

Government Provincial

Federal

Industry

Build on recent hospital investments with a predictable, multi-year funding framework for Ontario hospitals and public sector health organizations that supports the adoption of innovation, workforce planning, and system modernization.

Encourage stronger collaboration between suppliers, governments, and agencies (e.g., Supply Ontario), including information sharing and frequent dialogue, when pursuing procurement contracts.

Expand and resource the National Advisory Committee on Immunization (NACI) by providing sustained funding to provide timely recommendations that align with procurement cycles for new vaccines and publicly funded vaccine programs.

Ensure the Buy Ontario Act, 2025 and Buy Canadian Policy exempts pharmaceuticals, vaccines, medical devices, health technologies and health capital infrastructure projects (e.g., medical imaging systems, life-support devices, and surgical and laboratory/diagnostic systems), to meet demand and availability, while prioritizing greater access to care and patient safety.

Innovating the Supply Chain

Advancing Future-Ready Health Care in Ontario

Health Equity and Access to Care

Figure 4: Percentage of Canadian Adults who Report Having Access to a Regular Health Provider

Bringing Care Closer to Home

Canada’s health care system is founded on universal access. Ontario’s Primary Care Action Plan reinforces this commitment: recent investments have connected more than 700,000 Ontarians with a primary care provider. The introduction of “As of Right” rules and streamlined credentialing for nurses has also strengthened access to care. However, nearly 2 million Ontarians still lack a regular primary care provider, highlighting the need to accelerate efforts toward equitable access across the province (see Figure 4).

Canada

82.6% (81.9-83.2)

n/a NT

n/a

82.6%

79.9%

(81.9-83.2)

(78.0-81.6)

79.9%

(78.0-81.6)

83.8% (81.8-85.6)

82.6% (79.3-85.5)

85.0%

74.1%

(82.0-87.6)

(72.6-75.6)

61.7%

88.5%

(55.6-67.4)

(87.4-89.5)

81.6%

(78.2-84.5)

78.1%

(74.8-81.1)

~2M

Ontarians currently lack a regular primary care provider

Health Equity and Access to Care

Source: Ontario’s Primary Care Action Plan: 1-year progress update | ontario.ca

Advancing Future-Ready Health Care in Ontario

Figure 5: Components of a Team-Based Care Model

Training, Education and Continuing Professional Development

Measurement, Continuous Quality Improvement and Research

Strong primary care systems improve health outcomes, reduce health care costs, and support equitable access to care. Provincial estimates suggest that patients connected to primary care experience 36 per cent fewer emergency department visits, while individuals with poor primary care access are nearly 30 per cent more likely to require hospitalization.35 When access to care is delayed or unavailable, patients often seek treatment in higher-cost settings such as emergency departments, which increases pressure across the health care system. Therefore, improving health equity requires more than expanded health care capacity; it means rethinking how and where care is delivered. Team and community-based care models offer significant opportunities to improve access while supporting better health outcomes and system sustainability. They bring services closer to patients, leverage interdisciplinary health care teams with allied health professionals (e.g., nurse practitioners, pharmacists, diagnostics and lab technicians, physiotherapists, dietitians, mental health professionals) and integrate digital technologies (see Figure 5).36 New Brunswick demonstrates how health care services can be successfully delivered outside traditional institutional settings. Often described as a “hospital without walls,” the province’s Extra-Mural Program uses interdisciplinary care teams to provide coordinated hospital and community-based services in patients’ homes. Such team-based care models have been proven to support chronic disease management, increase patient satisfaction, improve quality of care, reduce emergency room use and hospitalizations, and improve access to care, while lowering burnout and delivering high-quality care overall.37

Health Equity and Access to Care

Ongoing Development

Accessible Care

Continuity of Care

Patient- and Family-Partnered Care

Community Adaptiveness and Social Accountability

Comprehensive Team-Based Care with Family Physician Leadership

Functions

Appropriate Infrastructure

Connected Care

Administration and Funding

Foundations Source: Team Based Care, SGFP

Advancing Future-Ready Health Care in Ontario

Ontario’s growing network of interprofessional primary care teams also demonstrates the benefits of leveraging the full health care workforce. Nurse Practitioners (NPs), for example, are playing an increasingly important role in delivering comprehensive primary care services such as diagnosing conditions, performing comprehensive assessments, and prescribing medications, across a variety of settings, including NP-led clinics, community practices, hospitals, long-term care homes, and interdisciplinary care teams.38 In 2025, Newfoundland and Labrador launched a pilot funding model that enables independently practising NPs to provide publicly funded primary care services with additional supports for them to offset business costs. This eliminates out-of-pocket costs for patients and increases access to primary care providers, particularly in communities facing physician shortages.39 The initiative reflects a growing recognition that empowering health care professionals to practise to their full scope can help address equity gaps in access to care. Similarly, community pharmacies continue to serve as accessible points of care, especially for those without a regular primary care provider. Pharmacists can provide preventive care services, improve medication management, and manage minor ailments, improving convenience for patients and helping to alleviate pressure on the broader health system. Since pharmacists’ scope of practice was expanded, they have completed more than 2.4 million minor ailment assessments, with over 99 per cent of pharmacies participating in the program. Building on this success, Ontario recently expanded pharmacists’ scope of practice to include nine additional minor ailments they can assess and prescribe, and enabled pharmacists and pharmacy technicians to administer six additional publicly funded vaccines.40 These efforts reflect a cost-effective approach to improving access and highlight the impact of enabling health care professionals to practice to their full competencies within collaborative care environments (see Figure 6).41

Health Equity and Access to Care

Despite this progress, pharmacists still have limited authority to prescribe vaccines, an area where timely access to care has been a challenge. Patients may need to obtain a prescription from a physician or nurse practitioner before going to the pharmacy, creating unnecessary delays and lost immunization opportunities.42 Greater alignment between scope-of-practice authorities, reimbursement frameworks, and care delivery models would help address these barriers. Expanding prescribing authority where appropriate, supported by sustainable compensation models and integration within team-based care, could further improve access to preventive care, reduce avoidable health care visits, and support more efficient use of health care resources. Figure 6: Access Through Diverse Community-Based Care Models in Ontario Care Delivery Channel

Reach / Impact

Community Pharmacies

95 per cent of Canadians live within 5 km of a pharmacy.

Community Pharmacy Minor Ailment Program

Over 2.4 million assessments have been performed.

Virtual Care

Improved access for rural and northern communities. In 2024, 1 in 3 Canadians reported receiving primary care virtually.

NP-Led Clinics

100,000+ patients served.

Advancing Future-Ready Health Care in Ontario

Case Study 3

Alberta’s Expanded Pharmacist Scope of Practice Alberta has emerged as a Canadian leader in expanding a pharmacist’s ability to prescribe, administer vaccines, order certain laboratory tests, and provide medication management services.43 By enabling pharmacists to practice to their full scope, the province has improved access to timely care and reduced pressure on primary care physicians. Alberta’s model demonstrates how regulatory modernization can enhance communitybased health care delivery and ensure stronger alignment between public and private reimbursement policies, while mitigating system pressure on other public health networks.

Advancing Future-Ready Health Care in Ontario

Technology-enabled care delivery is another key area of opportunity for improving health equity. Virtual care, remote patient monitoring, and emerging digital tools help address access barriers associated with geographic inequities and transportation challenges, particularly in rural, remote, northern, and Indigenous communities, where residents generally have access to fewer and narrower ranges of health services and providers than urban populations.44 Challenges with geographic inequity have led to 1 in 4 rural and remote hospitalizations involving a high or very high travel burden.45 Innovative care models that connect local providers with specialist expertise can help bridge these gaps. TeleVU, a Canadian health technology company, has developed an immersive virtual-care platform that enables community-based clinicians and NPs to collaborate with specialists in real time, helping patients access expertise closer to home while reducing travel burdens to urban centres.46 These digitally enabled models can strengthen local care capacity, improve continuity of care, and support the delivery of the right care, in the right place, at the right time. When paired with well funded, in-person services, they also help relieve system pressures and reduce burnout among rural physicians who often provide both primary and emergency care (see Figure 7).47

Figure 7: Visits to Emergency Departments that Could be Managed in Virtual Primary Care Canada

8.7%

8.5%

9.8%

8.4%

10.6%

8.8% 13.7%

YT QC BC

7.6% 7.2%

Source: Virtual primary care: Impacts and opportunities | CIHI

Health Equity and Access to Care

Advancing Future-Ready Health Care in Ontario

Case Study 4

Saskatchewan’s Indigenous-Led Virtual Health Hub Saskatchewan’s Virtual Health Hub (VHH), an Indigenous-led initiative being developed on Whitecap Dakota First Nation territory, highlights how technology can improve health care access in rural, remote, and northern communities. The Hub aims to support up to 30 communities through virtual care and robotic diagnostic technologies, reducing the need for patients to travel long distances for specialized services.48 One of the Hub’s first applications is robotic ultrasonography, allowing remote specialists to perform and interpret diagnostic imaging virtually. This technology has implications for maternal care in northern communities, where expectant mothers may otherwise have to travel by air to access routine ultrasound appointments. By combining virtual care, remote diagnostics, and Indigenous-led workforce development, the Virtual Health Hub offers a scalable model for Ontario to expand health care access, reduce travel burdens, and improve health equity for underserved populations.

Advancing Future-Ready Health Care in Ontario

However, while innovation in community-based care has shown promise, significant access gaps remain across Ontario. Equitable access depends on the strength and reliability of the infrastructure that supports care delivery. Healthcare products and services must be available where and when patients need them, including in communities outside major urban centres. Marginalized communities continue to face barriers to timely, continuous, and equitable access to care due to workforce shortages, transportation limitations, longer travel distances, and service availability.49

Health Equity and Access to Care

At the same time, Ontario’s population is aging rapidly, with more than one-fifth of residents projected to be over the age of 65 by 2046, increasing demand for chronic disease management, preventative services, and community-based supports.50 Without corresponding increases in health system capacity, workforce supply, and communitybased services, this demographic shift is expected to place significant pressure on care delivery.

Advancing Future-Ready Health Care in Ontario

Funding and regulatory frameworks have also struggled to keep pace with scope-of-practice reforms and team-based approaches, particularly for pharmacists, who face inconsistent reimbursement policies, administrative burdens, and potential underutilization of expanded clinical services due to limited public awareness. Across Canada, similar gaps have hindered the full utilization of a pharmacist’s skills and clinical expertise and the expansion of accessible, community-based care.51 Such reforms can translate into improved access only when accompanied by sustainable compensation models and practical implementation supports that enable consistent delivery of care.

Recruitment strategies alone will not address challenges such as burnout, workload pressures, and growing competition for talent that contribute to workforce instability across Canada.53 Sustainable workforce planning is imperative for improving forecasting, strengthening workplace supports, and implementing long-term retention strategies that enable providers to remain in practice and deliver care effectively.54 Leveraging digital tools and harnessing data interoperability can further strengthen workforce capacity by streamlining workflows, supporting clinical decision-making, reducing administrative tasks, and allowing clinicians to focus more on the patient journey.

Additionally, despite ongoing investments in workforce development and post-secondary education in the health sector, such as expanding training capacity through the Learn and Stay Grant and expanding pathways for internally educated professionals, workforce shortages remain one of the most pressing health care challenges. The FAO projects Ontario will need approximately 86,700 additional nurses and personal support workers by 2027-28 to meet demand and return to pre-pandemic vacancy levels.52 Supporting a model of future-ready care that strengthens workforce capacity will require not only expanding supply but also removing system barriers by better aligning education, scope-of-practice frameworks, reimbursement policies, and digital health infrastructure.

A sustainable health care system depends not only on its workforce size and capabilities, but also on how well it leverages providers’ skills and expertise. Workforce flexibility, modernized scopes of practice, and lower system barriers can improve access, equity, and long-term system performance.

Post-secondary institutions also play a critical role in building the workforce of tomorrow by ensuring training reflects emerging system priorities, including preventative care, interdisciplinary practice, digital health, and community-based service delivery. Newer educational models increasingly incorporate community placements, cultural competency, and interprofessional learning opportunities to address misalignment in care. Continued investment can further scale these programs and strengthen partnerships between academia and industry to develop a well-equipped workforce to meet future health system needs.

Health Equity and Access to Care

Advancing Future-Ready Health Care in Ontario

Recommendations

Government Provincial

Federal

Industry

Academia

Scale and sustain innovative local service delivery models through team-based care across Ontario, incentivizing greater collaboration among Ontario Health teams, family health teams, Indigenous communities, municipalities, and other allied health professionals. Establish equitable funding and compensation mechanisms that enable regulated, allied health professionals (e.g., NPs, pharmacists) and interprofessional teams to practice to their full scope, while expanding access to preventive, diagnostic, rehabilitative, and chronic disease management services delivered across care settings.

Develop health workforce retention and regional deployment strategies with a focus on underserved communities. • Build on Ontario’s ‘As of Right’ licensing reforms by extending streamlined registration pathways to additional regulated health professions where appropriate. • Strengthen regional recruitment and retention programs, including the Ontario Learn and Stay Grant, Northern and Rural Recruitment and Retention Initiative, and locum supports.

Invest in virtual care, remote monitoring, and broadband infrastructure for rural, remote, northern, and Indigenous communities.

Support evaluation and scaling of proven community-based care models through coordinated research partnerships.

Enhance and invest in health workforce data collection to improve workforce planning, identify service and staffing gaps, support recruitment and retention strategies, and evaluate the effectiveness of innovative care delivery models.

Health Equity and Access to Care

Advancing Future-Ready Health Care in Ontario

Conclusion Ontario has shown a willingness to embrace health care innovation through investments in primary care expansion, workforce modernization, digital transformation, and new models of care delivery. While these reforms have created momentum, the system must keep evolving, both to improve outcomes and enhance its sustainability amidst economic pressures and an aging population. By investing in integrated data systems, value-based procurement, and equitable access to care, Ontario can transform health care delivery to support healthier populations, stronger communities, increased productivity, and a more competitive economy. As Canada’s largest province, Ontario has the scale, expertise, and influence to become an international model of success for future-ready health care. The decisions made today will not only determine how we respond to tomorrow’s challenges; they will also define health care excellence for decades to come.

Conclusion

Advancing Future-Ready Health Care in Ontario

Endnotes 1

https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1410002201

https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=3610043403

https://ontariohealth.ca/system/reporting/performance/time-spent-in-emergency-departments

https://www.infoway-inforoute.ca/en/component/edocman/6443-quantifying-the-benefits-of-digital-health-interoperability/view-document?Itemid=103

https://www.toronto.ca/legdocs/mmis/2020/hl/bgrd/backgroundfile-159098.pdf

https://static1.squarespace.com/static/64a5d9ad28fcd800b6d17d4a/t/6716cf23a1822100f5c8b425/1729548068370/Adult+Vaccine+Alliance+-+The+Unmet+Value+of+Vaccines+in+Canada+-+Oct+2024+-+English.pdf 6

7 https://static1.squarespace.com/static/64a5d9ad28fcd800b6d17d4a/t/6716cf23a1822100f5c8b425/1729548068370/Adult+Vaccine+Alliance+-+The+Unmet+Value+of+Vaccines+in+Canada+-+Oct+2024+-+English.pdf 8

https://www.iqvia.com/-/media/iqvia/pdfs/canada/publications/time-to-vaccine-access-en.pdf

https://www.canada.ca/en/public-health/services/immunization-vaccine-priorities/national-immunization-strategy.html

https://www.kainos.com/insights/success-stories/nova-scotia-health-improves-access-to-health care-with-data-and-digital-innovation

https://www.cihi.ca/en/taking-the-pulse-a-snapshot-of-canadian-health-care-2023/better-access-to-electronic-health

https://www150.statcan.gc.ca/n1/daily-quotidien/260330/dq260330b-eng.htm

https://www.canada.ca/en/health-canada/news/2024/06/the-government-of-canada-introduces-the-connected-care-for-canadians-act-improving-patients-safety-and-access-to-their-health-information.html

https://www.cmaj.ca/content/198/6/E224

https://finance.yahoo.com/news/global-interoperability-gaps-revealed-2025-134500077.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_ sig=AQAAAKZNlD6rd9d8wJAFNzgBkBZttn-uyOHY4_9JmIJE1XHX8Fgj1up7ZNo6mWmCrMgeTVFT-Q2Fb4teLAKOuTnwq7qFlaaSAG23DicZrvzt5ufS5vfxs-e1HkFJijbnFdJD4fPpo9J08Jm4CQ4jSNyC2mPoSeHjd1VNnJAvWOi9ta0J 15

https://blackbookmarketresearch.com/2026-black-book-state-of-global-health care-technology

https://www.ontario.ca/files/2025-09/tbs-annual-report-and-consolidated-financial-statements-2024-2025-en-2025-09-26.pdf

https://www.signal49.ca/in-fact/the-value-of-shingles-vaccination_may2026/

https://www.ontario.ca/files/2025-09/moh-2024-cmoh-annual-report-en-2025-09-03.pdf

https://www.adultvaccinealliance.ca/value-of-vaccines-study

https://occ.ca/wp-content/uploads/OCC-Power-of-the-Purchase-Order.pdf

https://www.mckinsey.com/~/media/McKinsey/Industries/Pharmaceuticals%20and%20Medical%20Products/Our%20Insights/The%20European%20public%20procurement%20opportunity%20Delivering%20value%20in%20medtech/The-European-public-procurement-opportunity-Delivering-value-in-medtech-final.pdf 22

23 https://www.canada.ca/en/public-health/services/publications/vaccines-immunization/national-advisory-committee-immunization-recommendations-public-health-programs-use-pneumococcal-vaccines-children-including-use-15-valent-20-valent-conjugate-vaccines.html 24

https://ki.se/media/95244/download

https://www.iqvia.com/locations/canada/library/publications/time-to-public-vaccine-access-in-canada

https://occ.ca/wp-content/uploads/OCC-Power-of-the-Purchase-Order.pdf

https://www.auditor.on.ca/en/content/annualreports/arreports/en24/pa_infrastructureON_en24.pdf

https://pmc.ncbi.nlm.nih.gov/articles/PMC6944603/

https://fao-on.org/en/report/estimates-2026-health/

Endnotes

Advancing Future-Ready Health Care in Ontario

https://occ.ca/interactive-oer2026/

https://occ.ca/our-publications/buy-ontario-act-submission/

https://www.ontario.ca/page/expenditure-estimates-ministry-health-2026-2027#section-5

https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-8-herpes-zoster-(shingles)-vaccine.html

https://www.signal49.ca/product/the-value-of-shingles-vaccination_may2026/

https://www.ontario.ca/page/ontarios-primary-care-action-plan-january-2025

Ontario’s Primary Care Action Plan, January 2025 | ontario.ca

68094bbd14292655b047b9b7_SGFP-Implementing Team via PCNs-Nov2024 (2).pdf

Media - NPAO

Pilot Project to Increase Access to Primary Health Care Through Nurse Practitioners - News Releases

Ontario Expanding Scope of Practice for Pharmacists and Other Health Professionals | Ontario Newsroom ; Ontario Expanding Scope of Practice for Pharmacists and Other Health Professionals | Ontario Newsroom; From Classroom to Community: How OPA and UW Are Preparing Pharmacists for Minor Ailments Care | Ontario Pharmacists Association 40

2026-03-31-RPh-Prescribing-Authority-for-Vaccines_Final.pdf

Pharmacists’ Expansion of Scope | Dialogue - CPSO’s Publication for Ontario Doctors; Framework for Implementation of Expanded Scope of Practice for Pharmacists; Scope of Practice Immunization_EN ; Scope of Practice - English 43

https://www.cihi.ca/en/topics/rural-health-care-in-canada

https://www.cihi.ca/en/travel-burden-for-hospital-care-in-canada; What is travel burden and how does it vary throughout Canada? | CIHI

https://televu.tech/

https://www.cihi.ca/en/the-state-of-the-health-workforce-in-canada-2024

https://www.saskatchewan.ca/government/news-and-media/2024/may/23/saskatchewan-announces-funding-for-first-of-its-kind-virtual-health-hub

https://www.cpha.ca/health-inequities#:~:text=Health%20inequities%20in%20Canada%20disproportionately%20affect%20marginalized%20groups%2C,life%20expectancy%2C%20 and%20increased%20rates%20of%20chronic%20disease.

https://www.ontario.ca/page/ontario-population-projections

https://www.pharmacists.ca/advocacy/scope-of-practice/

https://fao-on.org/en/communication/mr-health-2023/

https://www.oma.org/advocacy/physician-burnout/; https://rnao.ca/media/10282/download

https://www.cihi.ca/en/the-state-of-the-health-workforce-in-canada-2024 / https://healthworkforce.ca/wp-content/uploads/2025/01/HWC-State-of-Health-Workforce-Modelling-andForecasting-in-Canada_2024.pdf 54

Endnotes

Advancing Future-Ready Health Care in Ontario

Primary Authors: Neeky Dalir, Senior Policy Analyst, Ontario Chamber of Commerce Sharan Khela, Policy Analyst, Ontario Chamber of Commerce Design: Wan-Chiao Hsu, Senior Graphic Designer, Ontario Chamber of Commerce The Indispensable Partner of Business | occ.ca

Lead Partner Advancing Future-Ready Health Care in Ontario

Supporting Partner Advancing Future-Ready Health Care in Ontario