Rise Up – A Call to Government: Lead with Courage, Not Caution

Part 1 of the Rise Up Series: Practical Paths to Healthcare Transformation

By Darren Larsen, MD | DarrenLarsen.com

Governments across Canada are sitting on a historic opportunity. Billions of dollars are flowing into healthcare. Public frustration with the system is at an all-time high. Technology that could transform care delivery exists today. And yet, progress remains painfully slow.

The question isn’t whether transformation is possible. It’s whether our governments have the courage to lead it.

Stop Funding Pilots That Go Nowhere

We have a chronic addiction to pilot projects in Canadian healthcare. Fund a small initiative. Evaluate it for three years. Publish a report. Then watch it quietly disappear when the funding ends. Meanwhile, the problems it was meant to solve persist or are made worse by the fact that their support has vanished.

Here’s a radical idea: if something works, scale it. Fast. The evidence on AI scribes, for instance, is clear. Physicians save hours weekly. Documentation quality improves. Burnout decreases. Yet we’re still  just piloting these tools in pockets across the country. Every month we delay is another month of preventable physician exhaustion.  Get them into the hand of doctors. These are not cost centres, they are system tools for quality and efficiency. Fund them.

Governments should establish rapid evaluation frameworks – sixty to ninety days, not three years – with clear criteria for scaling. If a technology meets the bar, fund provincial rollout immediately. Accept that perfection is the enemy of progress.

Mandate Interoperability – With Teeth

Interoperability has been a stated priority for two decades. We’re still waiting. The reason is simple: there’s no consequence for vendors who don’t play well with others, and no incentive strong enough to force change.

It’s time for mandates with teeth. If an EMR vendor wants to operate in a provincial market, they must meet interoperability standards – real ones, not checkbox compliance. Data must flow. Period. Tie vendor certification and payment to demonstrated interoperability. Ensure certification if functional, not just technical.  Watch how quickly the technical barriers disappear.

Invest in Workflow, Not Just Technology

Government procurement typically focuses on features and functions. Can the system do X? Does it integrate with Y? These are the wrong questions. The right question is: does this make a clinician’s day better?

Every technology investment should include workflow impact assessment. Bring practicing clinicians – not administrators, not consultants, but people seeing patients daily – into procurement decisions. Fund implementation support, not just software licenses. A brilliant tool that nobody uses because it adds fifteen clicks to every encounter is worse than no tool at all.

Look at your procurement processes. Do they exclude innovators? Do they favour large national vendors that are too big to pivot?  Are they fair by the standards of those who need them most? Is the balance of caution and risk aversion vs speed and agility effective or ineffective?  These are tough questions that demand introspection and bold answers.

Create Space for Honest Brokers

Transformation requires trust. Clinicians don’t trust vendors who are selling them something. We have too many “bright shiny things”.  We’re skeptical of governments with political agendas that come before the needs of patient and providers. We need intermediaries – honest brokers who understand clinical reality, speak the language of technology, and have no financial stake in the outcome.

These exist. You fund some of them now. Expand their mandate. Protect their independence. Give them seats at policy tables. When physicians trust the messenger, adoption follows.

Learn how to get the most out of private industry and how to partner, like in all effective relationships.

The Bottom Line

Canadian governments have the resources to transform healthcare. What’s been missing is the will to move fast, accept imperfection, and hold stakeholders accountable. This is a policy play, supported by appropriate regulation and legislation.  Government exists to do this.  The technology exists and is on the stree.

The need is urgent. The public is watching.