Industry committee  One of the things we see is that when CADTH or OTAC comes out with a positive recommendation on a new technology, it's well done. The review is completed very effectively. But what happens is it gets into the system and the system doesn't adopt the product because of cost constraints within the hospital.

Industry committee  Do you want to go into it a little bit more specifically?

Industry committee  We absolutely agree with the idea that a quality audit must be conducted to make sure that patient safety and quality standards are being met. The auditing process has to be efficient, and make sure it exposes what needs to be exposed, and that any issues are dealt with. In this particular case, what we're talking about is two different pathways within Health Canada, or whatever, in terms of the audits.

Industry committee  I'll start on it, then Diana will finish. What we found with Health Canada, with everything that was identified when the International Consortium of Investigative Journalists was looking at this, is that 80% of the work that the consortium was indicating needed to be done, Health Canada had already started.

Industry committee  Thank you so much. Diana and I both represent MEDEC, the trade association representing the medical technology industry in Canada, which includes surgical equipment, pacemakers, in vitro diagnostic blood tests and medical imagining equipment; that's the breadth of our membership.

Health committee  I'll make a really simplistic answer for it in the hospital environment. As I was saying during my presentation, when you take a look at a department budget versus a cross-hospital or cross-system budget, you see that it doesn't tend to get looked at in that hospital as the total benefit of outcomes.

Health committee  Often that's true.

Health committee  The other thing is if you have something that reduces the hospital stay, the mindset is that stay is just going to be replaced by another patient coming in, so you're not going to save money. It really is a system look at it. If you have enough products you utilize that reduce the stay, the stays would actually reduce.

Health committee  If you look at the large imaging companies, they tend to be in clusters with other areas of expertise. Even the companies GE and Philips are broadly into electronics in a big way.

Health committee  It's mostly provincial where that needs to come from, because that's where the delivery of the health care system happens. What you have to do is develop a process, like MaRS EXCITE, that identifies devices that are disruptive, that are really adding value. When you go though the process of doing that, to pick those particular products....

Health committee  That's something that IHE is trying to do. We've actually sat with CADTH and talked to them. We have regular sessions. CADTH's expertise is in pharmaceuticals, in terms of a lot of work they've been doing, versus the work that's being done by OHTAC and by AACHT. At IHE, which is Alberta-based, they're actually trying to pull the whole country together, because it's about the methodology that you see with OHTAC and with AACHT.

Health committee  To build on that, there are two parts to the regulations I was talking about. One of them is Health Canada approval. Health Canada is a world-renowned organization in terms of the quality of the work they do, but they are strapped at Health Canada and things end up taking longer and the approval time is relatively unknown.

Health committee  What we have to do is make the process a little more simplistic. We have to build a provision within it for the adoption of new technology.

Health committee  Absolutely.

Health committee  Sure. I visited with a company, and I won't give you the name, but they developed an incredibly innovative product that allows for hearing testing in infants. They can actually tell the child's level of hearing. The FDA.... It sells everywhere else in the world. Because of the system in Canada of paying for it, paying the physician to use the test, paying the health care professional, the whole system will not allow this product to be adopted.