Health Committee on April 25th, 2013

[The Chair, Conservative, Joy Smith]

Thank you.

[Lise St-Denis, Liberal, Saint-Maurice—Champlain, QC]

Do I have any time left?

[The Chair, Conservative, Joy Smith]

No.

[Lise St-Denis, Liberal, Saint-Maurice—Champlain, QC]

There's no more time. Okay.

[The Chair, Conservative, Joy Smith]

I would certainly let you know. Thank you.

We will now go on to Mr. Wilks and Mr. Lobb. I understand they're sharing their time, beginning with Mr. Wilks.

[David Wilks, Conservative, Kootenay—Columbia, BC]

Thank you.

Madam Chair, this will probably be more of a statement than anything else.

It's an interesting challenge for the medical profession when it comes to end of life. You get to the point when you can throw technology at it all you want. The reality is that you can have an artificial ventilator and keep someone going for a long time, with them just lying there.

To me, quality of life means a lot more than length of life. As a former police officer, I know that there were a few times when we had DNRs. That seems to be a simplistic way of doing something without using any technological innovation. Do not resuscitate: pretty simple. It's very difficult for the family to accept, but at least it gives a clear indication to the medical profession.

I'm wondering, on the idea of technological innovation, is there a way that we could create an electronic database that shows deterioration in the life of a human being?

Just use me as an example. It gets to a point where I'm 87 years old. I've shown that I have degenerative heart disease. We've tried 15 different things. There's just really no sense in...and I say I don't want it; please let me die with some dignity.

I don't know. What are your thoughts on that, Dr. Birtwhistle?

[Dr. Richard Birtwhistle]

Thank you, Madam Chair.

I absolutely agree that we could have some sort of electronic ability to capture that.

Again, an advance care plan, structured right, in the right way, may actually capture some of that information—a record of people who've had multiple treatments, for whom really there are no more treatments, and for whom any further attempts at life-sustaining or life-lengthening therapies are not worthwhile.

I think you could do that in an electronic way.

[The Chair, Conservative, Joy Smith]

Mr. Lobb.

[Ben Lobb, Conservative, Huron—Bruce, ON]

Thank you, Madam Chair.

My first question is for you, Dr. Quint. You have quite a nice outline here with regard to the number of different companies that you've founded and been able to grow—and then, probably fortunately for you, been able to sell.

We're looking at technological innovation, and really we're looking at using this to improve patient outcomes. I'm just wondering if you can give us an idea of why there aren't more people out there like you in Canada. What factor have you experienced in your career that maybe we're lacking in Canada with the entrepreneurial spirit?

[Dr. Saul Quint]

I think I'll take that as a compliment. Thank you.

I just get a thrill from trying to build something new. I think it takes passion, really, and I have a passion for preventative care. I have a passion for trying to do something early on and changing the course of somebody's life before disease hits.

I've been practising medicine for 28 years, and I've seen a lot of ill people. We've spoken a lot about end of life and the elderly and chronic disease. If you were to get a chronic disease and just die, without having that poor quality of life between the time you developed the disease and you died, then there'd be no need for this.

There are very many entrepreneurs, and I think you'd be surprised at how much competition we have in Canada. What we're doing in Canada is in its infancy. In the United States, it literally is a multibillion-dollar industry. As I said, 90% of corporations offer these programs. Probably 2% or 3% do in Canada.

I think it's a harder challenge here because of the government-funded health care system, if you will, and the reliance of employers on government to take care of it all.

INTERxVENT Canada is a MaRS-sponsored company. We've presented at MaRS. We've presented at the global health conference. There are many entrepreneurs working with us, partnering with us, talking about building in incentives, challenges, social media. We're exploring lots of different partnerships as we speak.

So I think Canada is growing in the world of proving itself on the stage of health care innovation.

[Ben Lobb, Conservative, Huron—Bruce, ON]

Okay. I probably have time for a quick last question.

What has your experience with patents and trademarks been like through the years, and have you had to defend those in courts in different countries? Has that been a difficult issue for you?

[Dr. Saul Quint]

We haven't really defended any patents in Canada, because our U.S. colleagues were fortunate enough to get, or apply for, patents in the United States.

In our world, it's not as much a patent issue as it is an evidence-based intellectual property issue. For instance, we have a way of stratifying people into low, moderate, or high risk that is built into our programs. No one knows what the algorithms are, but the programs put people into the right brackets. This is why corporations like Chevron in the United States use INTERxVENT. We offer programs to their employees in twelve countries and six languages. It's just because they're better programs. We don't really have patents.

[The Chair, Conservative, Joy Smith]

Thank you so very much.

Now we are going into our five-minute rounds. There have been absolutely amazing questions and amazing answers. Thank you, committee, for doing that.

We will begin with Dr. Morin.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you very much.

My first question is for Mr. Birtwhistle.

In your presentation and in replying to questions, you mentioned several low-tech things we could use to improve the health of our seniors. You mentioned, for example, advanced care planning and patient portals. Are there any other low-tech solutions you would like to share with us that we could put in the final report as good examples to adopt and to share throughout Canada?

[Dr. Richard Birtwhistle]

Thank you. That's a challenging question.

I'm tempted to say, "Just have people talk to each other", but that's probably not something you want to put in your report. I don't have any other examples I could provide you with at this moment.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Okay.

In your presentation you also talked about sharing best practices between federal and provincial governments. Do you have any tips respecting jurisdictions on how we can improve our intergovernmental sharing?

[Dr. Richard Birtwhistle]

I'm hoping that our Technology Evaluation in the Elderly Network will actually be able to provide some of those opportunities around developing best practices as part of our knowledge translation activities.

I hope that as we go forward in doing this, both as research and as a knowledge translation activity, we will be able to share it widely, at both a federal and a jurisdictional level. How that can happen, we'll leave up to you.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you very much.

My next question is for Dr. Quint.

In you presentation you talk about preventive care, cost-effective care, and evidence-based care, and you also mention several virtual programs.

It was a very good presentation, but what is the next step? How can the federal government really help the different industries related to health care or the different health care systems in the provincial governments to adopt preventive care, cost-effective care, and evidence-based care?

[Dr. Saul Quint]

Thank you. That's a very good question.

It's been our experience that when we've gone to present to workplace HR departments, and to CFOs of different large corporations, they all ask for the same thing. They ask for Canadian-centric proof that there will be improved outcomes, improved productivity, decreased absenteeism, and presenteeism.

Where government could greatly help is, number one, to do pilots with products like ours, not necessarily ours, but with health risk assessments, with evidence-based programs that are concordant with C-CHANGE and other Canadian guidelines. Offer those programs, do research on them, and prove that the ROI in Canada is no different to that proven in many other countries and published in major peer review journals for independent research.

The second thing that I think is probably the killer application, if you will, is to offer corporations tax incentives for offering such programs to their employees. As I mentioned, Chapman looked at half a million people and 62 different studies, and there were huge benefits in outcomes, drops in medication usage, compliance in those who needed medication, and improvements in all the other factors such as blood pressure, satisfaction scores, etc.

Given that government, and not the employer, benefits from the direct health care expenditures, if they were to transmit some of those savings back to the employer, I think that would be the catalyst that would get some of the large employers in Canada to start adopting these formal workplace wellness programs, much as they are across the United States and the rest of the western world.

[The Chair, Conservative, Joy Smith]

Thank you very much, Dr. Quint, for your insightful comments.

We want to welcome Dr. Ling to the committee.

We've been awaiting your arrival and are very grateful that you're able to join us, Dr. Ling. The other two doctors have given their presentations and we've gone through the first round. We're into the second round of questions right now.

Can you hear me, Dr. Ling? There's someone there to give you assistance.

[Dr. Victor Ling, President and Scientific Director, Terry Fox Cancer Research Institute]

Yes. That's perfect.

Thank you.

[The Chair, Conservative, Joy Smith]

Thank you so much.

Dr. Ling, as I've said, we've had some questions. We've had other presentations.

At 5:15 the bells will ring and I will have to bring our committee to a close. If you would be so kind, I'd very much appreciate it if you could take 10 minutes now to give your presentation. Could you do that?

[Dr. Victor Ling]

Yes, certainly.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Ling.

[Dr. Victor Ling]

Thank you. It's my pleasure to be here.

I really appreciate everybody being here. I think everybody has a copy of our briefing. Am I correct?