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. People tend to look at one or two elements, but it's really a system problem. Even though we get a great recommendation, and there are several examples of it coming out of OTAC, those products get minimal adoption and minimal uptake.
One of the things we're looking at when we talk to ISED and other departments in the government is a role for the federal government to champion what's called “value-based health care” and to actually show examples and to actually help the community. The change management at the hospital level comes down to cash flow. When one budget exists within a hospital or a department in a hospital and the other budget is outside the hospital, the benefit of a truly valuable solution from a cost perspective is not seen. It will be from a patient perspective.
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