Health committee  Yes. I mentioned this at the end. Outcomes collection in health care has been largely the hobby of academic clinicians. We need to turn it into something we do as a matter of course and to supply the systems that collect that data, because we will then have one of the best systems in the world to bring technologies in, begin the health technology assessment process, and look at long-term effects.

Health committee  That's technology, but not the process. We don't have the process issues.

Health committee  I could comment as it's a specific area of my expertise, but the issue there I think was related to people becoming comfortable with an alternative approach to using these mobile bunkers. I would have thought that it should have been relatively straightforward to get those cleared and approved through the regulatory agencies that govern the shielding-related issues.

Health committee  I'd like to talk on that, too, madam. I'll talk about what you asked me about. In my case, I was a physicist who worked in a hospital. Radiation delivery systems need to be managed by physicists. The technology we developed was really related to a direct observation within the clinic of a problem, and detailed insight into what was feasible.

Health committee  They would use them for what the hospital already suffers from, which is underfunding on a bunch of other fronts: lack of capital support, new technologies they cannot afford, or replacing failing systems. The budget issues in hospitals are always a problem.

Health committee  If I could add to that, many of the companies we work with will submit to the FDA, and then because of the way that Health Canada requires submissions, they'll submit those later. Even if we co-create a technology with them, we're the last ones to be able to use it on humans, even though we co-created that.

Health committee  Yes. Ten years ago the idea of putting your computer in your suitcase would have been absurd, but clearly you could put 50 iPads in your suitcase now. Technological innovation is constant. This is very important, there's science and discovery and then there's innovation in health care.

Health committee  It's about chicken and egg. Quite frankly, it's a lot more egg than chicken right now. A lot of technology goes in and is not evaluated, but we have a culture developing on the HTA front right now, a key development that will bridle that innovation appropriately.

Health committee  The model I would suggest is endorsing the hospitals to create innovation teams of some sort. They would, for example, bring forward a proposal that they would see savings, let's say, of 10%, in a certain set of procedures. They would then communicate that to an office that says, “We have this plan.

Health committee  We have to look at taking the existing investment in health care, realizing that it's not just a service, it's actually the way we figure out what will work for our population, and fund that activity to be a dynamic learning system that pulls technological or pharmaceutical innovations in, and we bolt health technology assessment onto that to confirm we have those delivered.

Health committee  We wrestle with this issue from the point of view of modelling. How do we model entrepreneur activity in these alternate environments? Within health care, there has been a lot of discussion, specifically on the intrapreneur, someone who's doing entrepreneur activities within an organization.

Health committee  I just want to be clear that I'm not supporting that we adopt the American health care system. When I worked there, it was very clear to me that if we were going to introduce a new technology to the hospital, I had to go to the board and demonstrate 15% return on that capital investment.

Health committee  Let's say, for example, we start to use the drug in a clinical context. We recognize that there are differences in response across a population of patients, only observed once it's in the clinical context. In the process, though, we're a research hospital, we're collecting extra tissue from those patients.

Health committee  Sure. I would say we've transitioned over the past ten years, or maybe a little bit longer back. We do have good links between the academic and health care environments. That's quite remarkable, in this country, and I'd say that's a strong asset. We no longer have the ivory tower fear that we had 10 years ago.

Health committee  It would be something that lets us exchange the value across the system. Then you would have innovators driving it and working together. This is the part we're missing. We're realizing that we need process. I won't speak to what Pascale will say—