We could be on the precipice of a significant transformation of healthcare that will deeply affect health administrators, established companies and start-ups in the sector, plus patients and healthcare providers.

But Zayna Khayat, Rotman School of Management adjunct professor of health sector strategy, admits changes that could — and should — happen, may come about very slowly in Canada, or possibly not at all.

“Healthcare as delivered in Canada largely hasn't changed in decades. But, in my view it will, or at least has the potential, to be virtually unrecognizable over the next five to 10 years,” she says. “The legacy business model no longer serves.”

As an applied health futurist, Khayat has insights into whether Canada’s universal healthcare system will stay the course, pivot or transform. The stakes are high as millions of people do not have a family doctor, emergency departments are clogged and many keep closing and we have lengthy wait-lists for specialists, surgeries, imaging and long-term care homes.

Here are some of the forces at play that are testing the status quo, and could shape the future.

Force #1: Demographics

In 2025, Canada enters the fairly small cohort of super-aged societies — the United Nations labels nations this when more than 20 per cent of the population is over 65. “That shifts the demand profile for healthcare,” says Khayat. Thanks to medical innovations, people are living longer, but longevity care is expensive and complex; in fact, older adults make up about 75 per cent of healthcare usage today. With fewer working-age people to finance the healthcare services through taxation, it’s a situation that’s tricky to afford in the current way healthcare is designed, delivered and paid for.

Force #2: Labour structure

Our healthcare delivery system is structured around skilled labour. Doctors, nurses, midwives and other highly trained professionals are central to every diagnosis, treatment plan, procedure and follow-up. “It’s a labour structure that has yet to be touched. We don’t have commensurate growth in funds from taxation to supply the labour needed to meet double-digit growth in demand,” says Khayat. Doctors and nurses, in particular, are in short supply — not just here but around the world — it takes years to train them and they cost a lot. “When you add this to demographic changes, you know the supply-demand gap is only going to widen if we do not tackle the labour structure of healthcare.”

Force #3: Perpetual shocks and dislocations

Pandemics, outbreaks, floods, fires and cybercrimes keep happening. “These kinds of events used to be once in decades occurrences. But now they’re happening again and again.” Perpetual crises further tax an already compromised health system that is built on largely static infrastructure, further stressing healthcare providers and challenging administrators to respond with limited resources and flexibility. This is in part why more conversations are happening around decarbonizing healthcare, for instance, says Khayat.

Force #4: Technology

“There has never been this rate of development of tech in healthcare,” says Khayat. Artificial intelligence (AI) will lead. She’s fascinated with autonomous agents, which can do human tasks such as making appointments, and helping clinicians read scans or diagnose patients better or faster. There’s an emerging startup ecosystem developing agents that can add efficiency across multiple parallel points in a care pathway, often at a low cost. AI can also fuel algorithms to process data for true evidence-based medicine and treatment breakthroughs. Consumer-facing AI tools can inform and empower patients, contributing to a democratization of the care process. Khayat also sees virtual reality able to transform clinical training, surgery and managing treatment for neuro-cognitive conditions like pain, anxiety and dementia.

Force #5: Treatment innovations

Drug breakthroughs and a better understanding of many diseases have already changed care, and that’s going to continue. “The emerging science for treating previously untreatable diseases is incredible,” she says. Khayat observes that the new GLP-1 agonists such as Ozempic are transforming our approach to treating obesity and metabolic diseases, and it’s just the beginning. “It’s going to blow our minds in the next five to 10 years,” she says of the impact of these drugs, especially since obesity is a major contributor to chronic disease. She expects better understanding of mental health will be next. “The science of mental wellness is advancing in new ways; we will have a new set of tools to diagnose objectively, and treat more specifically to each person’s unique context.” She also sees hope for rare diseases, as science evolves, and it becomes a lot more affordable to understand and develop treatments that target devastating conditions that impact the relative few.

Will the system bend to these powerful forces or stay the course? Khayat hopes for the former. “The legacy business model no longer serves. We have two options in Canada – go out of business or rebase the business model,” she says.

Khayat thinks that organizations that adopt a leadership or first-to-follow philosophy may thrive best in the coming years, becoming known for innovation and attracting talent. That’s important, as tech might be able to take over some tasks, but humans will always be king in this hands-on sector. Many who work in healthcare do so to make a difference, and will want to be associated with organizations that take risks to do things better.

“If you are obsessed with protecting the past and being what I call a preservative in Canadian healthcare, it could be rocky,” she says. “If you’re in it for making things better for patients, clinicians and the system, this is the best time to lead innovation in the sector.”

Are you new here? For more research-backed career guidance and development tips consider subscribing to our bi-weekly newsletter.