pdf Value-Based Procurement: Changing Healthcare Conversation in Canada (.pdf)

New approach considers best value, not just lowest price, enhancing focus on patient outcomes.



In Canada’s single-payer health system, buying medical products or services has traditionally focused primarily on lowest price.

But a 2016 survey across 23 hospitals making up the Council of Academic Hospitals of Ontario revealed that a singular focus on price had a hidden cost: 76% of respondents identified policies, directives, and procurement rules as major barriers to adopting innovation within their organizations.1


Ontario’s Southlake Regional Health Centre recognized the relationship between procurement and innovation. Southlake’s cardiac care team wanted a new process — one that would not only achieve value for money but would also enable the adoption of innovation into its heart program.

Following new recommendations from the Ontario Health Innovation Council and with permission and funding from the Ontario Ministry of Government and Consumer Services, Southlake experimented with a new approach — innovative procurement.

Rather than focusing solely on price, Southlake considered:

  • The value of a product or service beyond price
  • Patient outcomes, such as faster recovery time or reduced risk of rehospitalization
  • Device longevity
  • The most appropriate product or service for each individual patient

To improve operational efficiency and streamline medical procedures, Southlake engaged in “competitive dialogue” with Medtronic Integrated Health Solutions and others. Dr. Zaev Wulffhart, physician leader of the Regional Cardiac Care Program at Southlake, supports partnerships with healthcare companies. “Our relationships with the industry have to change,” he said. “They all have a commitment to a better quality of life for their patients, just as we do.”


Bill Charnetski

Bill Charnetski

Chief health innovation strategist for Ontario discusses value-based procurement.

The results of the new processes are encouraging. Because of the anticipating savings from operational improvements, Southlake could reallocate funds to finance the latest in treatment options. Better access to the most advanced medical technology may, in turn, lead to better patient outcomes.

“This whole process not only benefits our institution and the Ministry in terms of funding, but it also benefits the patients,” said Dr. Wulffhart. “Giving our patients the best advantage is the most significant thing we can achieve.”

“I think if any of us stood in front of a white board and redesigned the delivery of healthcare in Ontario, we would focus on competitive dialogue and innovative procurement,” said Bill Charnetski, chief health innovation strategist for Ontario. “These have the potential — if used across the system — to enhance the focus on patient outcomes and come to the appropriate method of getting to those outcomes at the right cost, measured across the patient journey through the system.”

Additional Device Information

An implantable pacemaker system relieves symptoms of heart rhythm disturbances. They do this by restoring normal heart rates. A normal heart rate provides your body with the proper amount of blood circulation. The pacemaker system is intended for patients who need rate-adaptive pacing or chronic pacing.

Risks associated with the Micra Transcatheter Pacing System (Micra) implant include, but are not limited to, complications at the surgical site, injury to the heart where the device is attached such as pericardial effusion (fluid around the heart) and/or sensitivity to the device material, failure to deliver therapy when it is needed, or receiving extra therapy when it is not needed. After receiving a Micra, you will have limitations with certain magnetic and electromagnetic radiation, electric or gas-powered appliances and tools in which you are allowed to be in contact.

Once implanted, removal of the Micra after it has become encapsulated may be difficult because of the development of fibrotic tissue. At such time, your physician has the option of permanently turning off the Micra, and leaving it in the heart.

This treatment is prescribed by your physician. This treatment is not for everyone. Please talk to your doctor to see if it is right for you. Your physician should discuss all potential benefits and risks with you. Although many patients benefit from the use of this treatment, results may vary. For further information, please call the Medtronic US toll-free number at 1-800-551-5544 (7:00 a.m. to 6:00 p.m., Monday–Friday, Central Time) or see the Medtronic website at www.medtronic.com or Medtronic Canada toll-free number at 1-888-660-4616 (9:00 a.m. to 8:00 p.m., Monday-Friday).


http://caho-hospitals.com/wp-content/uploads/2018/06/Art-of-the-Possible_Quick-Reference-Guide-to-Ontario-BPS-Procurement- Myths.pdf