The respiratory virus season is upon us, and those working in the emergency departments of Ontario’s hospitals understand the many challenges of delivering timely access to care when demand is at its peak. As of November 2023, the average length of stay in emergency departments (for patients waiting to be admitted to hospitals) across the province was the highest it has been in the last 12 months. 

Unfortunately, this reflects a historic seasonal pattern of increased demand for care that is being exacerbated by inadequate capacity across the health care system, and rampant respiratory illnesses circulating across Ontario during the winter months. As of January 13, there were 1,274 COVID-19 patients, 445 flu patients and 158 RSV patients receiving care at Ontario hospitals.

 Wait times at emergency departments is a critical issue for both Ontario hospitals and patients requiring immediate care. This long-term, systemic problem is largely a consequence of staffing constraints, high numbers of patients in hospitals awaiting discharge to another, more appropriate setting or alternate level of care (ALC), and low acute care bed capacity in Ontario compared to other jurisdictions. 

While Ontario’s hospitals are working closely with the Government of Ontario in increasing the number of health care workers and professionals, they are also continuing to provide care to increasing numbers of patients waiting in hospitals for other forms of care that are more appropriate and suitable to their needs. 

For example, as of late December, there were more than 4,200 ALC patients in acute care beds, with almost 40 per cent waiting for a long-term care bed. In this environment, it becomes very difficult for health care workers to admit patients in a timely manner – leading to longer-than-usual wait times and patients waiting in spaces that are not always conducive to optimal care. 

Growing wait times and high levels of hospital occupancy are also directly related to Ontario’s very rapidly changing population. A huge spike in population growth in recent years, and a growing population of elderly people with complex health needs is increasing demand for health services, alongside an increase in the acuity levels of patients presenting in emergency departments. 

In the next five years, Ontario will grow by 1.5 million under medium growth rates and by over 2 million under high growth rates, with seniors as the fastest growing age category. These challenges aren’t exclusive to Ontario. In fact, health systems all over the world are facing the same challenges. However, there is a growing recognition that the status quo is no longer tenable, and that technology and innovation can be leveraged to help prepare for the future health care needs of the province. 

There has been significant growth in the hospital sector workforce these past several years and Ontario has dramatically improved its health workforce recruitment and retention measures. But given the expected exponential growth in patient care demand, it will not be possible to simply hire more health care workers to address the expected long-term capacity challenges. 

In the face of these anticipated capacity limitations and challenges, innovation and technology also have enormous potential to reimagine and redesign health-based services in Ontario to meet the future demands that will be placed on it. At this key juncture, there’s a real appetite and opportunity ahead of us to drive change and innovate to meet the needs of the people of Ontario into the future. While short-term financial stability will be needed first and foremost by hospitals, we must also begin thinking about the delivery of care in new and innovative ways. 

Technology and innovation offer great potential for creating capacity and capability in the health system. Ontario is home to world-class researchers and experts in the application of innovations like artificial intelligence. The untapped potential of this research ecosystem should be prioritized and scaled and spread across the hospital system. While lengthy emergency department wait times have unfortunately become a historic component of health care delivery in Ontario’s winter months, they are a glaring reminder of the need for significant systematic change and the vital need to rethink the way that health care is delivered – now and for the years to come.