Canada’s healthcare system is overtasked, and it has led to increased wait times for cardiovascular procedures in Canada, delaying essential surgeries.
132 days. This is the number of days some Canadians will wait to receive bypass surgery to treat blockages in the heart.1 This is within what is considered medically acceptable although on the high end of the 14-to-182-day Canadian benchmark for this procedure. It is one of a few procedures where the wait time is monitored and reported in Canada. Excessive wait times lead to increased risk of death and poor quality of life before and after interventions.2-4 Despite this, we continue to see that the capacity of our healthcare system does not meet the demand for other procedures such as heart valve replacements and wait times continue to climb.5
Canada’s Healthcare Capacity
Wait times serve as a useful indicator of healthcare system capacity and performance, and can be the catalyst for improvements. This was recognized by Canada’s First Ministers, who agreed to establish benchmarks for cardiovascular care and other procedures in 2004. This led to the development and implementation of new management strategies to address growing wait times. However, the gains achieved were short-lived as a result of shifting government priorities and forced delays or cancellations for procedures based on the COVID-19 pandemic. The need to revitalize and expand these efforts is essential.
Several steps must occur before a person is placed on a cardiovascular care waitlist. Ideally, Canadians should be assessed by a primary care provider – a family doctor or nurse practitioner – and referred for testing or further assessment by a specialist. Once referred, the person should be monitored, or in some cases, timely referred for an intervention. In reality, access to primary care remains difficult, diagnostic testing is limited, specialist referrals take too long, and specialized care centres responsible for cardiovascular procedures often lack capacity. These barriers at every step have resulted in deep inequities in access to life-saving interventions for patients across the country.
Areas of Improvement
Cardiovascular disease is the second leading cause of death in Canada.6 It has never been more critical to address timely diagnosis and treatment. For this to become a reality, all Canadians must have access to a primary care provider. Our healthcare systems must ensure information can be seamlessly and safely shared. Referral systems must be integrated and, when appropriate, centralized to shorten the referral window. And finally, access to eConsult and eVisit technologies by primary care providers across the country to facilitate timely advice and support from specialists should be developed. Many of these improvements expand on Bill C-72: An Act respecting the interoperability of health information technology and to prohibit data blocking by health information technology vendors and should be accelerated across the country.
Time is of the essence
Without these improvements and in addition to establishing a comprehensive picture of cardiovascular care capacity and wait times for procedures, we cannot fully address the inequities and barriers to care within Canada. Strengthening primary care access, enabling cardiovascular screening, early detection and preventative strategies, integrating health systems and patient-centered coordinated care, and expanding resources at every level of care must be prioritized. Cardiovascular specialists across the country stand ready to work with governments and partners to implement these solutions to ensure equitable access to high-quality care for all Canadians. These improvements simply cannot wait.
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