From the Editors

Abstract

N ew ways and means of planning, delivering and improving healthcare are in place and in play across Canada, and novel opportunities for change beckon. At the same time, long-standing systemic problems are not yet dislodged -despite many works-in-progress on discrete fronts -and troubling disparities persist. The articles in this issue of Healthcare Quarterly speak to all of these realities.Readers learn how healthcare organizations are exploring and using advanced analytics and artificial intelligence (AI) to improve care; how health researchers are widening their circles to bring in and benefit from the experience and expertise of patients and caregivers; and how performance and accountability in cancer care progressed over the years.Red flags appear as well: Kathy Lee and her colleagues (2020) track a continuing upward trend in spending increases on public drug programs ($34.3 billion forecast for 2019, a 2.7% increase since 2018); the reporting rate of adverse drug reactions (ADRs) has increased four-fold over nine years; the confounding challenge of prolonged hospital stays exerts multiple ill effects; and ICES describes daunting disparities in health status and healthcare access between the general population and people who experience imprisonment in Ontario (Kouyoumdjian et al. 2020).Healthcare operates within an environment of finite resources and growing demand for more and new services, which often leads to trade-offs and recalibration. What principles should guide decision making and determine whether today's imperatives should be augmented, replaced, retained, reweighted or removed? What characteristics and capabilities must healthcare systems possess to meet the needs of Canadians in the second decade of the 21st century?Given the multifaceted and complex entity that is Canadian healthcare, the way forward will require concerted and coordinated efforts, targeted resources and continued stewardship, along with an infusion of skills and knowledge, more time and tenacity and the elixir of courage and vision.