May 3, 2023 • 34 mins
Technology’s changed how health care is delivered. Now, it’s time for psychiatric care to catch up to improve access to quality mental health care for all Canadians.
In this episode, Diane speaks with Sue Paish, CEO Digital Health Supercluster, who brings an expert’s perspective on the power of technology for change.
DIGITAL grows Canadian businesses through the development, adoption, and deployment of Canadian-made technologies and by working with industry to develop a digitally skilled workforce to positively impact lives across our country. For more information, visit Digital Supercluster
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
And uh after about three or four hours of waiting,
we were taken into a room and I'll never forget this.
A very,
a very,
I'll call it a crusty older nurse.
She'd been around.
Uh,
she sits down,
she says I got good news and bad news and she says,
um the bad news is you have a mental illness.
And if you had cancer and she worked in the cancer clinic for eight years and she said,
(00:23):
if you had cancer,
I'd be telling you that there are so many services available to you that you can't possibly use them all,
but you don't have cancer.
You have mental health.
There are no services,
please never come back here.
And she looked at me and said,
please never bring her back here again.
And then she said,
here's the good news.
The good news is you have a loving,
supportive and caring family.
(00:44):
And that's the only thing that's gonna get you through this because our health system is not going to help you.
I wish you all the very best.
Goodbye today.
I'm talking with Sue Paish.
Sue is the CEO of Canada's Digital Super Cluster.
An organization that uses collaborative innovation to create digital solutions for some of the world's biggest problems.
(01:05):
Previously,
she was the CEO of two of Canada's largest health care organizations,
Pharma Save and Life Labs.
Basically,
she's a force of nature.
If anyone believes in the power of people and digital technology,
it's Sue on a personal note.
Sue was one of the wonderful friendships I made during COVID.
(01:26):
So it was a real pleasure to sit down and talk to her about technology,
mental health innovation and changing a system.
Sue also shares some of her personal experience with the mental health care system and spoiler alert.
Sadly,
her story is not unique.
Oh,
and we also talk about courage.
I hope you enjoy the conversation.
(01:48):
Well,
hello,
Sue.
Hello Diane,
how are you?
It's been a while and I want to say before we start that,
you know,
I haven't seen you since before the,
well,
during the pandemic early in the pandemic.
And I learned from my patients years ago,
especially my patients who have ptsd that out of terrible things,
(02:08):
good things come.
And as I'm seeking to find some of the the gifts that have come out of this horrifying pandemic,
I came to realize that during that time,
I met some incredibly strong,
wonderful,
passionate professional women who have this ability to be direct and clear.
(02:30):
But at the same time,
truly compassionate.
And that for me has been a gift during this pandemic and my friend,
I count you among those women that have been really an inspiration to me.
So it's so wonderful to get a chance to talk to you.
Well,
I stayed back at you,
Diane.
We had lots of conversations uh on various topics and I've reflected on,
(02:52):
on a lot of your guidance and practical and at the same time,
visionary and aspirational.
And hopefully,
that's something we can all learn from the pandemic is that uh in many ways,
we have the ability to do things that we didn't think we had the ability to do before life threw us a curveball.
Absolutely.
And particularly with science and medicine,
(03:15):
they've shown that while it used to take 25 years to create a vaccine when people work together,
they can make it happen in a year.
This is something I think we can both appreciate.
So you and I worked together when I was co-chair of the board of the Digital Super Cluster for those who may not be familiar.
Can you please take a minute to explain what the digital super cluster is?
(03:39):
So it's just a little context on the digital technology super cluster.
It starts actually several years ago when some folks in the government of Canada were looking at our country's record if you will and history when it comes to both growing Canadian companies and deploying technologies and that record is dismal and it was going in the wrong direction.
(04:05):
So a small group of very smart people were put together to try and figure out a way to change Canada's trajectory in the innovation space because we've got lots of innovators.
We've got great business leaders,
we have some of the best health research and research generally in the world,
but we've been unable to bring it all together.
What the cluster program does is,
(04:26):
it says,
let's really understand what are some of the big societal and industry problems in the world that can be solved with technology.
Then secondly,
let's try and develop solutions to those problems in a collaborative context.
Have different organizations working together around solutions to the problem with the theory being,
(04:46):
we'll create better solutions together than any one of us would on our own.
Then thirdly invest in the development of those solutions as results are delivered.
So as a group or a consortium of organizations bring forward their potential solution and a business plan and that gets reviewed and approved,
(05:09):
we covet with taxpayers dollars,
30 cents on every private sector investment dollar as results are delivered.
So it's really a different model and I'll say we have delivered and we are about to deploy some literally world leading technologies across health across natural resources and decarbonising our natural resources,
(05:34):
industry and skilling and leadership.
So it's very fun.
It's very different,
there's no real book but always with the idea of building a better Canada for our kids and our grandchildren.
Well,
sad one of the reasons that I have had some shifts in my career is because of my frustration,
that medicine moves at a glacial pace.
(05:54):
It's tough to get my colleagues even,
you know,
with virtual care during the pandemic,
which I have been doing for several years.
There was still this resistance amongst my colleagues.
Oh,
we shouldn't do that.
You have to meet people in person the first time.
And I'm thinking how and how are we gonna do this when it's unsafe?
Let alone all the people that live so far away from any access to care.
(06:17):
I was really interested in learning more about your background.
Sue because I really knew it through the super cluster that you have been a leader.
It seems to me that you started your journey as a CEO,
as a CEO,
you,
you kind of started at the top.
So as I have tried to push for change and it's hard to get people to come along with you.
(06:38):
What are the things as a leader that help to support that change or support innovation?
Well,
let me talk about three things and I'll give you,
I'll give you a couple of examples.
One is,
and I'm talking in the health space now because I agree with you that it's almost unthinkable that we could move slower than we moved in the years prior to 2018.
(06:59):
And one of the first things that I like to do is,
is paint the picture of the possible,
some people call that a vision,
but visions can sometimes sound very ephemeral.
And so paint the picture of the possible in a very practical way.
So that's one thing.
(07:20):
The second thing is make sure that the practicality of the pitcher resonates with the audience that you're trying to speak to whether that audience is physicians or whether it's politicians or whether it's citizens or whether it's families.
Sometimes I think our health care system tries to be all things to all people all the time.
(07:40):
And that's not practical.
Sometimes we need to take care of this group as compared to a different group.
So make sure that there's a pitcher that is practical,
make sure that the practical element resonates with a particular group.
And then the third thing get it done.
Do not be a slave to.
(08:00):
This is the way we've always done it because if you do what you've always done,
you're gonna get what you've always got and what we've got in our health care system in the past is slow,
ineffective and impersonal.
And so let me just give you two examples.
One from back when I was the CEO of Pharma Safe,
the drugstore chain.
(08:21):
And I,
I left the legal profession to go into industry and,
and started as the CEO of Pharma Safe.
And one of the things as a non pharmacist that surprised me was,
this was in 2007,
2008 was the lack of information that was available to citizens about the medications that they were being prescribed.
(08:41):
And pharmacists were very good about putting pieces of paper in the bag with,
along with the medication.
But the reality was a lot of patients had a lot of things on their mind when they went and picked up their medications and they lost the paper or they didn't read it or they didn't understand it.
And so we had a conversation around Pharma,
save about whether we could do something different in that context and cutting a long story short,
(09:03):
we ended up developing the first online access to medication information for the most prescribed medications,
about 300 medications.
And that was in 2008,
2009.
And I can tell you there was a lot of resistance to that.
There was a lot of resistance across many segments of the health sector.
(09:25):
People won't understand this,
this will cause frustration.
People need to have face to face consultations.
And our response was we are giving people basic information about medications that they're gonna take into their bodies.
And if they have questions arising from that information,
yes,
they can follow up.
But right now,
a lot of them don't have of the information because they actually don't read the paper in the bag.
(09:48):
And the response was unbelievable.
Now,
now,
I think people would be shocked if you couldn't go online and look up Zoic clone or amoxicillin and find out a non manufacturer oriented description of the medication.
So that was the first time I thought,
ok,
well,
we can actually do things that haven't been done before.
The second one very quickly was in some ways more profound.
(10:10):
It was when I was CEO of Life Labs and I'm gonna say that was probably 2012 or so.
Some researchers had developed non-invasive prenatal testing.
So this is for pregnant women at the time in Canada.
If you had had any concerns about the health of your unborn baby,
you went through a very invasive high risk procedure called amnio synthesis.
(10:32):
And lots of women didn't want to go through that procedure or physicians determined it wasn't necessary.
And yet there was anxiety for parents or about to be parents.
And so this non-invasive prenatal testing in IP T really was a blood test to evaluate the genetics of the unborn baby.
And uh and it was available in the United States,
(10:52):
but it wasn't available in Canada.
And there was a list of 100 reasons why we couldn't do it in Canada.
And it ranged everything from parents don't need to know to the physician will determine if the person if the mom needs a amnio synthesis to,
there's no funding to,
there's no way to deploy it.
And there were all these reasons being given to us as to why we couldn't bring this technology into Canada.
(11:15):
And very few voices other than parents and grandparents voices around,
why it would be a good thing.
So I remember being in a meeting where I was told that it would take six years to get the first approval for this test.
And I could remember saying I'm not gonna wait another day for a family to go through the anxiety of having an unwell baby or not knowing the health of their child,
(11:46):
especially if there's a,
a history in the family.
And so we went forward and we got the appropriate regulatory approval for N IP T,
but it was not covered by any health care plans.
And the demand and the pickup for that testing was through the roof and it very quickly was picked up by various provinces as it carried or a reimbursable test for certain groups.
(12:10):
And I'd say now and I have three daughters,
all of whom are in childbearing years.
And,
and what I hear from them is it's assumed now that that's a standard of care.
And I think it was 10 years ago,
I was told it was impossible.
In fact,
I was told at one point it was going to be impossible to bring this technology to Canada.
So there's two examples of where we looked at a problem,
(12:33):
we looked at a potential solution and we painted the picture of what if we did this,
then we made sure that the people who it was supposed to support thought it would be useful and then quite frankly get her done.
Don't be a slave to how we've done things in the past.
I love both of those stories and of course,
they make me very frustrated because as I said,
(12:55):
I feel like we just move so slowly and people are throwing bales of hay and pylons and barriers in front of change.
And I used to reflect on it as,
and I think a lot of people do as this is paternalistic.
You know,
we're doing patient centered care and these doctors are saying,
you know,
I need to be the one to decide.
(13:15):
And but as I've mellowed,
I do know that there is an important element of care.
They do worry about their patients and they worry about how they experience that information.
But the reality is the person who is receiving the care is the owner of the body,
it is their health care and we have to shift things around.
(13:37):
The other thing I want to say to both of those stories is the word that strikes me sue is courage as a leader.
You do have to have that courage to say no,
we're gonna get her done and stand up to all those forces that are saying no.
And I certainly have seen that from you again and again.
So how do we stand up and tackle the problem that is our mental health care system,
(13:59):
a system that in my opinion,
seems broken beyond repair.
What needs to happen,
what needs to change.
Let me just make a couple of comments about mental health and wellness and my views of it and our family fortunately and unfortunately,
has had lots of experience in this since I was a little child and we don't really have uh in my view,
(14:20):
a mental health system in our province,
I can't speak to other provinces but in our province.
And let me make three comments about that.
As long as we combine mental health and substance use in the same sentence,
we are doing a disservice to the millions of people across the country who have mental health issues that are in no way related to substance use.
(14:44):
And when you have that mindset that mental health and substance use are inextricably intertwined.
Um These people are marginalized and don't receive service because point number two,
we do have an epidemic in substance use and all of the dollars are going into dealing with that and it must be dealt with.
(15:05):
We throw millions of dollars at the wrong end of the supply chain.
We cannot build enough recovery beds to support people who have substance use issues.
And let me just give you one tiny example on uh pain management,
post surgical pain management treatment in this country.
Well,
let me say in this province,
I should,
I don't know if it applies across the whole country is still very much opioid based pain management,
(15:28):
you get a week or two weeks,
maybe even three weeks of opioids for pain management.
And by the end of that period,
when you go and see your health care practitioner,
you might be in the early stages of substance use or addiction in the NHS.
In Britain pain management is for a lot of post surgical situations.
Aspirin Tylenol with regular follow-up.
(15:49):
We have technology,
we have technology that is in the early stages of development where you could be taking Tylenol or Aspirin for post surgical pain management and be able to contact virtually instantly a health care professional.
If your pain is unmanageable and be coached through pain management and maybe you do need something more.
(16:11):
But why do we continue to build the supply chain of potential people in the substance use trajectory by giving them opioids post surgically.
So,
first of all,
separate mental health and substance use recognize that there are people with mental health conditions that aren't tied to substance use.
Second,
let's rethink how we address substance use.
And the third is when it comes to mental health services,
(16:33):
let's make them available in the same way that we make cancer services available.
And I'm gonna tell you a little story about a loved one in our family who has lived with mental health issues.
And we were at a,
at an emergency center dedicated to mental health with this loved one for the third time in about six weeks.
This was a few years ago.
(16:53):
And,
uh,
after about three or four hours of waiting,
we were taken into a room and I'll never forget this.
A very,
a very,
I'll call it a crusty older nurse.
She'd been around,
uh,
she sits down,
she says I got good news and bad news and she says,
and the bad news is you have a mental illness and if you had cancer and she worked in the cancer clinic for eight years,
(17:15):
and she said,
if you had cancer,
I'd be telling you that there are so many services available to you that you can't possibly use them all,
but you don't have cancer.
You have mental health.
There are no services.
Please never come back here.
And she looked at me and said,
please never bring her back here again.
And then she said,
here's the good news.
The good news is you have a loving,
supportive and caring family and that's the only thing that's gonna get you through this because our health system is not going to help you.
(17:42):
I wish you all the very best.
Goodbye.
That is what we say to people with mental health situations that are so serious.
They feel they need to go to a mental health emergency center and that will be forever branded in my brain and my heart and we have to do better as a society or there won't be enough beds to take care of these people and um there won't be enough services to support the broken family.
(18:12):
So how do we do that sue?
How do we,
how do we leverage technology but make sure that it's rooted in science.
Obviously,
there's a biopsychosocial approach.
We have to think about the whole person and it has to be usable for that person,
but there has to be a demonstrable benefit from these rooted in health care science.
(18:34):
Yeah.
So thank you.
That's a perfect opening for me to talk about two things.
One exactly that,
how do you develop mental health services that are going to be useful to the citizens and families that need them?
And secondly,
I want to talk about mindset in terms of adoption and deployment of these technologies.
(18:56):
So I'm gonna come back to our super cluster model.
So in our super cluster model,
if there's a problem that comes forward and let's call it stress or burnout or or mental health issues in frontline health care workers,
let's just use that as an example and someone comes forward and says we have to help these people.
You're right.
There are apps all over the world these days.
(19:19):
Many of which don't have any basis in medicine or science.
When someone brings a problem to us,
in order for us to look at supporting the development of a solution,
there needs to be certain groups around on the table.
First of all,
if you're developing something in the health space,
you have to have health professionals at the table.
(19:39):
Maybe they're not physicians but people who work in the health space.
So maybe it's a health authority,
maybe it's a clinic,
maybe it is a group of physicians.
So you need to have the people that are experts there.
Every single project in our portfolio must have an academic,
a research or a postsecondary institution at the table.
(20:00):
Why in part to address your issue,
there needs to be scientific research that is the foundation of anything that we do in health.
It can't be somebody's good idea off the side of their desk that needs to be grounded in research.
So every project has to have academic research,
post-secondary professionals at the table.
(20:22):
And to give you a sense of how attractive that has become,
we started working when we started the Supercluster in 2018,
we had six post working with us.
We now have 51 pretty much every major research institution and major university across the country is working with us.
And so you have to have that at the table.
Third,
you have to have a customer.
(20:43):
So who is the customer?
Maybe the customer is the citizen.
In which case you have a citizens group or a patient advocacy group.
Maybe the customer is an employer who wants to deploy this technology to their workforce or I'll give you a real life case.
Maybe the customer is a health authority and in this case is leading to a real life example.
(21:03):
In this case,
Fraser health authorities who came forward and said early in the pandemic,
we're really worried about frontline workers and we have no ability to support them in what we think is going to be a very,
very difficult time.
So you think of putting all those different groups around the table with their different interests,
their different ideas,
(21:24):
their different perspectives,
some want to own it,
some don't want to own it.
Some want to invest,
some have science,
some don't want to have science and say we're gonna figure this out together and we're gonna do it fast.
And so that comes to my second point,
which is mindset.
If you want to solve a problem and to solve a problem really effectively,
the mindset is far more important than the action plan.
(21:48):
In my view,
you need to have both.
But if you don't have the right mindset,
um having an action plan that starts every sentence with the word I is not going to get you there if you start with the word we and how can we do this together?
You see it differently than I see it.
That's something we don't see a lot in health care.
(22:08):
And so I'm very proud that our health care portfolio is our biggest portfolio.
We've got hundreds of projects that have been launched.
And on that mental health one,
we did develop and deploy a platform through Fraser Health with the support of all of those different groups that I mentioned for mental health,
um virtual mental health services.
And it was picked up so quickly and so significantly that access was then expanded into people in the education system,
(22:36):
but that's what we need.
And but let me just make one more comment because I always want to try and find a real positive in the last month.
Let's say I have seen some willingness of the provincial Ministry of Health to start to think about these kinds of things.
I'm holding on to that little ray of light.
We did have a meeting about a week ago with some officials who were curious.
(23:01):
Curiosity is all I'm looking for right now,
curious about perhaps there's a different way of doing things than we've done in the past.
Such a beautiful segue into the question that was sitting in the back of my brain waiting to come out talking about courage.
Is there such a thing as a courageous politician when it comes to health care?
(23:23):
How do we kind of beat the bushes a little bit and get them out and starting to tackle these problems?
Because I know that and I'm not talking about any particular group.
It's just that health care has become this terrifying thing for anyone to touch.
We need people to grasp that nettle and say,
you know,
we ought to change this.
It's not working and politicians don't like to create those kind of controversies.
(23:49):
What's the answer there?
Do you have any thoughts?
Yeah,
I do have a couple of thoughts and I've had lots of conversations on that topic over the last few years,
well,
over the last few decades,
but certainly over the,
the last few years during the pandemic.
And let me make my first comment,
not in the context of all that needs to be done in the health care system,
but from a financial perspective,
we're going bankrupt this country.
If we don't fix our health care system,
(24:10):
we cannot keep throwing money at the problem.
Throwing money at the problem is not going to solve it.
And you know,
the proof with that,
we've been doing it for 40 years,
we've been throwing money at the problem and it's getting worse.
So if you keep doing what you've always done,
you're gonna get what you've always got,
which is a broken system.
We are a country of 38 million people spread over a broad geography agreed.
(24:32):
Do we need 13 different ways of doing everything in a society that is digitally empowered and it is,
it is as a citizen beyond me that we cannot find a way to do something together.
Back to my earlier comment,
we will find better solutions if we do things together and you know what the SARS C O V two virus and,
(24:58):
and there are many other health conditions,
whether it's cancer or whether it's mental health have proven that a citizen in Nova Scotia,
in Toronto,
in Gimli Manitoba and in Sydney on Vancouver Island experience the same health conditions.
These health conditions don't change at the border.
(25:20):
So turning our minds towards building a health care system for 38 million people rather than 13 different health care systems is a good start.
That's a mindset issue.
Technology will help you get there.
Is there going to be the courage to do that?
I haven't seen it yet.
(25:41):
I remain forever hopeful.
I would argue we need to encourage courage.
We need to vote for courage.
I don't think there are any sacred cows and I could not agree more with every word that you just uttered.
Sue.
Can I I shift gears for a moment because you've kind of teased and given us some ideas.
But I would love to hear about any exciting advancements or innovations in the health care space that you'd like to share that things that,
(26:10):
that kind of lift the hair on the back of your neck and you feel like this is something that could be a real game changer.
Well,
I'll give you two that are out there and are sort of proud moments for us in uh in the cluster.
And so one of the biggest issues in health and health research is sharing health data and for all kinds of reasons,
researchers and academics are reluctant to share health data in meaningful ways.
(26:34):
And during the early stages of the COVID crisis,
a company out of Ontario called DNA Stack came to us and said,
you know,
one of the big,
biggest challenges we're going to have as a world is keeping ahead of this virus and making sure that research is shared around the world.
Good as gracious.
We don't even share research from British Columbia to Saskatchewan,
(26:56):
let alone around the world.
And so this young company said,
you know,
we think we can build a data platform that will secure and protect health research so that people don't lose their rights to it but will allow it to be shared.
And when I heard that I thought you're either really smart or really bold or way up to lunch,
but I hope it stores one and two and it turned out to be that.
(27:17):
And so through our cluster,
we did this consortia did build the world's first Federated health data platform for the sharing of health data.
And one of the ways this platform is being,
being used is allowing Canadian parents to load the genome of their child on the spectrum on this platform and made aware of potential treatments anywhere in the world.
(27:39):
It almost feels cruel that we haven't done that 10 years ago.
My second story is next month in December,
the World Health Organization is going to take a small Canadian company,
Vancouver Company and put them on the world stage and say that this company,
a company called First Line has developed the new world standard for treating antimicrobial resistance.
(28:01):
And I've said to folks in government,
I don't know the last time a Canadian company was put on the world stage by the World Health Organization and the world is told this is the best technology in the world,
but I'm pretty proud that we've done it here and we can do more.
And what we need is our health care leaders in the public system to embrace and support Canadian made technologies and deploy them for the benefit of Canadians because the world's using them.
(28:26):
And to appreciate that when we work together,
we do good things and we do them better than when we work on our own with the doors closed.
But I think Canadian families and citizens and I think frontline health care workers are ready for this and want it.
They want us to have a functioning health care system and we can deliver it.
(28:50):
There's no doubt we can deliver it if we effectively deploy technologies and think like a country.
I was at a really interesting meeting a couple of weeks ago and someone asked provincial digital health leaders if they felt that they can achieve the goal of interoperability without a mandate or edict to make it.
(29:11):
So what do you think about the role of our many levels of government?
What should they be doing to move that needle?
The only thing preventing our leadership from moving.
That needle is their mindset.
Except that mental health is as important as physical health and fund and encourage treatment and supports on a national coast to coast,
(29:41):
coast to coast basis fast.
And if I was a health leader in that domain,
I'd probably ask myself if it's not gonna be me,
who's gonna do it?
Why can't I be the person?
Why can't I be the minister or deputy minister,
whoever who actually makes it better for Canadians by working together?
This has been an absolute delight.
(30:02):
Sue Thank you for taking the time to talk today.
I love this conversation.
It's a treat,
being able to hang out with you and thank you for doing these podcasts.
It's fantastic and I will remain an absolute determined optimist who takes my optimism and moves it into action and I hope that we can inspire others to do the same.
Thank you so much.
(30:23):
Sue,
reflecting on my conversation with Sue,
I think she clearly demonstrated how important strong leadership is.
If you actually want to make change happen,
there's no shortage of people that will be willing and able to work together towards solutionss.
But without a thoughtful strategy and capable,
(30:46):
engaging leadership,
we'll continue to be in crisis and Canadians will continue to face unacceptable barriers to mental health care.
We need a mindset change.
We just can't keep doing the same thing we've always done and expect to get different results if it's not us,
who is going to solve these problems.
(31:07):
If not now,
when we can't afford to keep kicking this ball down the field as always,
Sue left me,
inspired her leadership experience gives me hope that things can actually change and even the most difficult health care challenges have solutions.
Thank you for listening.
(31:28):
The Wicked Mind podcast is a series of unique conversations with individuals that share experiences and perspectives on mental health care together.
We will uncover ideas that inspire action.
Please make sure you subscribe,
share and comment.
And if you have a topic or guest suggestion,
please reach out to me at Dr Diane macintosh dot com.
And uh after about three or four hours of waiting,
we were taken into a room and I'll never forget this.
A very,
a very,
I'll call it a crusty older nurse.
She'd been around.
Uh,
she sits down,
she says I got good news and bad news and she says,
um the bad news is you have a mental illness.
And if you had cancer and she worked in the cancer clinic for eight years and she said,
(00:23):
if you had cancer,
I'd be telling you that there are so many services available to you that you can't possibly use them all,
but you don't have cancer.
You have mental health.
There are no services,
please never come back here.
And she looked at me and said,
please never bring her back here again.
And then she said,
here's the good news.
The good news is you have a loving,
supportive and caring family.
(00:44):
And that's the only thing that's gonna get you through this because our health system is not going to help you.
I wish you all the very best.
Goodbye today.
I'm talking with Sue Paish.
Sue is the CEO of Canada's Digital Super Cluster.
An organization that uses collaborative innovation to create digital solutions for some of the world's biggest problems.
(01:05):
Previously,
she was the CEO of two of Canada's largest health care organizations,
Pharma Save and Life Labs.
Basically,
she's a force of nature.
If anyone believes in the power of people and digital technology,
it's Sue on a personal note.
Sue was one of the wonderful friendships I made during COVID.
(01:26):
So it was a real pleasure to sit down and talk to her about technology,
mental health innovation and changing a system.
Sue also shares some of her personal experience with the mental health care system and spoiler alert.
Sadly,
her story is not unique.
Oh,
and we also talk about courage.
I hope you enjoy the conversation.
(01:48):
Well,
hello,
Sue.
Hello Diane,
how are you?
It's been a while and I want to say before we start that,
you know,
I haven't seen you since before the,
well,
during the pandemic early in the pandemic.
And I learned from my patients years ago,
especially my patients who have ptsd that out of terrible things,
(02:08):
good things come.
And as I'm seeking to find some of the the gifts that have come out of this horrifying pandemic,
I came to realize that during that time,
I met some incredibly strong,
wonderful,
passionate professional women who have this ability to be direct and clear.
(02:30):
But at the same time,
truly compassionate.
And that for me has been a gift during this pandemic and my friend,
I count you among those women that have been really an inspiration to me.
So it's so wonderful to get a chance to talk to you.
Well,
I stayed back at you,
Diane.
We had lots of conversations uh on various topics and I've reflected on,
(02:52):
on a lot of your guidance and practical and at the same time,
visionary and aspirational.
And hopefully,
that's something we can all learn from the pandemic is that uh in many ways,
we have the ability to do things that we didn't think we had the ability to do before life threw us a curveball.
Absolutely.
And particularly with science and medicine,
(03:15):
they've shown that while it used to take 25 years to create a vaccine when people work together,
they can make it happen in a year.
This is something I think we can both appreciate.
So you and I worked together when I was co-chair of the board of the Digital Super Cluster for those who may not be familiar.
Can you please take a minute to explain what the digital super cluster is?
(03:39):
So it's just a little context on the digital technology super cluster.
It starts actually several years ago when some folks in the government of Canada were looking at our country's record if you will and history when it comes to both growing Canadian companies and deploying technologies and that record is dismal and it was going in the wrong direction.
(04:05):
So a small group of very smart people were put together to try and figure out a way to change Canada's trajectory in the innovation space because we've got lots of innovators.
We've got great business leaders,
we have some of the best health research and research generally in the world,
but we've been unable to bring it all together.
What the cluster program does is,
(04:26):
it says,
let's really understand what are some of the big societal and industry problems in the world that can be solved with technology.
Then secondly,
let's try and develop solutions to those problems in a collaborative context.
Have different organizations working together around solutions to the problem with the theory being,
(04:46):
we'll create better solutions together than any one of us would on our own.
Then thirdly invest in the development of those solutions as results are delivered.
So as a group or a consortium of organizations bring forward their potential solution and a business plan and that gets reviewed and approved,
(05:09):
we covet with taxpayers dollars,
30 cents on every private sector investment dollar as results are delivered.
So it's really a different model and I'll say we have delivered and we are about to deploy some literally world leading technologies across health across natural resources and decarbonising our natural resources,
(05:34):
industry and skilling and leadership.
So it's very fun.
It's very different,
there's no real book but always with the idea of building a better Canada for our kids and our grandchildren.
Well,
sad one of the reasons that I have had some shifts in my career is because of my frustration,
that medicine moves at a glacial pace.
(05:54):
It's tough to get my colleagues even,
you know,
with virtual care during the pandemic,
which I have been doing for several years.
There was still this resistance amongst my colleagues.
Oh,
we shouldn't do that.
You have to meet people in person the first time.
And I'm thinking how and how are we gonna do this when it's unsafe?
Let alone all the people that live so far away from any access to care.
(06:17):
I was really interested in learning more about your background.
Sue because I really knew it through the super cluster that you have been a leader.
It seems to me that you started your journey as a CEO,
as a CEO,
you,
you kind of started at the top.
So as I have tried to push for change and it's hard to get people to come along with you.
(06:38):
What are the things as a leader that help to support that change or support innovation?
Well,
let me talk about three things and I'll give you,
I'll give you a couple of examples.
One is,
and I'm talking in the health space now because I agree with you that it's almost unthinkable that we could move slower than we moved in the years prior to 2018.
(06:59):
And one of the first things that I like to do is,
is paint the picture of the possible,
some people call that a vision,
but visions can sometimes sound very ephemeral.
And so paint the picture of the possible in a very practical way.
So that's one thing.
(07:20):
The second thing is make sure that the practicality of the pitcher resonates with the audience that you're trying to speak to whether that audience is physicians or whether it's politicians or whether it's citizens or whether it's families.
Sometimes I think our health care system tries to be all things to all people all the time.
(07:40):
And that's not practical.
Sometimes we need to take care of this group as compared to a different group.
So make sure that there's a pitcher that is practical,
make sure that the practical element resonates with a particular group.
And then the third thing get it done.
Do not be a slave to.
(08:00):
This is the way we've always done it because if you do what you've always done,
you're gonna get what you've always got and what we've got in our health care system in the past is slow,
ineffective and impersonal.
And so let me just give you two examples.
One from back when I was the CEO of Pharma Safe,
the drugstore chain.
(08:21):
And I,
I left the legal profession to go into industry and,
and started as the CEO of Pharma Safe.
And one of the things as a non pharmacist that surprised me was,
this was in 2007,
2008 was the lack of information that was available to citizens about the medications that they were being prescribed.
(08:41):
And pharmacists were very good about putting pieces of paper in the bag with,
along with the medication.
But the reality was a lot of patients had a lot of things on their mind when they went and picked up their medications and they lost the paper or they didn't read it or they didn't understand it.
And so we had a conversation around Pharma,
save about whether we could do something different in that context and cutting a long story short,
(09:03):
we ended up developing the first online access to medication information for the most prescribed medications,
about 300 medications.
And that was in 2008,
2009.
And I can tell you there was a lot of resistance to that.
There was a lot of resistance across many segments of the health sector.
(09:25):
People won't understand this,
this will cause frustration.
People need to have face to face consultations.
And our response was we are giving people basic information about medications that they're gonna take into their bodies.
And if they have questions arising from that information,
yes,
they can follow up.
But right now,
a lot of them don't have of the information because they actually don't read the paper in the bag.
(09:48):
And the response was unbelievable.
Now,
now,
I think people would be shocked if you couldn't go online and look up Zoic clone or amoxicillin and find out a non manufacturer oriented description of the medication.
So that was the first time I thought,
ok,
well,
we can actually do things that haven't been done before.
The second one very quickly was in some ways more profound.
(10:10):
It was when I was CEO of Life Labs and I'm gonna say that was probably 2012 or so.
Some researchers had developed non-invasive prenatal testing.
So this is for pregnant women at the time in Canada.
If you had had any concerns about the health of your unborn baby,
you went through a very invasive high risk procedure called amnio synthesis.
(10:32):
And lots of women didn't want to go through that procedure or physicians determined it wasn't necessary.
And yet there was anxiety for parents or about to be parents.
And so this non-invasive prenatal testing in IP T really was a blood test to evaluate the genetics of the unborn baby.
And uh and it was available in the United States,
(10:52):
but it wasn't available in Canada.
And there was a list of 100 reasons why we couldn't do it in Canada.
And it ranged everything from parents don't need to know to the physician will determine if the person if the mom needs a amnio synthesis to,
there's no funding to,
there's no way to deploy it.
And there were all these reasons being given to us as to why we couldn't bring this technology into Canada.
(11:15):
And very few voices other than parents and grandparents voices around,
why it would be a good thing.
So I remember being in a meeting where I was told that it would take six years to get the first approval for this test.
And I could remember saying I'm not gonna wait another day for a family to go through the anxiety of having an unwell baby or not knowing the health of their child,
(11:46):
especially if there's a,
a history in the family.
And so we went forward and we got the appropriate regulatory approval for N IP T,
but it was not covered by any health care plans.
And the demand and the pickup for that testing was through the roof and it very quickly was picked up by various provinces as it carried or a reimbursable test for certain groups.
(12:10):
And I'd say now and I have three daughters,
all of whom are in childbearing years.
And,
and what I hear from them is it's assumed now that that's a standard of care.
And I think it was 10 years ago,
I was told it was impossible.
In fact,
I was told at one point it was going to be impossible to bring this technology to Canada.
So there's two examples of where we looked at a problem,
(12:33):
we looked at a potential solution and we painted the picture of what if we did this,
then we made sure that the people who it was supposed to support thought it would be useful and then quite frankly get her done.
Don't be a slave to how we've done things in the past.
I love both of those stories and of course,
they make me very frustrated because as I said,
(12:55):
I feel like we just move so slowly and people are throwing bales of hay and pylons and barriers in front of change.
And I used to reflect on it as,
and I think a lot of people do as this is paternalistic.
You know,
we're doing patient centered care and these doctors are saying,
you know,
I need to be the one to decide.
(13:15):
And but as I've mellowed,
I do know that there is an important element of care.
They do worry about their patients and they worry about how they experience that information.
But the reality is the person who is receiving the care is the owner of the body,
it is their health care and we have to shift things around.
(13:37):
The other thing I want to say to both of those stories is the word that strikes me sue is courage as a leader.
You do have to have that courage to say no,
we're gonna get her done and stand up to all those forces that are saying no.
And I certainly have seen that from you again and again.
So how do we stand up and tackle the problem that is our mental health care system,
(13:59):
a system that in my opinion,
seems broken beyond repair.
What needs to happen,
what needs to change.
Let me just make a couple of comments about mental health and wellness and my views of it and our family fortunately and unfortunately,
has had lots of experience in this since I was a little child and we don't really have uh in my view,
(14:20):
a mental health system in our province,
I can't speak to other provinces but in our province.
And let me make three comments about that.
As long as we combine mental health and substance use in the same sentence,
we are doing a disservice to the millions of people across the country who have mental health issues that are in no way related to substance use.
(14:44):
And when you have that mindset that mental health and substance use are inextricably intertwined.
Um These people are marginalized and don't receive service because point number two,
we do have an epidemic in substance use and all of the dollars are going into dealing with that and it must be dealt with.
(15:05):
We throw millions of dollars at the wrong end of the supply chain.
We cannot build enough recovery beds to support people who have substance use issues.
And let me just give you one tiny example on uh pain management,
post surgical pain management treatment in this country.
Well,
let me say in this province,
I should,
I don't know if it applies across the whole country is still very much opioid based pain management,
(15:28):
you get a week or two weeks,
maybe even three weeks of opioids for pain management.
And by the end of that period,
when you go and see your health care practitioner,
you might be in the early stages of substance use or addiction in the NHS.
In Britain pain management is for a lot of post surgical situations.
Aspirin Tylenol with regular follow-up.
(15:49):
We have technology,
we have technology that is in the early stages of development where you could be taking Tylenol or Aspirin for post surgical pain management and be able to contact virtually instantly a health care professional.
If your pain is unmanageable and be coached through pain management and maybe you do need something more.
(16:11):
But why do we continue to build the supply chain of potential people in the substance use trajectory by giving them opioids post surgically.
So,
first of all,
separate mental health and substance use recognize that there are people with mental health conditions that aren't tied to substance use.
Second,
let's rethink how we address substance use.
And the third is when it comes to mental health services,
(16:33):
let's make them available in the same way that we make cancer services available.
And I'm gonna tell you a little story about a loved one in our family who has lived with mental health issues.
And we were at a,
at an emergency center dedicated to mental health with this loved one for the third time in about six weeks.
This was a few years ago.
(16:53):
And,
uh,
after about three or four hours of waiting,
we were taken into a room and I'll never forget this.
A very,
a very,
I'll call it a crusty older nurse.
She'd been around,
uh,
she sits down,
she says I got good news and bad news and she says,
and the bad news is you have a mental illness and if you had cancer and she worked in the cancer clinic for eight years,
(17:15):
and she said,
if you had cancer,
I'd be telling you that there are so many services available to you that you can't possibly use them all,
but you don't have cancer.
You have mental health.
There are no services.
Please never come back here.
And she looked at me and said,
please never bring her back here again.
And then she said,
here's the good news.
The good news is you have a loving,
supportive and caring family and that's the only thing that's gonna get you through this because our health system is not going to help you.
(17:42):
I wish you all the very best.
Goodbye.
That is what we say to people with mental health situations that are so serious.
They feel they need to go to a mental health emergency center and that will be forever branded in my brain and my heart and we have to do better as a society or there won't be enough beds to take care of these people and um there won't be enough services to support the broken family.
(18:12):
So how do we do that sue?
How do we,
how do we leverage technology but make sure that it's rooted in science.
Obviously,
there's a biopsychosocial approach.
We have to think about the whole person and it has to be usable for that person,
but there has to be a demonstrable benefit from these rooted in health care science.
(18:34):
Yeah.
So thank you.
That's a perfect opening for me to talk about two things.
One exactly that,
how do you develop mental health services that are going to be useful to the citizens and families that need them?
And secondly,
I want to talk about mindset in terms of adoption and deployment of these technologies.
(18:56):
So I'm gonna come back to our super cluster model.
So in our super cluster model,
if there's a problem that comes forward and let's call it stress or burnout or or mental health issues in frontline health care workers,
let's just use that as an example and someone comes forward and says we have to help these people.
You're right.
There are apps all over the world these days.
(19:19):
Many of which don't have any basis in medicine or science.
When someone brings a problem to us,
in order for us to look at supporting the development of a solution,
there needs to be certain groups around on the table.
First of all,
if you're developing something in the health space,
you have to have health professionals at the table.
(19:39):
Maybe they're not physicians but people who work in the health space.
So maybe it's a health authority,
maybe it's a clinic,
maybe it is a group of physicians.
So you need to have the people that are experts there.
Every single project in our portfolio must have an academic,
a research or a postsecondary institution at the table.
(20:00):
Why in part to address your issue,
there needs to be scientific research that is the foundation of anything that we do in health.
It can't be somebody's good idea off the side of their desk that needs to be grounded in research.
So every project has to have academic research,
post-secondary professionals at the table.
(20:22):
And to give you a sense of how attractive that has become,
we started working when we started the Supercluster in 2018,
we had six post working with us.
We now have 51 pretty much every major research institution and major university across the country is working with us.
And so you have to have that at the table.
Third,
you have to have a customer.
(20:43):
So who is the customer?
Maybe the customer is the citizen.
In which case you have a citizens group or a patient advocacy group.
Maybe the customer is an employer who wants to deploy this technology to their workforce or I'll give you a real life case.
Maybe the customer is a health authority and in this case is leading to a real life example.
(21:03):
In this case,
Fraser health authorities who came forward and said early in the pandemic,
we're really worried about frontline workers and we have no ability to support them in what we think is going to be a very,
very difficult time.
So you think of putting all those different groups around the table with their different interests,
their different ideas,
(21:24):
their different perspectives,
some want to own it,
some don't want to own it.
Some want to invest,
some have science,
some don't want to have science and say we're gonna figure this out together and we're gonna do it fast.
And so that comes to my second point,
which is mindset.
If you want to solve a problem and to solve a problem really effectively,
the mindset is far more important than the action plan.
(21:48):
In my view,
you need to have both.
But if you don't have the right mindset,
um having an action plan that starts every sentence with the word I is not going to get you there if you start with the word we and how can we do this together?
You see it differently than I see it.
That's something we don't see a lot in health care.
(22:08):
And so I'm very proud that our health care portfolio is our biggest portfolio.
We've got hundreds of projects that have been launched.
And on that mental health one,
we did develop and deploy a platform through Fraser Health with the support of all of those different groups that I mentioned for mental health,
um virtual mental health services.
And it was picked up so quickly and so significantly that access was then expanded into people in the education system,
(22:36):
but that's what we need.
And but let me just make one more comment because I always want to try and find a real positive in the last month.
Let's say I have seen some willingness of the provincial Ministry of Health to start to think about these kinds of things.
I'm holding on to that little ray of light.
We did have a meeting about a week ago with some officials who were curious.
(23:01):
Curiosity is all I'm looking for right now,
curious about perhaps there's a different way of doing things than we've done in the past.
Such a beautiful segue into the question that was sitting in the back of my brain waiting to come out talking about courage.
Is there such a thing as a courageous politician when it comes to health care?
(23:23):
How do we kind of beat the bushes a little bit and get them out and starting to tackle these problems?
Because I know that and I'm not talking about any particular group.
It's just that health care has become this terrifying thing for anyone to touch.
We need people to grasp that nettle and say,
you know,
we ought to change this.
It's not working and politicians don't like to create those kind of controversies.
(23:49):
What's the answer there?
Do you have any thoughts?
Yeah,
I do have a couple of thoughts and I've had lots of conversations on that topic over the last few years,
well,
over the last few decades,
but certainly over the,
the last few years during the pandemic.
And let me make my first comment,
not in the context of all that needs to be done in the health care system,
but from a financial perspective,
we're going bankrupt this country.
If we don't fix our health care system,
(24:10):
we cannot keep throwing money at the problem.
Throwing money at the problem is not going to solve it.
And you know,
the proof with that,
we've been doing it for 40 years,
we've been throwing money at the problem and it's getting worse.
So if you keep doing what you've always done,
you're gonna get what you've always got,
which is a broken system.
We are a country of 38 million people spread over a broad geography agreed.
(24:32):
Do we need 13 different ways of doing everything in a society that is digitally empowered and it is,
it is as a citizen beyond me that we cannot find a way to do something together.
Back to my earlier comment,
we will find better solutions if we do things together and you know what the SARS C O V two virus and,
(24:58):
and there are many other health conditions,
whether it's cancer or whether it's mental health have proven that a citizen in Nova Scotia,
in Toronto,
in Gimli Manitoba and in Sydney on Vancouver Island experience the same health conditions.
These health conditions don't change at the border.
(25:20):
So turning our minds towards building a health care system for 38 million people rather than 13 different health care systems is a good start.
That's a mindset issue.
Technology will help you get there.
Is there going to be the courage to do that?
I haven't seen it yet.
(25:41):
I remain forever hopeful.
I would argue we need to encourage courage.
We need to vote for courage.
I don't think there are any sacred cows and I could not agree more with every word that you just uttered.
Sue.
Can I I shift gears for a moment because you've kind of teased and given us some ideas.
But I would love to hear about any exciting advancements or innovations in the health care space that you'd like to share that things that,
(26:10):
that kind of lift the hair on the back of your neck and you feel like this is something that could be a real game changer.
Well,
I'll give you two that are out there and are sort of proud moments for us in uh in the cluster.
And so one of the biggest issues in health and health research is sharing health data and for all kinds of reasons,
researchers and academics are reluctant to share health data in meaningful ways.
(26:34):
And during the early stages of the COVID crisis,
a company out of Ontario called DNA Stack came to us and said,
you know,
one of the big,
biggest challenges we're going to have as a world is keeping ahead of this virus and making sure that research is shared around the world.
Good as gracious.
We don't even share research from British Columbia to Saskatchewan,
(26:56):
let alone around the world.
And so this young company said,
you know,
we think we can build a data platform that will secure and protect health research so that people don't lose their rights to it but will allow it to be shared.
And when I heard that I thought you're either really smart or really bold or way up to lunch,
but I hope it stores one and two and it turned out to be that.
(27:17):
And so through our cluster,
we did this consortia did build the world's first Federated health data platform for the sharing of health data.
And one of the ways this platform is being,
being used is allowing Canadian parents to load the genome of their child on the spectrum on this platform and made aware of potential treatments anywhere in the world.
(27:39):
It almost feels cruel that we haven't done that 10 years ago.
My second story is next month in December,
the World Health Organization is going to take a small Canadian company,
Vancouver Company and put them on the world stage and say that this company,
a company called First Line has developed the new world standard for treating antimicrobial resistance.
(28:01):
And I've said to folks in government,
I don't know the last time a Canadian company was put on the world stage by the World Health Organization and the world is told this is the best technology in the world,
but I'm pretty proud that we've done it here and we can do more.
And what we need is our health care leaders in the public system to embrace and support Canadian made technologies and deploy them for the benefit of Canadians because the world's using them.
(28:26):
And to appreciate that when we work together,
we do good things and we do them better than when we work on our own with the doors closed.
But I think Canadian families and citizens and I think frontline health care workers are ready for this and want it.
They want us to have a functioning health care system and we can deliver it.
(28:50):
There's no doubt we can deliver it if we effectively deploy technologies and think like a country.
I was at a really interesting meeting a couple of weeks ago and someone asked provincial digital health leaders if they felt that they can achieve the goal of interoperability without a mandate or edict to make it.
(29:11):
So what do you think about the role of our many levels of government?
What should they be doing to move that needle?
The only thing preventing our leadership from moving.
That needle is their mindset.
Except that mental health is as important as physical health and fund and encourage treatment and supports on a national coast to coast,
(29:41):
coast to coast basis fast.
And if I was a health leader in that domain,
I'd probably ask myself if it's not gonna be me,
who's gonna do it?
Why can't I be the person?
Why can't I be the minister or deputy minister,
whoever who actually makes it better for Canadians by working together?
This has been an absolute delight.
(30:02):
Sue Thank you for taking the time to talk today.
I love this conversation.
It's a treat,
being able to hang out with you and thank you for doing these podcasts.
It's fantastic and I will remain an absolute determined optimist who takes my optimism and moves it into action and I hope that we can inspire others to do the same.
Thank you so much.
(30:23):
Sue,
reflecting on my conversation with Sue,
I think she clearly demonstrated how important strong leadership is.
If you actually want to make change happen,
there's no shortage of people that will be willing and able to work together towards solutionss.
But without a thoughtful strategy and capable,
(30:46):
engaging leadership,
we'll continue to be in crisis and Canadians will continue to face unacceptable barriers to mental health care.
We need a mindset change.
We just can't keep doing the same thing we've always done and expect to get different results if it's not us,
who is going to solve these problems.
(31:07):
If not now,
when we can't afford to keep kicking this ball down the field as always,
Sue left me,
inspired her leadership experience gives me hope that things can actually change and even the most difficult health care challenges have solutions.
Thank you for listening.
(31:28):
The Wicked Mind podcast is a series of unique conversations with individuals that share experiences and perspectives on mental health care together.
We will uncover ideas that inspire action.
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