Many healthcare-system interest holders in Canada lightheartedly debate whether the Canadian Healthcare System is truly a ‘system’? Several have called it the ‘non-system’. We will settle the debate for good right now. The way our healthcare is organized is indeed a system, it is, however, a flawed one. The fact that feedback loops are poorly structured, that critical information is not available or accessible, and that important elements of a system are not in place is attributable to those who are the stewards and governors of the system, and not the fault of the system itself. We get what we design.

Arguably, the Canadian healthcare system is more reactive than proactive. In other words, our priorities as a system are to spend our limited resources on treating illness rather than on preventing the occurrence of diseases. We pour resources into shortening waiting lists and purchasing the latest productivity-enhancing technologies in the glorious hope that soon, very soon, we will turn the corner and finally get ahead of all the surgeries and procedures that need to be done, and everyone in Canada will be healthy again. We try to reassure ourselves that this is not a vain hope, but in our heart of hearts we know that perhaps we need to take another route.

The Future of Health Leadership, Informatics and Policy conference was inaugurated at the Dalla Lana School of Public Health and the Institute for Health Policy, Management and Evaluation at the University of Toronto as an initiative to bring back hope to our healthcare system. We are pleased to be working with the health informatics community at the University of Victora, the University of Waterloo, and Dalhousie University in bringing these proceedings to life.

It is our collective belief that informatics thinking and digital health technologies can change the trajectory of our current system and help to convert it to one that is more proactive. New, advanced, predictive technologies have become available which make this more possible than ever before, nevertheless, it is unlikely to occur without improved policies, regulations, and governance of our health system.

We are delighted to present the papers in this collection on the topic of From Reactive to Proactive: The Role of Digital Health Policy. It is our belief that health informatics and digital health have much to say about how our healthcare system can function more efficiently. To provide policymakers, decision makers and other stakeholders with the information they need to make better allocative decisions and intervene more effectively, informatics needs to play at the macro level, not just at the user level or the inter-organizational level.

The authors have thought deeply about the key issues that plague our healthcare system, and here they present their ideas about how to address them. The topics in this collection range from interoperability to governance, regulation of electronic medical records to addressing the needs of vulnerable populations. Some authors have discussed the roles of innovative approaches and new digital technologies – including artificial intelligence – to solve healthcare-system issues.

We hope you enjoy reading these papers and considering the creative ideas the authors have developed to solve important issues in our healthcare system to help us move From Reactive, to Proactive.

Karim Keshavjee

Assistant Professor, Teaching Stream

Program Director, Health Informatics Program

Institute for Health Policy, Management and Evaluation

Dalla Lana School of Public Health

University of Toronto

Alireza Khatami

Institute for Health Policy, Management and Evaluation

Dalla Lana School of Public Health

University of Toronto