[This article was originally published in Healthcare Papers, 13(2) ]

In the lead paper, Tomblin Murphy and MacKenzie advocate the application of population health needs in the planning and delivery of clinical services across Canadian healthcare systems. The authors are correct in urging the minimal use, if not abandonment, of legacy demand data as a relevant predictor for advancing a more effective and sustainable healthcare system. The primary challenge for a reader of their paper is the confusion of terminology and a resulting dissonance among the title, the abstract and the content. Expectations created by the title are not attained due to the unfortunate interchangeability of key phrases and the propriety of the case studies selected as examples. This commentary focuses on the choice of language and concerns of secondary uncertainty between "needs" and process management; this is framed by a brief review of terminology and the principles that underpin needs-based models.