Health systems in developed countries face escalating challenges, including rising costs, workforce crises, safety concerns and persistent inequities. Despite widespread recognition of the need for transformation, progress has been slow and fragmented. The Canadian experience underscores this reality: a decade after the federal health minister's Advisory Panel on Healthcare Innovation released its landmark report, many of its key recommendations – including a $1-billion innovation fund and a national healthcare innovation agency – remain unfulfilled. During this period, system pressures have intensified, compounded by the COVID-19 pandemic and growing financial constraints. At the same time, digital technologies, particularly artificial intelligence, offer unprecedented opportunities to redesign care delivery, though adoption has been patchy and uncoordinated. This commentary argues that health systems must embed innovation into their core mission, linking transformation with economic development through clinician- and patient-driven solutions, commercialization, procurement reform and sustained national strategies to ensure that healthcare becomes both sustainable and socially generative.

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