Skip to main content
The Globe and Mail
Support Quality Journalism.
The Globe and Mail
First Access to Latest
Investment News
Collection of curated
e-books and guides
Inform your decisions via
Globe Investor Tools
per week
for first 24 weeks

Enjoy unlimited digital access
Enjoy Unlimited Digital Access
Get full access to
Just $1.99 per week for the first 24 weeks
Just $1.99 per week for the first 24 weeks
var select={root:".js-sub-pencil",control:".js-sub-pencil-control",open:"o-sub-pencil--open",closed:"o-sub-pencil--closed"},dom={},allowExpand=!0;function pencilInit(o){var e=arguments.length>1&&void 0!==arguments[1]&&arguments[1];select.root=o,dom.root=document.querySelector(select.root),dom.root&&(dom.control=document.querySelector(select.control),dom.control.addEventListener("click",onToggleClicked),setPanelState(e),window.addEventListener("scroll",onWindowScroll),dom.root.removeAttribute("hidden"))}function isPanelOpen(){return dom.root.classList.contains(}function setPanelState(o){dom.root.classList[o?"add":"remove"](,dom.root.classList[o?"remove":"add"](select.closed),dom.control.setAttribute("aria-expanded",o)}function onToggleClicked(){var l=!isPanelOpen();setPanelState(l)}function onWindowScroll(){window.requestAnimationFrame(function() {var l=isPanelOpen(),n=0===(document.body.scrollTop||document.documentElement.scrollTop);n||l||!allowExpand?n&&l&&(allowExpand=!0,setPanelState(!1)):(allowExpand=!1,setPanelState(!0))});}pencilInit(".js-sub-pencil",!1); // via darwin-bg var slideIndex = 0; carousel(); function carousel() { var i; var x = document.getElementsByClassName("subs_valueprop"); for (i = 0; i < x.length; i++) { x[i].style.display = "none"; } slideIndex++; if (slideIndex> x.length) { slideIndex = 1; } x[slideIndex - 1].style.display = "block"; setTimeout(carousel, 2500); } //

Armen Bakirtzian, the CEO of IntelliJoint Surgical Inc., a Waterloo-based company that has created a technology for ensuring hip replacements are aligned correctly.

Glen Lowson/The Globe and Mail/The Globe and Mail

When Armen Bakirtzian’s startup developed technology in the early 2010s to improve the outcome of hip-replacement surgeries, 12 orthopedic surgeons at five Ontario hospitals helped it get the product right.

But after nine months of trying to sell the finished product – a miniature navigation system used during surgeries to better select and align implants – to the same five hospitals, his Kitchener, Ont.-based Intellijoint Surgical Inc. gave up.

“The surgeons were champions of our product, [but] they had very little influence over purchasing decisions,” said Mr. Bakirtzian, the company’s chief executive. So he turned his attention south. Now, 90 per cent of Intellijoint’s business comes from the United States and the rest from Australia, where doctors have used his system in more than 10,000 operations. “It pains me to not have any [business] in Canada; it’s slightly embarrassing,” he said.

Story continues below advertisement

Mr. Bakirtzian’s story is all too familiar in Canada, where medical-technology (medtech) startups typically struggle to sell in their own backyard despite the country’s reputation for breakthroughs, including the discovery of insulin and creation of the pacemaker. A federal government pilot project is aiming to change that.

On Monday, Small Business Minister Mary Ng will announce Ottawa is investing up to $20-million to create a network comprised of eight health-care institutions in Ontario, including Trillium Health Partners, Sunnybrook Health Sciences Centre and University Health Network, and five in Western Canada anchored by the Saskatchewan Health Authority.

The goal is for the institutions to work collectively through the network to become early adopters of homegrown medical technology and “unlock a new health-care economy … and to scale Canadian companies so they have a local market and can compete globally,” said Trillium chief of staff Dante Morra, the driving force behind the project.

“This is about creating a domestic integrated market,” Ms. Ng said. “I’m a big fan of being practical and pragmatic. … That’s what this is.”

Under the project, Dr. Morra said, the partners will each put forward various problems they are looking for Canadian innovators to solve. The focus will be on medical devices and software, not drugs. Once one institution validates and agrees to buy the technology, the startup will then be able to sell to the other network partners “without having to go through another procurement cycle,” Dr. Morra said. “The initiative is a buying group that is buying innovation.”

The pilot targets a problem that’s a byproduct of Canada’s public health-care system, which “is very efficient and good at buying commoditized health-care products,” said Brian Courtney, a cardiologist at Sunnybrook and CEO of Toronto’s Conavi Medical Inc., a developer of medical devices that provide images from inside the heart during procedures such as angioplasties.

But that cost-consciousness breeds risk aversion. “We tend to be relatively late adopters of technologies compared to other jurisdictions,” he said. “There is no financial incentive [in Canada] to use newer technologies that might improve care” – despite the longer-term impacts, including lower overall health-care costs the innovations may bring.

Story continues below advertisement

That is borne out in several studies, including an October, 2018, paper by the University of Toronto’s Impact Centre, which found “the [Canadian] health-care system is not aligned to purchase the innovation that comes out of the health tech system, and in fact, can act as a brake on innovation.”

By contrast, doctors and institutions in the private U.S. health-care market are likelier to try and adopt new technologies to stay competitive. That leaves many Canadian medtech startups with a choice: spend precious time and money working with potential domestic customers without knowing if it will lead to revenue, or focus abroad. Many choose the foreign route because “it’s very irresponsible for companies to spend limited resources on an uncertain outcome,” Intellijoint’s Mr. Bakirtzian said.

Making the Canadian system more friendly to innovators would require changes to procurement practices and reimbursement schedules, and a broader culture shift by provincial health departments to see themselves as not only providers of care, but also stimulants of domestic economic activity.

In the absence of such broader changes, Mr. Bakirtzian said he welcomed the pilot as a “hack to the system” that could benefit startups such as his. “I’m more hopeful about this program than I have been for other” government initiatives to support medtech startups. “We have confidence there’s something different here. It’s an exciting pathway we’re willing and happy to go down.”

Your time is valuable. Have the Top Business Headlines newsletter conveniently delivered to your inbox in the morning or evening. Sign up today.

Your Globe

Build your personal news feed

  1. Follow topics and authors relevant to your reading interests.
  2. Check your Following feed daily, and never miss an article. Access your Following feed from your account menu at the top right corner of every page.

Follow the author of this article:

Follow topics related to this article:

View more suggestions in Following Read more about following topics and authors
Report an error Editorial code of conduct
Due to technical reasons, we have temporarily removed commenting from our articles. We hope to have this fixed soon. Thank you for your patience. If you are looking to give feedback on our new site, please send it along to If you want to write a letter to the editor, please forward to

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff.

We aim to create a safe and valuable space for discussion and debate. That means:

  • Treat others as you wish to be treated
  • Criticize ideas, not people
  • Stay on topic
  • Avoid the use of toxic and offensive language
  • Flag bad behaviour

If you do not see your comment posted immediately, it is being reviewed by the moderation team and may appear shortly, generally within an hour.

We aim to have all comments reviewed in a timely manner.

Comments that violate our community guidelines will not be posted.

UPDATED: Read our community guidelines here

Discussion loading ...

To view this site properly, enable cookies in your browser. Read our privacy policy to learn more.
How to enable cookies