How do we enable an integrated health system in Alberta? This was the guiding question at the IHE Policy Forum on September 17th, 2025, a gathering of leaders, researchers, clinicians, policymakers, and system innovators. Hosted in Edmonton, the forum brought together a deliberately small, yet high-impact circle of participants. They came not only as representatives of their own organizations, but more importantly as part of a shared inquiry.
The Shared Challenge
Across the globe, health systems are converging on a common aim: population health. But the big question is how to get there. Alberta, like many other provinces, faces the paradox of bold ambition alongside entrenched barriers. Participants named shared struggles such as siloed funding models, workforce strain and burnout, and the urgent demand to deliver on both equity and outcomes. These challenges were not framed as Alberta’s alone, but as part of a global story that requires local courage.
Beyond these challenges, Alberta’s health system is currently facing significant restructuring. In May 2025, the Government of Alberta introduced four distinct ministries aligned with the provinces refocused health agencies: Primary and Preventative Health Services, Hospital and Surgical Health Services, Mental Health and Addiction, and Assisted Living and Social Services.
This change signals an intent to move deeper into addressing each domain of care, strengthening focus and accountability within specific and well-defined portfolios. Yet, as participants reflected, the real opportunity lies not only in the depth of each ministry, but in the connective tissues that links them together. We are starting to understand that integration depends on the relationships, governance structures, and shared priorities that bridge ministries, sectors, and regions. The promise of this new configuration will be realized when Albertans experience these ministries as one connected system, centred on people first rather than distinct groupings of health.
The emerging Integration Council was seen as a key mechanism to create the conditions for collaborative leadership, when interdependence is intentionally hardwired and the opportunity to lead both within and across ministries is enabled.
Defining Quality in an Integrated System
The session opened with reflections on Alberta’s evolving definition of quality. Jessie Gish, Lead for Health System Improvement at Health Quality Alberta, shared the new Alberta Quality Framework for Health, a refreshed approach that redefines what quality means in an integrated, people-centred system.
In developing this new framework, HQCA brought together system partners, patient advisors, and national experts to reflect on the best of Canada’s quality and safety frameworks, while also drawing on international sources such as the Nine Pillars of Integrated Care from IFIC. The result is a modernized graphic that places people at the centre and introduces “Integrated” as a new dimension of quality, alongside being safe, effective, equitable, efficient, accessible, and timely.
These dimensions are interdependent: quality depends on integration, and integration depends on a people-centred approach. Integration, as defined in the new matrix, means “interconnected people, teams, sectors, organizations, and communities.” It calls for relationships across different roles, accountabilities, and professional cultures that bring about responsive and organized models of care delivery.
Gish reminded the audience that Alberta is at a critical moment for health system planning and delivery. “When people agree on what quality care looks like,” she noted, “we are far more likely to align on how we fund, plan, measure, and deliver it across the system.”
A Systems Lens
The conversation moved deeper. Transformation, many reflected, is not achieved solely through technical redesign. Transformation requires a shift in the deeper conditions that shape systems, including relationships, power dynamics, and mental models. As voices built on one another, a theme emerged: change happens when we move from transactional exchanges to radical collaboration; from organizational mandates to shared purposes; from Old Power to New Power; from scarcity thinking to abundance mindsets. These deeper conditions are not surface-level technicalities. They reflect long-standing patterns and embedded norms that must be shifted if real change is to take root.
From Vision to Practice
Building on these ideas, the conversation turned to the Nine Building Blocks of Integrated Care. These elements — three fundamental (shared values and vision, people as partners, governance and leadership), three enabling (aligned funding, workforce capability, digital solutions), and three outcome-oriented (transparent measurement, resilient communities, population health) — were presented as levers for alignment across systems. Participants observed that what matters most is not their individual strength, but how they work together as an interconnected framework for improvement.
The Alberta Quality Framework provides one such anchor. A bridge between the conceptual and the operational. It connects global principles of integration to local action.
Learning from Abroad
The forum also looked outward. Using examples from New South Wales (NSW), Australia, participants explored how Alberta and NSW are “oceans apart but two sides of the same coin.” Both have regionalized structures. Alberta’s seven corridors of care and NSW’s ten primary health networks, with similar hospital capacity and investment.
In NSW, the performance framework has been foundational. It clearly defines roles, priorities, and expectations across the health system, from purchasing and commissioning to quality improvement and analytics. Local health districts are assessed publicly, and this openness and transparency has driven improvement and collaboration rather than competition.
As Ray Messom explained, this structure provides a “playbook” for system alignment, but success depends on having the “team coaches” who bring it to life. Integration there is what people come to work and strive for every day. Data governance is central, linking patient experiences, workforce well-being, and clinical outcomes through programs like LUMOS, which connects primary and acute care data to highlight patient journeys and guide local improvement.
The NSW experience reinforced that integration is both a mindset and a management discipline. It thrives when governance, measurement, and shared learning are connected. When improvement is not something done to people, but done with them.
Modelling Collaboration in Real Time
Perhaps the most striking element of the forum was how the room itself became a model of what integration looks like. Policy voices sat alongside practitioners. Researchers exchanged with community leaders. System executives listened to those driving innovation on the ground. As these perspectives interacted and shared, new patterns of possibility began to emerge.
We are at a moment where integration cannot just be managed and discussed. It must be lived. These interactions offered a glimpse into what Alberta’s health future could look like when collaboration becomes the norm.
Looking Forward Together
By the end of the forum, the collective learning was clear. Enabling an integrated health system in Alberta will take courage, creativity, and deliberate connection. It will require reimagining how we convene, how capacity is supported, and how collective action is aligned to outcomes that matter most to people and communities. One theme echoed throughout the day, capturing both the spirit of the conversation and the collective journey ahead.
You can watch Jodeme's presentation here and find the rest of the forum videos on the IHE Youtube channel:
Connection is the correction. Together makes progress.