A Data Driven Approach to Healthcare Planning

In the shadow of Alberta’s majestic Rockies, the towns of Canmore and Grande Cache offer a compelling case study in rural opportunity—and disparity. Both are rich in natural beauty and outdoor recreation, attracting visitors and residents alike with the promise of mountain living. Canmore, nestled in the Bow Valley, and Grande Cache, surrounded by 21 rugged peaks, share a history rooted in coal mining and a lifestyle shaped by their remote geography.

On paper, these towns should be equally vibrant. Both boast stunning landscapes and the potential for economic and recreational growth. Yet while Canmore thrives with a booming population, bustling tourism, and an active lifestyle economy, Grande Cache continues to grapple with economic stagnation, poor health outcomes, and outmigration. The contrast between them is stark—and telling.

A subtle, yet symbolic, indicator of this divide? Boston Pizza. Canmore has one; Grande Cache doesn’t.

That may seem trivial, but it’s not. The presence of a Boston Pizza franchise can be read as a proxy for community viability—signaling sufficient economic activity, population density, and social engagement to support a large family-friendly restaurant. Which begs the question: if Boston Pizza uses data-driven models to decide where to open new locations, why can’t Alberta’s health system apply similar private-sector logic to public health planning and fiscal stewardship?

When Demand Shifts, So Should the System

Just like schools, health care infrastructure must evolve with the communities it serves. In nearly every Alberta town, the story is familiar: one school faces closure due to declining enrollment, while another down the highway is bursting at the seams. Then the demographics shift again, and the cycle reverses. Our public services, especially health care, need the same kind of adaptability.

A younger population needs maternity wards, walk-in clinics, emergency care, and immunization programs. As that same population ages, the focus shifts to chronic disease management, home care, and rehabilitation. Eventually, the priority becomes mobility support, convalescent care, and continuing care services. But Alberta’s infrastructure hasn’t kept pace. It remains stuck in the 1970’s—often misaligned with the evolving needs of health care technology and the people it’s meant to serve.

Nowhere is this more evident than in our acute care system.

In 2023–24, Canada saw 3.05 million hospitalizations, representing a rate of 6,992 per 100,000 people (CIHI, 2025). But these raw numbers obscure a deeper issue: many hospital admissions are for conditions that could have been treated in community settings. Others represent repeat visits or are driven by gaps in preventive care. Hospital beds are being filled, but not always appropriately.

The result? A growing number of patients are stuck in the wrong place at the wrong time. Across Canada, 6.2% of hospital stays result in what’s termed “alternate level of care” (ALC) days—when a patient occupies a hospital bed but no longer requires acute care. In Alberta, this translates to nearly 190,000 hospital stays annually. Edmonton’s hospitals, for example, report occupancy rates ranging from 100% to 112%, with ALC rates as high as 17.7% (HQCA, 2025).

At any given moment, about 1,600 acute care beds in Alberta are filled by people who should be recovering in supportive housing, rehabilitation centres, or continuing care homes. Instead, they’re receiving the province’s most expensive care in the least appropriate setting—at taxpayer expense.

So how do we fix it? Look at the data the same way Boston Pizza does. A simple overlay of Boston Pizza locations and Alberta’s population density shows a familiar pattern.

These restaurants don’t appear in isolated communities—they follow people, demand, and economic viability. Meanwhile, Alberta’s 106 hospitals are scattered more like A&W outlets – tucked between the grain silos and the town’s only traffic light.

By using this kind of logic—private sector value for dollar applied to public sector planning—we could reimagine Alberta’s healthcare map. Of the 106 current acute care hospitals, 63 are within 50 km of a major hospital and could be transitioned into restorative and community care hubs. These facilities could specialize in rehabilitation, convalescence, maternal and child health, palliative care, and long-term chronic disease management along with urgent care – services that are increasingly in demand but underserved in many communities.

The result? A system that matches care to real need.

By reducing Alberta’s acute care facilities from 106 to 43, the province could maintain universal access to critical services while repurposing existing infrastructure to meet the demographic realities of each region. It’s about smarter allocation, about making sure the system serves today’s Alberta, not yesterdays.

Using the new regional health corridors, a hub-and-spoke model could deliver more responsive, integrated care, while empowering local decision-makers to tailor services to their communities.

When the System Shifts, So Should the Staffing

Alberta’s health system isn’t just overwhelmed—it’s misaligned. While hospitals operate beyond capacity thresholds, staff shortages are grinding the system to a halt, especially in rural communities. Emergency departments, maternity wards, operating rooms, and acute care beds are being shuttered—not due to lack of buildings, but lack of healthcare workers.

With a population just over 5 million, Alberta’s healthcare demands are outpacing its capacity to supply professionals. As of April 2025, the province had approximately 12,212 registered physicians, including 4,370 family medicine specialists. Despite adding 474 new physicians in 2024, population growth continues to surpass physician availability (Saeed, 2025). The Alberta Medical Association has raised alarms about family doctors being overwhelmed by patient volumes, compromising their ability to manage chronic diseases and potentially delaying diagnoses (Villani, 2025).

Meanwhile, more than 44,798 registered nurses and nurse practitioners renewed their licenses in 2024–25, and the health system is increasingly integrating nurse practitioners (NPs) and licensed practical nurses (LPNs) (CRNA, 2024; Alberta Health, 2025). This workforce represents an untapped opportunity: if strategically deployed and supported to work to full scope, these professionals could play a transformative role in shifting care away from overburdened hospitals and toward community-based models.

Looking again to private industry—Boston Pizza doesn’t build in places where there’s no one to hire. The cost of recruiting, relocating, and retaining staff is steep, so the smart play is to build where the workforce already exists. In health care, of course, staffing is more complex than in hospitality. Hospitals need far more than doctors and nurses. They require teams of specialized professionals: physiotherapists, occupational therapists, lab technologists, pharmacists, environmental services staff, engineers, dieticians, cooks, maintenance, and more. Many of these roles require years of education and even more years of experience.

In rural Alberta, the challenge is even more acute.

A single family doctor may be expected to provide hospital coverage, run a busy primary care clinic, and manage everything from prenatal care to palliative support—all while promoting prevention and managing chronic disease. Allied health staff, often spread thin across several rural communities, may only be available one or two days a week. That’s not enough to rehabilitate elderly patients recovering in hospital, or support community members managing complex conditions.

We don’t just have a staffing shortage—we have a workforce distribution problem.

By redesigning the system and refocusing services around true population needs, Alberta can make better use of the talent it already has. That means matching staff skills to settings where they can work to full scope and make the greatest impact.

We already see it in pockets of success. Registered Nurses with advanced training are working in primary care networks across the province, managing caseloads, leading health promotion programs, and providing direct interventions without a hospital or physician visit. If that model were scaled, every Albertan could receive community-based chronic disease management: diabetes or asthma care from a nurse, medication reviews and prescription renewals from a pharmacist, and ongoing support from a care team coordinated by family doctors or nurse practitioners.

This isn’t theoretical—it’s essential.

The global shortage of health professionals is real. But Alberta doesn’t just need more people; it needs to rethink how and where they work. Acute care hospitals and specialized restorative care sites could be structured to support the full breadth of healthcare providers, allowing regulated professionals to operate where their training and licensing are best aligned with local needs.

A workforce strategy built on population demand, supported by legislative change, and designed around collaborative care models would relieve pressure on physicians, empower nurses and allied health professionals, and make health care more accessible, responsive, and sustainable for every Albertan.

Rethinking the Map of Health Care

Alberta stands at a crossroads—one shaped not just by policy decisions or budget lines, but by geography, demography, and the very real lives of people across the province. From the active, thriving community of Canmore to the resilient but underserved residents of Grande Cache, it’s clear that our current health care system isn’t keeping pace with population needs or patterns.

The presence of a Boston Pizza might seem like a trivial marker of community vitality—but it tells us something important. Private businesses succeed when they place themselves where people live, work, and gather. They invest where there’s demand, infrastructure, and a workforce to draw from. If Alberta’s health system took the same pragmatic, evidence-informed approach—anchored in where people are and what services they truly need—we could unlock extraordinary value for both patients and taxpayers.

This isn’t about doing more with less. It’s about doing better with what we already have.

By strategically realigning acute care services, converting underused hospitals into restorative and community care hubs, delivering urgent care services where they are needed, and redistributing the health workforce to reflect population health—not just historical precedent—we can build a smarter, more resilient health system. One that offers timely access to acute care when it’s needed and delivers high-quality, continuous care in communities before that need ever arises.

The future of health care in Alberta won’t be decided by any one program or policy. It will be shaped by our willingness to look critically at the data, to borrow what works from beyond the sector, and to put people—not buildings or legacy systems—at the centre of our decisions.

It’s time to think differently.

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By Kimberly Nickoriuk (RN) & Lisa Gordey (RN)