F R E E I S S U E
THE
Contributors to this issue:
Colin Andersen, CEO of the Ontario
Power Authority, weighs in on the great
opportunities the Green Energy Act presents
to the engineering sector (page 16).
Tony Dean, a fellow in residence at the
School of Public Policy at the University
of Toronto, explains how engineers can
influence public policy-making (page 19).
Matthew Mendelsohn, founding
director of the Mowat Centre for Policy
Innovation at the University of Toronto,
details highly effective strategies
engineers can use to get a foot in the
door at Queen’s Park (page 21).
Volume 1 • No 4 | September 2009
JOURNAL
OF POLICY ENGAGEMENT
Introduction
ne of our goals at the Ontario Centre
O for Engineering and Public Policy is to
demonstrate to decision-makers, opin-
ion leaders and the broader public the breadth of
the work of Ontario’s engineers, especially in ar-
eas where their contributions are perhaps unrec-
ognized. One such field is the health-care system.
In our own way, we are trying to redress this situ-
ation with three separate articles on the subject.
As with issue #3 of The Journal of Policy En-
gagement, I am pleased to showcase the ground-
breaking work of a bright young engineer–in this
case Alex Mihailidis of the University of Toronto. I
first became aware of Alex’s work about this time
last year through the Toronto Star. Alex was one
of five innovators profiled by the newspaper, two
of whom were engineers. The goal of Alex Intel-
ligent Assistive Technology and Systems Lab is to
“develop zero-effort technologies that are adaptive,
flexible and intelligent to enable users to participate
fully in their daily lives.”
I was particularly attracted to Alex’s work for a
couple of reasons. First, Alex and his collaborator,
Jennifer Boger, are working outside of a traditional
faculty of engineering, in this case the department
of occupational science and occupational therapy.
Second, Alex makes no bones about engineering
being a helping profession. His work is all about
dignity and quality of life. I have particular empathy
for this research since I sit on the volunteer board
of directors of a Meals on Wheels organization in
my community, a group also dedicated to provid-
ing individuals with the means that allow them to
remain in their homes.
The second article also demonstrates the im-
portant role engineering plays in the health-care
sector. In their work, Michael Carter and Andriy
Kolos of the Centre for Research in Healthcare
Engineering at the University of Toronto fo-
cus “...on the application of industrial/systems
engineering techniques in relation to demand and
capacity modelling and resource allocation issues in
Vol 1 • No 4 | September 2009
the health-care industry. Our goals include creating
quantitative decision support tools to help policy-
makers and industry leaders make better-informed
decisions.” In this particular article, they review
their efforts attacking the surgery wait list problem
in Ontario. While the McGuinty government is to
be credited for allocating additional resources to
this problem, it is equally refreshing to see that
Carter’s and Kolos’s work has led to data-driven
decision-making at Queen’s Park.
In the past few months, the issue of medical
isotopes has dominated national headlines, not
least because of some unfortunate comments
In this issue:
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
How engineers are helping seniors
with dementia stay at home
By Alex Mihailidis and Jennifer Boger . . . 2
Reduction of Ontario surgical
wait times
By Michael Carter and Andriy Kolos . . . . . . 9
Canada’s medical isotope crisis:
A way forward
By Jatin Nathwani . . . . . . . . . . . . . . . . . . . . . 12
Between a rock and a hard place:
An engineer’s duty to warn
By Catherine Karakatsanis . . . . . . . . . . . . . . 14
The Green Energy Act and the
future of sustainable electricity
in Ontario
By Colin Andersen . . . . . . . . . . . . . . . . . . . . . 16
What can engineers do to gain better
access to the corridors of power?
By Tony Dean . . . . . . . . . . . . . . . . . . . . . . . . . . 19
What can engineers do to gain better
access to the corridors of power?
By Matthew Mendelsohn . . . . . . . . . . . . . . . 21
1
 e of the federal natural resources minister that
ON TA R IO CEN T R E
FOR ENGINEERING
AND PUBLIC POLICY
THE
JOURNAL
OF POLICY ENGAGEMENT
Vol 1 • No 4 | September 2009
The Journal of Policy Engagement is pub-
lished six times a year by the Ontario
Centre for Engineering and Public Policy.
The council of Professional Engineers
Ontario (PEO) established the centre
in June 2008 to enhance the engage-
ment of the engineering profession in
the development of public policy to bet-
ter serve and protect the public inter-
est. The centre’s mandate also includes
outreach to members of the engineering
profession, the academic community,
policy-makers and others interested in
advancing the public interest. The views
expressed here are those of the authors
and do not necessarily reflect those of
PEO or any other organization.
Contact:
Donald Wallace, Executive Director
Ontario Centre for Engineering
and Public Policy
1000-25 Sheppard Avenue West
Toronto, Ontario M2N 6S9
416-840-1078
dwallace@ocepp.ca
SUBSCRIPTIONS (non-PEO members)
Canada (6 issues): $21.00 incl. GST
Other (6 issues): $25.00
Students (6 issues): $10.50 incl. GST
Single copy: $3.67 incl. GST
Approximately $5.00 from each PEO membership fee
is allocated to The Journal of Policy Engagement and
is non-deductible. Contact: Catherine Shearer-Kudel,
416-224-1100, ext. 1204, cshearerkudel@ocepp.ca.
2 The Journal of Policy Engagement
were caught on tape. If you are like me, you’ll
appreciate University of Waterloo engineer Jatin
Nathwani’s dispassionate and reasoned approach
to this complex subject. With his work on this
matter and others like Smart Grid, Jatin is the
epitome of an engineering leader fully engaged
with government and the pressing issues of our
society. Excerpts from his recent testimony before
a Commons committee are included inside.
We are also most fortunate to have PEO
President Catherine Karakatsanis contribute an
article on an engineer’s duty to report. This piece
had its genesis in a presentation Catherine made
at a seminar of the Ontario Bar Association’s en-
vironmental section. That session was designed
to address the tricky problem of the potential
conflict between the duty to report and client/
solicitor privilege. When I attended the seminar,
I instantly perceived that Catherine’s insightful
overview deserved a wider audience. I’m grateful
to Bruce Matthews, PEO deputy registrar, regula-
tory compliance, and David Smith, PEO’s manager
of communications, for their help on this article.
I am very pleased to include here three pre-
sentations from our recent policy conference. On
May 8, the Ontario Centre for Engineering and
Public Policy gathered more than 200 industry
executives, engineers, Ontario government policy
How engineers are helping seniors with dementia
stay at home
By Alex Mihailidis, PhD, P.Eng., and Jennifer Boger
Executive summary
Medical breakthroughs and better overall health
care have become part of a double-edged sword.
While people are living longer, there has been an
increase in mental conditions associated with ag-
ing, such as dementia and particularly Alzheimer’s
disease. Looking ahead, people are expected to
grow even older and, as a result, more people will
suffer from these debilitating conditions.
While there is no cure for this mental aspect of
aging, engineers are at the forefront of developing
innovative technology that allows sufferers to
cope better with day-to-day living. Among the
exciting discoveries, known as cognitive assistive
technologies, are sophisticated sensors that help
advisers, university faculty and students, and
association personnel to examine the interface
between engineering and public policy. The day
was a resounding success, in no small measure
as a result of the uniformly high quality of the
presentations. From his current perspective as
CEO of the Ontario Power Authority and backed
by a background as a long-standing Ontario dep-
uty minister of finance, Colin Andersen offered
a frank and insightful reading of how engineers
can make their voices heard by policy-makers
and opinion leaders, particularly in the context
of the recently adopted Green Energy Act.
We were exceptionally privileged to have
Tony Dean, former secretary to the Ontario
cabinet and head of the Ontario public ser-
vice, and Matthew Mendelsohn, former
associate secretary of the cabinet among
other deputy minister assignments, as speak-
ers. Many engineers have asked me how to
engage effectively in the policy process, and I
am glad to include the advice of these ulti-
mate insiders.
Please don’t hesitate to share your thoughts
with me (dwallace@ocepp.ca). Your views matter.
Donald Wallace
Executive Director
Ontario Centre for Engineering and Public Policy
people manage ordinary tasks, such as hand wash-
ing or toileting, which they might not otherwise
be able to perform on their own. Through verbal
and/or visual cues, dementia sufferers are taken
through these activities on a step-by-step basis
that allows them to accomplish these basic func-
tions without the help of a caregiver.
The result: a greater number of older people
with cognitive impairments can remain in the
familiar surroundings of their homes, relieving
pressure on family and institutions that might
otherwise have to care for them.
One of the most sophisticated cognitive assis-
tive technologies is the product of the University
of Toronto’s Intelligent Assistive Technology and
Systems Lab in collaboration with the Toronto Rehabilitation Institute.
Known as COACH, this user-friendly system employs computer vision and
artificial intelligence techniques to provide oral and/or visual reminders
for common-care activities. Its success demonstrates how engineers,
working in tandem with professionals from other disciplines, can achieve
results that dramatically make a difference in people’s quality of life.
Introduction
Imagine losing the ability to take care of yourself, not being able to
remember how to complete even the most basic tasks like using the
toilet or getting dressed. As your memory gets worse, your need for
supervision and help from your spouse, son, daughter or a caregiver
increases to the point where the burden becomes so great that you
are forced to leave your own home and live in a long-term care facility.
Sadly, this scenario is far too common for many older adults who live
with a cognitive disability, such as dementia or Alzheimer’s disease.
What can be done to help these people stay in their own homes,
while easing the burden of care on their families and loved ones?
Various research studies have concluded that older adults (par-
ticularly those who have Alzheimer’s) function better in familiar en-
vironments that can provide memory and task cues (Bryant, Cutchin,
Intille). However, any shift from hospital to home-based care means an
increasing dependence on family members and other informal caregiv-
ers to attend to the long-term health-care needs of older adults with
Alzheimer’s. Continuous supervision of the care recipient is exhausting
and difficult for family caregivers, especially for activities that require
an invasion of privacy, such as toileting.
Furthermore, increased dependence and changes in the relationship
dynamic between people with Alzheimer’s and their family caregivers
are often difficult to accept. The role reversal that accompanies care
by a son or daughter can add to feelings of helplessness and embar-
rassment for both the caregiver and recipient (Dura, Stukenberg and
Kiecolt-Glaser).
In response to the above concerns, engineers have become in-
strumental in addressing the question of how to better care for our
growing older-adult population. They have developed new, sophisticated
technological solutions, known as cognitive assistive technologies
(CAT). These CATs help Alzheimer’s and dementia sufferers perform
a range of different tasks, such as getting dressed, meal preparation
and self-care (Intille).
These technologies come in a wide variety of forms, from hand-held
devices, such as Palm Pilots, to more advanced systems that are inte-
grated into the user’s environment, such as a smart home. Often coupled
with some form of artificial intelligence, CATs strive to support cognitive
disorders, thereby enhancing the user’s autonomy (Mann et al.).
This paper presents an overview of CATs and how they have been
used to date in the home to support older adults with dementia. The
scope includes a consideration of aging and dementia, key examples of
CATs, including a case study of a breakthrough technology developed at
the University of Toronto. The paper concludes with a discussion of this
field’s future and how engineers can continue to play a significant role,
not only in the development of new CATs but also in the wider application
of technology to some of the challenges of aging.
Volume 1 • No 4 | September 2009
Aging and dementia
Globally, the number of individuals aged 65 years and older is predicted
to increase steadily, particularly among those aged 80 years and over,
after the year 2010 (U.S. Census Bureau). This will result in an increase
in the worldwide number of individuals diagnosed with dementia,
particularly Alzheimer’s, to 81.1 million by 2040 from the estimated
24.3 million individuals in 2006 (Ferri et al.).
Dementia is an acquired, persistent condition where significant
deficits exist in memory and other cognitive functions sufficient to
interfere in social and occupational function (American Psychiatric
Association). Alzheimer’s is the most common form of dementia and
has, in many respects, become synonymous with the broad category
of dementia. The primary clinical features associated with Alzheimer’s
include severe memory deficits and compromised episodic, procedural
and semantic memory (memory involved in recalling personal events,
remembering the sequence of actions and retaining knowledge, skill
and understanding).
People with Alzheimer’s have difficulty with delayed and immediate
recall of information. These memory difficulties cause problems with
orientation to time, place and person. Alzheimer’s is a progressive
disease, with associated difficulties worsening with time. This makes
it extremely difficult, and eventually impossible, for a person with
Alzheimer’s to learn and retain new information (Lubinski). To date,
there is no cure, although drug treatments can slow the progression
in most cases.
As a dementia such as Alzheimer’s progresses, a person may need
assistance in various self-care activities because he/she lacks the initiation
and planning abilities to carry out these tasks (Harrell et al.). In the early
stages, the underlying problem may be an inability to locate a particular
room, such as the washroom, as a result of spatial disorientation. As
the disease progresses, a person tends to have difficulty initiating a
task, such as taking medication or remembering the proper sequence
of steps that must occur during the activity. For example, a person may
use the toilet before removing the appropriate clothing.
During early stages, occasional verbal cueing, or prompting, will
suffice. However, as dementia progresses, constant supervision and
assistance are required. It is often at this stage that the burden of care
becomes too great, and the person is removed from his/her home.
Cognitive assistive technology
CATs have been developed to assist people with a variety of disabilities,
including traumatic brain injury, stroke, learning disabilities, multiple
sclerosis, autism and dementia (LoPresti, Mihailidis and Kirsch). De-
pending on the user’s specific needs, these technologies may be used
in a number of ways. One approach is to capitalize on skills that have
not been compromised, enabling a person to complete tasks using
alternative strategies. For example, a person with poor visual letter
recognition, but strong verbal language skills, may employ a computer
that generates emails using speech recognition rather than typing.
Similarly, a personal digital assistant may be used for daily planning
by a person with memory impairments, but relatively intact execu-
tive skills. For more severely impaired individuals, an alternative ap-
proach has been to develop extrinsic interventions that assume greater
3
responsibility for initiation, cueing, activity guidance and maintenance
of daily information. For example, a technology may be designed that,
in addition to providing simple alarms about when medications are
to be taken, provides step-by-step guidance about how to take the
medication (LoPresti, Mihailidis and Kirsch).
A multitude of CAT devices have been developed in response to the
broad and diverse range of needs and abilities. As it is not possible to
address the full spectrum of available CATs, this paper primarily focuses
on technologies intended for older adults with dementia and similar
cognitive impairments. (For a more detailed discussion of other types of
CATs, the reader is referred to LoPresti, Mihailidis and Kirsch.)
A significant amount of recent work in CATs relies on various
computing techniques, such as artificial intelligence and probabilis-
tic modelling, to infer task and user status from sensors distributed
throughout a person’s living environment (Pentney et al.). For example,
software known as Autominder uses artificial intelligence planning to
schedule events (e.g. medication taking) at times when they will not
interfere with a person’s daily schedule, such as favourite television
programs or daily walks (Pollack). Autominder also uses environmental
sensors to detect the status of activities and, if required, provides the
user with context-aware reminders regarding unattended activities.
The Gator Tech Smart House is an example of a smart home de-
signed with older adults in mind (Helal et al.). Sensors distributed
throughout the house interact with applications running on computers
to take into account context when performing actions. For example, if
it is a sunny day outside and the occupant has the television on, the
Gator Tech Smart House will automatically close the blinds to reduce
glare. Other features include medication reminders that can appear
on the bathroom mirror and automatic sensing and ordering for soap
and toilet paper refills.
Pigot et al. developed Archipel, a cognitive modelling system for
cooking tasks that recognizes the user’s intended plan and adapts
prompting to a predetermined cognitive impairment level. Sensors
placed in the kitchen environment, such as radio frequency identification
technology tags and readers, detect which objects have been used
and provide cues (audio, video and strategic lighting) to help users
through each step in the task. As with Autominder, Archipel will not
give reminders for tasks the person has already accomplished.
In addition to the above systems, which are primarily installed
within a person’s environment, there are also several CATs designed
as wearable devices. For example, memory glasses is a context-aware
memory aid that is embedded in a pair of eyeglasses, which provides
reminders to the wearer (Bharucha et al.). The reminders take the form
of images and text. These glasses use a variety of computer vision
techniques to collect data from the user’s environment to infer the
user’s context and provide prompts that are relevant to the user and
his/her actions, preferences, etc. This device is targeted at helping
people to remember names and faces, which is a common problem for
those who have a mild cognitive impairment or dementia.
Microsoft’s SenseCam is a retrospective memory aid that uses a
small digital camera to passively take pictures while being worn around
a user’s neck. It employs a wide-angle lens to record events as they
happen, without any manual input from the user. The SenseCam then
4 The Journal of Policy Engagement
allows a user to view image sequences to help him/her remember
events that have occurred and share them with others, which in turn
is thought to lead to consolidation of autobiographical memory and
positive social interactions (Bharucha et al.).
The COACH prompting system
The extent to which CATs can aid an individual with dementia
depends on the user’s willingness to implement them, which in
turn depends on whether the individual and/or his/her caregiver
can operate the devices and feels the devices are helpful, and
whether they support or undermine the sense of personal identity
(McCreadie and Tinker). To be useful to both a care recipient and
his/her caregiver(s), a CAT must be autonomous, non-invasive
and not require explicit feedback (e.g. button presses), as this
cannot reasonably be expected of either people with Alzheimer’s
or overworked family members and caregivers.
The cognitive assistance should be able to accommodate
high levels of customization, as the more it is personalized and
appropriate to the deficits in question, the more likely it will be
adhered to and understood by the user (Wilson et al.). In addition,
assistance should be given only on an “as needed” basis to minimize
confusion and to keep the user as cognitively involved in the task
as possible.
Finally, the CAT should be user-friendly. The majority of currently
available CATs require extensive sensor deployment and maintenance
and/or input from a cognitively intact individual. This means the
caregiver would likely have to learn how to operate and, to some
degree, maintain a potentially complex planning system. As many
caregivers are overburdened as is, this additional expectation is not
realistic or appropriate and leads to non-acceptance or abandon-
ment of the device.
The Intelligent Assistive Technology and Systems Lab (IATSL)
at the University of Toronto and Toronto Rehabilitation Institute has
been working for several years to develop more advanced CATs that
keep the above design criteria in mind. IATSL, part of the university’s
department of occupational science and occupational therapy, is a
unique engineering laboratory in that it not only employs engineers
and engineering students, but also works with professionals from
other disciplines, such as occupational therapy, rehabilitation sci-
ences, speech language pathology and computer science, as well
as theatre and drama. This mix produces a highly interdisciplinary
approach in the development of new technologies, which is extremely
important in ensuring that a holistic approach is taken throughout
the engineering design process.
One of the devices that has come from this collaborative ap-
proach is an advanced CAT called COACH (Cognitive Orthosis for
Assisting aCtivities in the Home). COACH employs various computer
vision and artificial intelligence techniques to autonomously provide
an older dementia sufferer with oral and/or visual reminders during
common self-care activities, such as handwashing. Handwashing
was chosen because it is a relatively safe activity that older adults
with dementia have difficulty completing because of the planning and
initiation skills required.
 Camera

Monitor
and
speakers

(a) (b)
Figure 1: The COACH installation shows (a) a small video camera and a flat-screen monitor, and (b) a close-up of the
video prompt (for the rinse-hands step) being played in (a).

Since COACH uses very little hardware, purchasing costs are low
and installation requirements are realistic for a home environment.
As seen in Figure 1, the latest version of COACH consists only of an
overhead camera, a flat-screen monitor with built-in speakers and a
laptop computer.
The computerized portion of the system is represented in Figure 2.
It has four integrated components: tracking, state monitoring, policy
and prompting. During the software’s development, images captured
by the video camera are processed by the tracking system. The
tracking system extracts the hand and towel positions, which
are used by the belief-monitoring system to compute the belief
state, a probabilistic estimation of the current state of the user
and environment.
The belief state is passed from its monitor to the policy, which is es-
sentially a look-up table that determines the best course of action for the
system to take. The policy translates each belief state into an action.

Tracking hand Belief monitor

positions
video
grab frame convert
update tracker observations

check belief change

summon human
camera caregiver
new, stable belief
detected?

belief(s)

action
Prompting Policy

audio/video

Figure 2: The COACH system

Volume 1 • No 4 | September 2009 5

 Possible COACH actions are to provide a low-guidance oral prompt,
a high-guidance oral prompt, an oral prompt with an accompanying video
demonstration, a call to the caregiver to intervene, or to do nothing and
continue to observe the user. Having different levels of prompts allows
COACH to select the most appropriate support for each individual’s stage
of Alzheimer’s and overall responsiveness. Thus, the type of prompt
played for the user is based on factors such as the error committed,
sensory and cognitive status of the user, and past responsiveness to
the previous prompts.
Tracking is accomplished using a computer-vision technique known
as flocking, which was developed by IATSL collaborators at the Univer-
sity of Dundee (Hoey). Flocking uses models of skin and towel colour
combined with a Bayesian probability sequential-estimation method.
This means of tracking is able to dependably determine the location
of the user’s hands and the position of the towel, even after occlusion
by an object or after its leaving and returning to the camera’s field of
view. The COACH system tailors itself autonomously to the individual
needs of its users because it can estimate and use an individual’s
traits (e.g. cognitive awareness and responsiveness levels) and can
dynamically adapt to daily and long-term needs.
COACH audio prompts are recorded using a male actor to emulate
the cadence and tone of an expert caregiver. The user’s name is said at
the beginning of each prompt to get his/her attention. Previous studies
with COACH have found that some users can get confused about which
activity they were asked to complete (e.g. previous participants have
been known to wash the towel in the sink, wash their face instead of
their hands). Therefore, to help device users remember why they are
at the sink, prompts often contain a reminder of which activity they
are attempting to complete (e.g. “John, you’re washing your hands”),
followed by guidance for the step in the activity he/she is attempting
(e.g. “Try turning on the water using the silver lever”).
Since the addition of video capable of demonstrating how to cor-
rectly complete the activity step was shown to be helpful (Labelle and
Mihailidis), these capabilities were added to this version of COACH. The
video was shot from the perspective of the person who was washing
his/her hands. They were pre-recorded in the same washroom where
the device was installed to provide accurate demonstrations.
An important aspect of the research and development activities
at IATSL is the testing of all new technologies in real-world environ-
ments. This is especially crucial when developing new health-care
and assistive technologies for people with disabilities, as designing
for special or vulnerable populations could result in consequences
that are far more critical than when designing for a “typical” user.
With this in mind, the most recent COACH prototype was installed
in a long-term care facility where it was tested with six people with
dementia, five of whom had moderate-level dementia and one who
had severe dementia.
Efficacy testing of the system first consisted of observing each
participant perform handwashing without the use of the technology
(phase A) to obtain baseline measures of how much of the activity
he/she could complete independently and how much assistance he/
she required from a caregiver. At the completion of this baseline
phase, the COACH system was introduced and used as the primary
6 The Journal of Policy Engagement
form of assistance for each participant (phase B). The phases were
repeated in the order A-B-A-B. As can be seen in Figure 3, when
participants used COACH, they showed an overall increase in the
number of handwashing steps they were able to complete without
assistance from the caregiver, as well as a decrease in the number
of times they required assistance during the activity.
In general, COACH made the participants less dependent on a
human caregiver. Looking at the results individually, the effective-
ness of COACH varied considerably and seemed to be dependent on
each individual’s idiosyncrasies. These findings suggest that COACH
could be useful to individuals who prefer visual to tactile clues (e.g.
touching a person’s arm or physically guiding his/her hand). These
findings also support the importance of understanding the special,
diverse and dynamic needs of this target population to ensure that
appropriate, customizable assistance is available.
Overall results for all participants in the COACH efficacy trials
show (a) the mean number of steps completed independently, and
(b) the number of times the caregiver had to provide assistance. A1
and A 2 are the baseline phases (COACH not used), B1 and B2 are the
intervention phases (COACH used).
Still, several areas in need of improvement have been identified.
During this study, COACH had a total of 750 observed conditions. Of
these, 170 (23 per cent) were errors (i.e. a false alarm or a miss), which
occurred because the system misinterpreted a step in the handwashing
task. For example, an ambiguous user action like touching the taps
may have caused the system to incorrectly presume the water had
been turned on. Wrong assumptions by COACH reduce the probability
that the correct course of action will be taken. When COACH was not
able to correct itself through other observations, prompts were often
either missed or provided for the wrong step.
Yet the overall study results are very encouraging. Further clinical
trials are being planned that will include more participants and will be
conducted within homes. Some COACH improvements could include the
adaptation of the system to distinguish between multiple washroom
activities of daily living, such as tooth brushing, and, eventually, toilet-
ing, as well as the implementation of speech recognition to allow the
system to recognize other types of implicit user feedback and multiple
camera input (vision/tracking systems) gained by placing cameras in
various positions throughout the washroom. The latter could provide
greater user observation accuracy and versatility and would enable
3-D observations.
The future
The research described in this paper is changing the face of the assis-
tive technology field. The positive results being obtained are providing
strong evidence that assistive technology can be used to support older
adults with cognitive impairments remain independent. Those people–
especially those who have more severe levels of impairment–have often
been ignored in the development and use of assistive technologies.
In addition, the sophisticated techniques that are being applied in
these new CATs are providing strong evidence that areas that have
not traditionally been a part of the assistive technologies field, such
as artificial intelligence, can play a significant role in the development
 A1: B1: A 2: B2 :
Without COACH With COACH Without COACH With COACH
5

4.5

3.5

3
Mean (µ) number of interactions with a caregiver

2.5

1.5

0.5

0
0 5 10 15 20 25 30 35 40
Trial number

A1: B1: A 2: B2 :
Without COACH With COACH Without COACH With COACH
7

0
0 5 10 15 20 25 30 35 40
Trial number
Figure 3: How COACH can help

of solutions that are more flexible, scalable and robust–all important
design criteria for any technology to support older adults.
This realization has resulted in a large influx of new researchers
from fields like computer science, computer engineering and electrical
engineering, as well as an explosion in the number of research projects
that are being conducted with a focus on advanced technologies for
older adults with dementia. As a result, the road is being paved for more
innovative research and technologies.
In addition to developing COACH, researchers at IATSL and elsewhere
at the University of Toronto are working on several new projects that
capitalize on the emergence of artificial intelligence and other advanced
computer science concepts. Many of these projects apply concepts that
were developed for the COACH system. For example, similar computer
vision concepts have been used in the development of a fall detection
system that can automatically determine if a person has fallen (without
any markers or devices having to be worn by the user) and place a call
to the appropriate respondent based on a dialogue the system has with
the user via speech recognition.
With respect to the overarching goal of keeping older adults safe
in their own homes, many research groups are working towards the
common goal of developing an “intelligent home” that integrates
many of the CATs and concepts discussed in this paper. Such a home
would be able to sense and determine the actions, needs, preferences,
abilities and overall context of an occupant–and provide appropriate
assistance if and when necessary. This assistance may come in many
different forms, such as guidance for self-care activities, reminders
for medication, semi-automation of tasks (such as automatically
turning off the water when the bath is full), or just checking in with
the occupant to make sure he/she is feeling okay.
This type of intelligent environment would be useful to anyone,
not only to older adults who wish to stay in their own homes. For
example, a common scenario is an occupant who wants to leave the
house but does not remember where the has left the keys. Imagine
the house being able to recognize the user’s intent of wanting to
leave, automatically locating the keys and telling the occupant where
they are. While this scenario may seem far-fetched, the basis for
many of these technologies already exists (such as the COACH and
Autominder) and simply requires integration into a common platform.
The development of such a common platform has started to emerge
as a new research area at several universities across Canada (and,
indeed, globally), with the goal of achieving an intelligent home within
the next decade.

Volume 1 • No 4 | September 2009 7

 The future of the assistive technologies field, and in particular
CATs, to enable older adults to remain at home longer is looking
extremely bright. This is a direct result of the involvement of highly
skilled engineers from various disciplines and the close collaboration of
these engineers with researchers and experts from other professions,
such as computer science, rehabilitation sciences and nursing.
The field continues to flourish because of the significant increase
in the number of engineering students who are becoming interested
and actively involved in health care. Training of highly qualified en-
gineers and researchers, who are able to understand the needs of
older adults and others with health issues or disabilities, is proving
to be a crucial element in the expansion of this field.
The University of Toronto has become a renowned world leader
in biomedical engineering and rehabilitation engineering. These
and similar programs at other universities will provide the expertise
needed to develop new and innovative technologies that will help
older adults (and other people with disabilities) remain independent.
Improving independence among this population will significantly and
positively impact quality of life, as well as help to reduce the burden
of care facing many families and caregivers. Clearly, engineering will
continue to play an invaluable role in the development of CATs, as
the profession strives to achieve greater success in providing older
adults, and any person with a disability, the ability to remain in their
own homes and communities much longer.

References
American Psychiatric Association. DSM-
IV: Diagnostic and Statistical Manual of Mental
Disorders (4th ed.). Washington DC: American
Psychiatric Association, 1994.
Bharucha, A.J. et al. “Intelligent assistive
technology applications to dementia care:
Current capabilities, limitations, and future
challenges.” American Journal of Geriatric
Psychiatry 17.2 (2009): 88-104.
Bryant, Lucinda. “In their own words: A
model of healthy aging.” Social Science and
Medicine 53.7 (2001): 927-41.
Cutchin, Malcolm. “The process of medi-
ated aging-in-place: A theoretically and em-
pirically based model.” Social Science and
Medicine 57 (2003): 1077-90.
Dura, J.R., K.W. Stukenberg and Janice
Kiecolt-Glaser. “Anxiety and depressive disorders
in adult children caring for demented parents.”
Pscyhology and Aging 6 (1991): 467-73.
Ferri, Cleusa et al. “Global prevalence of
dementia: A delphi consensus study.” The
Lancet 366.9503 (2006): 2112-17.
Harrell, Minnie et al., eds. Cognitive Re-
habilitation of Memory: A Practical Guide.
Maryland: Aspen Publishers, 1992.
Helal, Sumi et al. “The Gator Tech Smart
House: A programmable pervasive space.”
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Hoey, Jesse. “Tracking using flocks of
features, with application to assisted hand-
washing.” British Machine Vision Conference.
Edinburgh, Scotland, 2006.
Intille, Stephen. “A new research challenge:
Persuasive technology to motivate healthy ag-
ing.” IEEE Transactions on Information Technol-
ogy in Biomedicine 8.3 (2004): 235-37.
Kaelbling, L.P., M.L. Littman and A. R. Cas- to older people.” Ageing and Society 25
sandra. “Planning and acting in partially observ- (2005): 91-110.
able stochastic domains.” Artificial Intelligence Patterson, Christopher. “Focusing on
101 (1998): 99-134. Alzheimer’s disease.” The Canadian Journal
Labelle, K.L., and Alex Mihailidis. “Fa- of Diagnosis. December (1999): 62-74.
cilitating handwashing in persons with Pentney, William et al. “Learning large scale
moderate-to-severe dementia: Comparing common sense models of everyday life.” 27th
the efficacy of verbal and visual automated Annual Conference of AAAI. Vancouver, 2007.
prompting.” American Journal of Occupational Pigot, Hélène et al., eds. A Smart Home
Therapy 60.4 (2006): 442-50. to Assist in Recipe Completion. Amsterdam:
LoPresti, E.F., Alex Mihailidis and Ned IOS Press, 2008.
Kirsch. “Assistive technology for cognitive Pollack, M.E. “Autominder: A case study of
rehabilitation: State of the art.” Neuropsycho- assistive technology for elders with cognitive
logical Rehabilitation 14.1/2 (2004): 5-39. impairment.” Generations 30.2 (2006): 67-79.
Lubinski, Rosemary. Dementia and Commu- U.S. Census Bureau. Global Population
nication. Philadelphia: B.C. Decker, Inc., 1991. Profile: 2002. International Population Reports
Mann, W.C. et al. “Effectiveness of as- Wp/02. Washington DC: U.S. Government
sistive technology and environmental inter- Printing Office, 2004.
ventions in maintaining independence and Wilson, Rozanne et al. “Examining effec-
reducing home care costs for the frail elderly.” tive communication strategies used by formal
Archives of Family Medicine 8. May/June caregivers when interacting with Alzheimer’s
(1999): 210-17. disease residents during an activity of daily
McCreadie, Claudine and Anthea Tinker. living (ADL).” Brain and Language 103.1-2 (2007):
“The acceptability of assistive technology 199-200.
Alex Mihailidis, PhD, P.Eng., is an assistant professor in the department of occupational science
and occupational therapy, University of Toronto, with cross appointments in the university’s
Institute of Biomaterials and Biomedical Engineering and the department of computer science.
He is also a scientist at the Toronto Rehabilitation Institute. He has been conducting research
in the field of pervasive computing and intelligent systems in health for the past 12 years, hav-
ing published more than 80 journal papers, conference papers and abstracts. Mihailidis has
specifically focused on the development of intelligent home systems for elder care and wellness,
technology for children with autism, and adaptive tools for nurses and clinical applications. He
holds a PhD in rehabilitation engineering from the University of Strathclyde.
Jennifer Boger is research manager for the Intelligent Assistive Technology and Systems Labora-
tory in the department of occupational science and occupational therapy at the University of
Toronto and the Toronto Rehabilitation Institute. She graduated from the University of Toronto
in 2004 with a master of applied science degree in biomedical engineering. Boger also holds an
undergraduate degree from the University of Guelph in biological engineering (honours).

8 The Journal of Policy Engagement

Reduction of Ontario surgical wait times
By Michael Carter, PhD, and Andriy Kolos
Executive summary
Engineering methods developed by the Uni-
versity of Toronto’s Centre for Research in
Healthcare Engineering are making a major
contribution to a better understanding of
how best to reduce wait lists for key medical
procedures. Under the direction of the cen-
tre’s director, Michael Carter, PhD, a team of
researchers has developed a mathematical
model that allows for a reliable forecast of
how many people are going to require certain
types of surgery and how long they will have
to wait to receive it. From this model, predic-
tions can be made about the additional public
funding that is required to increase the number
of available surgeries and, as a result, reduce
wait times.
The impetus for developing such a model
comes from the 2003 federal-provincial agree-
ment on health care that led to the establish-
ment of targeted wait times for certain medical
procedures. The five designated procedures
were diagnostic scans, as well as four types
of surgeries: cancer, cardiac, ophthalmic and
orthopedic. The provinces agreed that 90 per
cent of these procedures should take place
within six months of a decision to operate.
Developing an appropriate model to help
achieve this objective has had to overcome a
number of hurdles, including the lack of reliable
information on how many people are waiting
to have a certain type of medical procedure.
Once the model was put in place, it led to the
McGuinty government announcing increased
funding that produced a significant reduction
in wait times for a number of procedures.
Introduction
In February 2003, the country’s first ministers
signed the historic Accord on Health Care Re-
newal that included a commitment to reduce
wait times for five key services. The targeted
procedures were diagnostic scans, plus cancer,
cardiac, ophthalmic and orthopedic surgeries.
For example, the accord led to establishing
benchmarks for cataract, hip and knee re-
placement surgeries. It called for 90 per cent
of these procedures to take place within six
months of a decision to operate.
Volume 1 • No 4 | September 2009
To help achieve these standards, Ontario
announced its own Wait Time Strategy in
November 2004. A key element of the plan
was the establishment of a Wait Times Infor-
mation Office (WTIO). The WTIO is devoted
to documenting, analyzing and reporting
wait-time data. Initially, the WTIO focused
on the five key benchmark services, although
the mandate has now expanded to include all
types of surgery.
In March 2006, the WTIO asked the Centre
for Research in Healthcare Engineering (CRHE)
at the University of Toronto and the Institute
for Clinical Evaluative Sciences (ICES) to help
determine the number of additional surgeries
that needed to be publicly funded to ensure the
province would achieve the national targets
by March 2007. For example, at the time only
71 per cent of hip replacement surgeries were
conducted within the recommended maximum
wait time of 26 weeks. The Ministry of Health
and Long-Term Care’s goal was to increase
the percentage to the mandated 90 per cent
within that period. (Wait time is measured
from the day the surgeon decides to operate,
the decision-to-treat date, to the surgery.)
The CRHE/ICES team focused on three
types of surgeries: cataract, hip and knee re-
placement. (The Cardiac Care Network and
Cancer Care Ontario monitor the wait times
for cardiac and cancer surgeries.)
By applying engineering and quantitative
methods to health-care issues, the CRHE
helped develop a model that could forecast
both future arrivals of patients requiring sur-
gery and the resulting wait list. By comparing
the expected wait list to historical patterns
for how long patients had to wait for certain
operations, the model could be used to sug-
gest solutions to lower these wait times to
acceptable levels.
Methodology
Conceptually, the measurement of wait times
should be straightforward. If one knows the
number of people waiting for a particular
surgery, and the arrival rate of new patients
seeking the same surgery, one can create a
model to compute the number of additional
surgeries required. Prior to the creation of
the WTIO, wait-list information was typi-
cally kept in individual surgeons’ offi ces.
The hospitals learned who required surgery
only a week or so before the procedure was
scheduled to take place.
The CRHE/ICES research team began
its work by reconstructing past wait lists
from historical data between April 2001
and October 2006. Since most surgeons are
paid on a fee-for-service basis, the research
team relied on Ontario Health Insurance
Plan (OHIP) billing records to determine the
number of operations for previous years.
The researchers performed an analysis to
determine a patient’s last consult date and
used it as the decision-to-treat date. The
ensuing time to the surgery provided a wait-
time estimate.
The number of surgeries performed be-
tween each patient’s decision-to-treat date
and their actual surgery could therefore be
calculated. The time in between was consid-
ered as the wait list for each patient. CRHE
researchers plotted the mean, median and
90th percentile of the wait-list length among
the patient population scheduled for surgery.
(The critical 90th percentile in this analysis
is that point on the wait list where 90 per
cent had a shorter wait time for an operation
than the remaining 10 per cent.)
Figure 1 shows the number of patients
waiting for cataract surgery by month. It
illustrates the mean, median and the 90th
percentile for patient wait-list time. In 2004,
there were approximately 110,000 cataract
surgeries in Ontario. Since the 90th percen-
tile wait time was over one year, some 11,000
people were waiting for more than a year
for their surgery.
Since the wait time for surgical patients
could be identified only after the surgery
took place, the completeness of the wait list
decreased as the measurements approached
the present. Therefore, as the 90th percentile
of the wait-list duration began to drop sharp-
ly, the researchers assumed there were still
a significant number of people on the wait
list who had not yet had their surgery.
9
 450
is simply the number of people waiting divided
400 Mean by the number of surgeries performed, the
90th percentile
350 Median
constant ratio averages are easier to quantify
300 than the 90th percentile. A similar pattern was
250 observed for hips and knees.
Days

200 Based on the three years of OHIP data

150
from Figure 1, the researchers computed the
100
number of monthly arrivals (new additions
50
to the wait lists). This summary informa-
0
tion provided sufficient data to model trends
Apr-01

Jan-02

Apr-02

Jan-03

Apr-03

Jan-04

Apr-04

Jan-05

Apr-05

Jan-06
Oct-01

Oct-02

Oct-03

Oct-04

Oct-05
Jul-01

Jul-02

Jul-03

Jul-04

Jul-05
and seasonality patterns. Forecasting with
exponential smoothing created an estimate
Figure 1: Patient wait times for cataract surgery over time
for future patients’ decision-to-treat dates
(arrival) and provided a predictive model for
the length of the surgical wait list. Figure 3
3.0 illustrates the forecast for cataract surgeries.
2.5 Note that monthly surgeries tend to decline
2.0 in summer and around Christmas and March
1.5 break, when surgeons often take vacation.
1.0 By spring 2006, WTIO had collected four
0.5 months of hospital estimates for the length
0.0 of the wait lists. For hip and knee surgeries,
the researchers were able to construct a
Apr-01

Apr-02

Apr-03

Apr-04
Oct-01

Oct-02

Oct-03

Apr-05
Oct-04

Oct-05
single model that nicely imitated the char-
acteristics of these four monthly wait lists.
Figure 2: 90th percentile-to-mean ratio as an approximation for the curve of Given the nature of the cataract data, the
the wait time distribution researchers found it necessary to construct
an “aggressive” model to match the first two
months of the hospital wait-list estimates
Arrivals Corrected arrivals Total surgeries
14,000
and a “conservative” model to capture the
13,000 last two months. The researchers assumed
12,000 the data quality was improving month by
11,000 month, so they were more confident in the
10,000
results of the conservative approach. Finally,
9,000
the Ministry of Health and Long-Term Care
8,000
7,000
provided estimates of future base rates for
6,000 surgical procedures. All these estimates (i.e.
5,000 current wait list, forecasted arrivals and
Apr-01
Jul-01
Oct-01
Jan-02
Apr-02
Jul-02
Oct-02
Jan-03
Apr-03
Jul-03
Oct-03
Jan-04
Apr-04
Jul-04
Oct-04
Jan-05
Apr-05
Jul-05
Oct-05
Jan-06
Apr-06
Jul-06
Oct-06
Jan-07
Apr-07
Jul-07
Oct-07
Jan-08

number of funded surgeries) were combined

to predict the wait list as of March 31, 2007.
The target wait list was obtained by multiply-
Figure 3: Arrivals to wait list (observed and forecast) and surgeries (observed) ing the average weekly surgical volumes by
11 weeks, the target for the mean. The differ-
ence between these two estimates provides
One of the challenges that faced the team observed that even as wait times improved,
the additional number of surgeries required
involved the estimate of the 90th percentile. the ratio remained approximately constant
to reduce the wait list to the target.
It is difficult to relate the wait-list length to around 2.3.
To validate the methodology, we used
the 90th percentile without an estimate of This constant ratio provides important
the Cardiac Care Network’s data set that
the underlying wait-time distribution. Since information about the shape of wait lists. In
includes a central provincial wait list. The
wait times vary by surgeon, there is a wide particular, to achieve the 90th percentile (tar-
researchers found that by using only three
range of wait times. Figure 2 depicts the ratio get wait time of 26 weeks), the mean should
years of observations, they were able to fore-
of the 90th percentile of the cataract wait list be 11 weeks (assuming the distribution stays
cast future arrivals to within one standard
to that list’s mean over time. The researchers relatively unchanged). Since average wait time

10 The Journal of Policy Engagement

deviation of actual observations, nine
times out of 12, and to within two standard
deviations, 12 times out of 12. Clearly, the
model worked.
Results
The aggressive cataract model produced a
recommendation that an additional 5400
cataract procedures needed to be funded by
March 2007, while the conservative model
identified that the observed current surgical
rate would adequately reduce the wait list.
(The actual model recommended a reduction
of 4141 surgeries below the current level.)
The hip and knee surgery models identified
a need for 5500 more knee replacements
and 1000 more hip replacements before
March 31, 2007.
Armed with these results (along with
other sources of information), the McGuinty
government on September 12, 2006 an-
nounced additional funding to improve ac-
cess to five key health-care services as part
of its wait times strategy. Specifically, the
province provided funding for 6100 more cata-
ract surgeries and a combined total of 3008
more hip and knee joint replacements. One
can only speculate on the rationale behind
funding so many cataract surgeries. How-
ever, such surgery is relatively inexpensive,
and resources were readily available. So it is
not perhaps surprising that the ministry was
keen to ensure that the 90th percentile was
exceeded. The funding for hips and knees
was likely tempered by capacity, and human
resource and time constraints.
Hospitals were awarded additional fund-
ing for surgeries if they were on target to meet
base surgical volumes for the year and had
available capacity. Hospitals were required to
maintain current volumes of other surgeries.
By March 31, 2007, wait times had mark-
edly improved from the previous six months.
Ninety per cent of cataract surgeries took
place within 156 days, inside the six-month
target, while hips were operated on within
244 days and knees within 326 days.
Not all hospitals were able to take advan-
tage of the additional funding. Many found
they could not meet the target volumes due
to resource or personnel constraints. Of the
6100 additionally funded cataract surgeries,
Volume 1 • No 4 | September 2009
it was estimated that only 5217 were per- rates. Moreover, the wait list can be predicted
formed. Similarly, only 1032 hip and 1340 knee for any time in the future. (It is much better to
replacement surgeries were completed. know you may have a problem in the future so
However, a review of the number of ac- you can take remedial action today.)
tual arrivals and wait-list observations as of The current reporting system is retrospec-
March 31, 2007 reveals the research model tive and leaves little time to correct resource
recommendations were accurate. The 90th issues. The models would be particularly use-
percentile wait time for cataracts would have ful for monitoring future wait lists in provinces
been 185 days with the conservative model such as Ontario that have adopted a guar-
and, had the normal surgical rates for hips anteed wait time for some services (i.e. if
and knees not changed, 169 days for hips wait times fall below the target, the province
and 183 days for knees. is required to pay for people to have their
surgery out of province if necessary.)
Situation today Maximum recommended wait times are a
In the past two years, there have been fur- function of ensuring the majority of patients
ther marked improvements in lowering wait do not wait for surgery longer than some rea-
times, although the 182-day standard has not sonable clinical standard based on quality of
been met in all cases. As of March 2009, the life and medical recommendations. Engineer-
observed 90th percentile provincial wait time ing modelling techniques allow governments
was 111 days for cataract surgery, 153 days and institutions to act proactively, knowing a
for hip replacement surgery and 176 days for problem is approaching, instead of reacting
knee replacement surgery. to observations of inappropriately long wait
times for key surgical procedures.
Conclusions The modelling work was effectively used
WTIO has significantly improved its data- to provide quantitative decision support to
capture capabilities and accuracy over the help the ministry make informed decisions to
years. Wait-list information is now collected reduce wait times. Improved data on service
for all types of surgery. However, the wait rates and arrival rates offer health-care man-
times are still calculated on the basis of pa- agers a higher level of wait-list control and
tients who have already had their surgery. allow them to make modifications to service
In the model described here, the wait list is volumes for key services. The result: a health-
constructed based on arrivals and the wait care system that runs more effectively for the
times are estimated using planned service benefit of the patient.
Michael Carter, PhD, is director of the Universit y of Toronto’s Centre for Research
in Healthcare En g ineerin g and a professor in its depar tment of mechanical and
i ndustr ia l en g i neeri n g. Car t er received h is doctorate i n mathematics f rom the
Un iversit y of Waterloo in 1980. Since 1989, h is research focus has been health-
ca re resou rce model l i n g w it h a v a r iet y of project s i n hospit a l s, home ca re,
rehabi l itat ion, lon g-t er m ca re, med ica l labs a nd menta l hea lt h i n st it ut ion s.
Ca r ter is a th ree -ti me w i n ner of the A n nual P ractice P r i ze f rom the Ca nad ian
Operational Resea rch Societ y (1988, 1992 and 1996) and, i n 2 0 0 0, received the
societ y ’s Awa rd of Mer it for l i feti me contr ibutions. He ser ves on the ed itor ia l
boa rd of t he Jour n a l of S ch edulin g an d Hea lth Ca re Man a ge m e nt S c i e n ce,
is a member of the adv isor y boa rd for the R egenstrei f Centre for Hea lthca re
En g ineerin g at P urdue Universit y and is an adjunct scientist w ith the Institute
for Cl i n ica l Eva luative Sciences i n Toronto.
Andriy Kolos has been a research associate with the Centre for Research in Health-
care Engineering since 2006, focusing his efforts on forecasting, wait lists, patient
travel and mapping models. Prev iously, the Universit y of Toronto engineering
graduate worked on a collaborative radiology system improvement project with three
Ontario hospitals : Ross Memorial in Lindsay, Northumberland Hills in Cobourg,
and the Peterborough Regional Health Centre.
11
Canada’s medical isotope crisis: A way forward
By Jatin Nathwani, PhD, P.Eng.
Editor’s note: The headlines over the recent closure of the Chalk River reactor that produced isotopes for hospital patients around the world
were naturally dominated by the medical fallout. The political name-calling between the government and the opposition over the handling of the
issue also competed for public attention. Lost amid the scare stories and mud-slinging was the reasoned voice of one of the province’s leading
engineers. This paper is based on Jatin Nathwani’s testimony before the House of Commons Committee on Natural Resources in June.

Executive summary
Jatin Nathwani, executive director of the Uni-
versity of Waterloo Institute for Sustainable
Energy, appeared before a Commons commit-
tee on June 18, 2009 to urge the government
to remain in the isotope production business.
Nathwani argued that too much is at stake to
abandon an industry in which Canada, until
recently, was a world leader. He called for the
resurrection of the troubled MAPLE reactors,
saying their technical concerns can and need
to be resolved in the national interest.
Nathwani also called for a more reasoned
debate about nuclear technology. He urged the
politicians to judge nuclear technology on the
basis of its “net benefit” and not to succumb
to popular anti-nuclear sentiment.

Introduction
The shutdown of the National Research Uni-
versal (NRU) reactor at Chalk River, Ontario,
has again brought into sharp focus the critical
need for a reliable supply of isotopes to our
hospitals. The most compelling and difficult
issue, however, is the reliability and safe
operation of a single aging reactor on which
depends the well-being of so many–both in
Canada and globally.
The realization of such extreme depen-
dency and vulnerability on a single source is An interior view of the Chalk River reactor. It was the world’s largest source of
a matter of profound shock and incredulity. medical isotopes until its closure earlier this year.
How did we get into this corner? And what
steps do we take next? 2. technology choices and future options; overall health and well-being of Canadians, the
The current medical isotope crisis that and exit strategy does not appear to be prudent.
has dominated newspaper headlines is but 3. some suggestions on governance and public The provision of a reliable supply of medi-
the simplest and clearest example of how we dialogue for acceptance. cal isotopes is far too important to have the
effectively ignore the benefits of nuclear tech- terms and conditions of supply and prices de-
nology because the political “comfort zone” is The need for a reliable isotope termined by others. If frustration with current
too narrow to allow for a more balanced and supply costs is the primary driver for determining exit,
nuanced response. The government’s recent indication to exit from what of the higher costs later when we have
I will confine my comments to three as- the supply side of isotopes production by 2016 conceded all control of any assurance of our
pects: would make us dependent on sources outside own supply?
1. the need for a reliable supply of isotopes; of Canada. For a resource this critical to the Upon exit, we simply become a minor
player with no influence. Having enjoyed a

12 The Journal of Policy Engagement

reasonable degree of success in the global
markets, what is the compelling case for jeop-
ardizing our own security of supply?
And if we take the long view, could the
exit strategy not compromise our ability to
control health-care costs if, over time, the
use of isotopes continues to become more
widespread in medical practice?
The fact that Canada has played a leader-
ship role in the development and application
of the innovations in nuclear medicine and
nuclear technology over the last 50 years is
worth noting. Why would we simply walk
away? Is there not a case for nurturing our own
strengths and putting in place the solutions
for realizing the benefits of this technology
into the future?
Technology choices and options
One option is a combination of best-effort,
short-term fi xes for the NRU reactor. That
would allow us to muddle along until 2016
or so. Given the age of the reactor, this is the
best that can be done in the short term. But
this is not a credible or a sustainable solution
for the long term. If we accept that the need
for medical isotopes is not about to disappear,
a more robust solution is necessary.
In light of our current difficulties, it makes
sense to revisit the decision to cancel the MA-
PLE reactors. There are technical issues that
need to be resolved to be sure, but a strong
recommendation by the House of Commons
Committee on Natural Resources to reconsider
the decision would pave the way for the reso-
lution of the technical issues. Whatever the
business model, whether it is a public-private
partnership, government ownership or some
other, the goal is to ensure the national inter-
est is taken into account.
Atomic Energy Canada Limited halted work
on the reactors last year after 15 years and $300
million had failed to yield a replacement for the
NRU. Bringing the already built MAPLE reactors
to an operating state over the next six to 18
months offers the best prospect for an assured
supply of isotopes for Canadian needs.
Governance and public acceptance
When I appeared before the House of Com-
mons Committee on Natural Resources on
February 7, 2008, I advocated an amendment
Volume 1 • No 4 | September 2009
to the Nuclear Safety and Control Act (NSCA) The current crisis is but the simplest and
that would have included a test of “net ben- clearest example of how we effectively ignore
efit” to Canada. Such a legislative test would the benefits of nuclear technology, because
provide a stronger framework and guidance the political comfort-space is too narrow for
to the regulatory function, clarity of direc- a more balanced and nuanced response. We
tion to industry and broad public support for create a cultural straightjacket that leads
a coherent decision-making rationale in the directly to an exit strategy–an easier and
public interest. quicker response to a problem. However, such
We cannot allow ourselves to be stymied a rash decision does not take into account
by “perceived risk of reactor operation,” which the full consequences in the long term. For
places undue weight on hypothetical imagin- Canada, it would be truly unfortunate to walk
ings and ends up denying patients the healing away from having built and led a successful
benefits of the reactor technology. The costs enterprise around the production of isotopes
are real, but not astronomical; the risk is not without a determined effort to fix the short-
zero, but low–while benefits are large and term problems.
positive. The trade-off to serve the public In conclusion, I have four simple recom-
interest is clear and simple. mendations:
There is a small but strong anti-nuclear 1. Confirm the need for a robust and depend-
sentiment that dominates public discourse on able supply of medical isotopes for use in
matters nuclear. Even though the safety risks medical practice and whether the trend for
are generally very low, the social amplifica- increased use is expected to continue;
tion of risk through the media gives rise to a 2. Revisit the decision to cancel the MAPLE
political and cultural climate that makes it reactors. This is a credible path to a robust
difficult for policy-makers to take a strictly base for supply assurance long into the
rational approach. It reduces their comfort future;
zone of operation and forces the easier way 3. Amend legislation to include a test of net
out–witness the exit strategy proposed by benefit to Canada in the NSCA. This would
the government. provide a strong foundation for balancing dif-
The time has come to shift the terms of ficult trade-offs in regulatory decision making;
debates around nuclear issues and help re- and
duce the social friction so all parties will begin 4. Commit to a useful public dialogue on
to articulate clearly the benefits of nuclear matters nuclear to help create a positive
technologies. Over time, this would create environment for policy-makers to make
sufficient space in the public sphere for a more rational decisions.
informed dialogue.
Jatin Nathwani, PhD, P.Eng., is a professor and the Ontario research chair in public policy
and sustainable energy management in the faculties of engineering and environment at the
University of Waterloo. Nathwani has extensive experience in the energy sector at the corporate
level, focusing on strategy and policy development, business planning for long-term initiatives,
contributions to the evolution of industry structure, management of regulatory affairs and en-
vironmental issues and timely integration of strategic R&D into business practice. Recently, he
contributed to the development of the Ontario Power Authority’s integrated power system plan
focusing on the environmental and sustainability issues relevant to the planning process. He
holds a PhD in chemical engineering and applied chemistry from the University of Toronto.
Looking for an earlier paper?
Past issues of this publication are available at www.ocepp.ca, while
articles are posted individually on the Research page of our site.
13
Between a rock and a hard place: An engineer’s duty to warn
By Catherine Karakatsanis, P.Eng.
Editor’s note: This paper is based on a presentation to the Ontario Bar
Association’s environmental law section in June.
Executive summary
Engineers are unique among regulated professionals in that they have an
obligation to take action to prevent any situation involving engineering
that might cause harm to the public. This responsibility to the public good
is often cited, but poorly understood, even among practising engineers.
A large part of the problem is a lack of legal or other clarity as to how
this responsibility should be exercised in the real world. Sometimes the
practitioner is trapped in an impossible position, with no clear path out.
Professional Engineers Ontario (PEO), as the provincial regulator
for the profession, must assure the public that licensed engineers are
qualified. It must also ensure that engineers are appropriately exercising
their obligations to both their clients and the public at large. It is when
these two obligations come into conflict that the water muddies, despite
the paramountcy of an engineer’s duty to public welfare.
An engineer’s challenges in dealing with this thorny issue are discussed
by PEO President Catherine Karakatsanis, P.Eng., in her aptly titled paper
“Between a rock and a hard place.” Karakatsanis suggests some paths
engineers might take when facing potential dangers to society, such as
first raising the matter with the client. If that fails to produce a satisfactory
solution, the next step is reporting a potential danger to the appropriate
authority. But at the end of the day, Karakatsanis acknowledges that
public authorities have the final say when dealing with an engineer’s
concerns.
Introduction
The ancient Roman engineers had a wonderful tradition for assuming
accountability for their work. Whenever an engineer constructed an
arch, he assumed responsibility in the most profound way possible. As
the keystone was hoisted into place, he stood under the arch.
Now, unlike in Roman times, licensed practitioners, which include
professional engineers and holders of temporary, provisional and limited
licences, aren’t asked to stand behind–or under–their work in such a
literal way. They are, however, held professionally accountable in as
strong a fashion.
How, exactly, does PEO, as the provincial regulator, hold its licence
holders responsible for their actions and handle issues of reporting
situations that represent a danger to the public?
For 87 years, the Professional Engineers Act has set the bar for
practice in a profession in which the public welfare and safety–in its
broadest sense–is paramount.
Public safety and the public good are the key focus of the years
of education, training and supervised experience that go into mak-
ing the now more than 71,000 professionals who practise within 41
engineering disciplines.
As the regulator of engineering in Ontario, PEO’s role is to assure the
public that licensed practitioners are competent to practise in their chosen
14
discipline, and that they are taking responsibility for the outcomes of their
work. And that licence holders, themselves, understand their professional
obligations–both to their clients or employers and to the general public.
Once in a while, however, these obligations will be in conflict. For
example, on the one hand, a practitioner is obligated to keep confidential
information relating to the business affairs, technical methods or processes
of his or her client or employer and must avoid the use of such information
to the disadvantage of the client or employer.
On the other hand, PEO’s definition of professional misconduct provides
that failure to report a situation that a practitioner believes may endanger
the safety or welfare of the public constitutes professional misconduct
that could result in disciplinary action.
Engineers obliged to act
There should be no doubt, however, about how PEO licence holders must
act. They must regard their duty to public welfare as paramount.
So, regardless of the scenario, the obligation of a licensed engineer-
ing practitioner is always the same: if he or she believes that a situation
represents a danger to the safety or welfare of the public, he or she
must act to correct or report the situation.
In reporting the situation to an appropriate authority, the practitioner
is not, however, obliged to disclose all the details about his or her client
or the tasking. That is, he or she does not have to reveal the client’s
identity, or provide details about the work he or she was undertaking
when the danger to the public became apparent.
Similarly, he or she would not have to disclose any report produced
for the client. However, whatever evidence led the practitioner to the
conclusion that there is a potential danger should be provided.
As noted, it would be professional misconduct, specifically under
section 72(2)(c) of Regulation 941, for a licence holder to fail to report
such a situation. Of course, in a disciplinary hearing arising from any
such alleged misconduct, the burden is on PEO to prove the practitioner
actually believed a danger existed and failed to act–clearly, not an
easy thing to do.
It has been very rare for this particular scenario to form the basis of
a disciplinary hearing. This is largely due to the fact that professional
engineers take their “duty to report” obligations very seriously.
A recent example
A relatively recent case, however, demonstrates the extent to which
licence holders can be held accountable. In 2002, a consulting engineer,
John Yat-Man Kwan of Markham, Ontario, was selected as an independent
party to investigate alleged construction deficiencies in a home under
construction in Ajax.
The homeowner had concerns that certain construction items ap-
peared not to comply with his understanding of the Ontario Building
Code and CSA standards. Kwan, hired by the builder at the urging of the
town to settle the dispute between the homeowner and the builder, was
responsible for reporting on the alleged deficiencies.
The Journal of Policy Engagement
 In his report, Kwan noted some, but not all, of the actual deficiencies.
Later, in sealed documents, he incorrectly stated that all remedial work
had been identified and subsequently rectified by the builder.
The homeowner, however, observed that certain deficiencies were
left uncorrected by Kwan. The homeowner consequently engaged another
consultant to check the work allegedly inspected by Kwan. In his final
report, the second consultant noted several instances where the original
inspection reports issued by Kwan stated that the finished work complied
with the applicable CSA standards and the Ontario Building Code when,
in fact, it did not.
Based on these facts and a plea agreement entered into by Kwan, PEO’s
Discipline Committee found him guilty of professional misconduct for:
• negligence;
• failing to report construction deficiencies that he knew, or ought to have
known, were in violation of the Ontario Building Code;
• providing information in an inspection report that he knew, or ought to
have known, was incorrect with respect to completion of the remedies
stipulated in an earlier report; and
• acting in an unprofessional manner.
As a result, Kwan received a penalty of a reprimand, a requirement to
write and pass PEO’s professional practice examination within a fixed time
frame or else face suspension or revocation, and an order to pay costs.
Professional obligations, ethical principles
Although a licensed practitioner’s ultimate responsibility to public safety
is clear, there is no set procedure for discharging this responsibility. Our
licence holders’ duty to report is founded on certain professional obliga-
tions and ethical principles found in the same Regulation 941, which
defines professional misconduct as “failure to act, to correct or report a
situation that the practitioner believes may endanger the safety or the
welfare of the public.”
In most cases where professional conflict occurs, it is resolved simply
by informing the client or employer of the situation and working with them
to determine an alternative, acceptable course of action. In some cases,
the approach to the client or employer may have to be reinforced by cit-
ing the requirements of applicable legislation, including the Professional
Engineers Act or the Ontario Building Code. In the rare case where there’s
a stand-off with the client or employer, the practitioner must consider
taking more drastic action with highly increased personal jeopardy. PEO
does not have provisions to protect whistleblowers and it is possible that
reporting a dangerous situation to a responsible authority could result in
punitive action against the engineer.
Sense of duty
Nevertheless, we expect our licence holders to act out of a sense of duty,
with full knowledge of the effect of their actions, and to accept responsibil-
ity for their judgment. They are encouraged to raise their concerns first
with their employers or clients in an open and forthright manner before
reporting the situation to a responsible authority or, ultimately, to PEO.
In addition, PEO’s Code of Ethics supplements the legal obligation
to public safety and welfare. According to the code, practitioners have
Volume 1 • No 4 | September 2009
a clearly defined responsibility to regard their duty to public welfare as
paramount, above their obligations to clients or employers.
The Code of Ethics is a basic guide to professional conduct and
imposes duties on practitioners with respect to:
• society;
• employers;
• clients;
• colleagues (including employees and subordinates);
• the engineering profession; and
• himself or herself (a duty to oneself is a reflection of the integrity
that PEO expects of practitioners).
This code has no legal weight at present. Section 72 of Regulation
941 excludes from the definition of professional misconduct “an action
that is solely a breach of the Code of Ethics.” The PEO Code of Ethics
is essentially “unenforceable” to the extent that no disciplinary action
can arise from a breach of only the Code of Ethics.
But section 77 of Regulation 941 states that: “A practitioner shall
regard the practitioner’s duty to the public welfare as paramount”
and that, “A practitioner shall maintain the honour and integrity of
the practitioner’s profession and without fear or favour expose before
the proper tribunals unprofessional, dishonest or unethical conduct
by any other practitioner.”
Exercising the duty to report
The obligation to correct or report a situation that a practitioner believes
is a danger is absolute. In fact, there are few serious breaches of the
Code of Ethics that are not captured in some way in the legal definition
of professional misconduct, as there is considerable overlap of subject
matter between the two sets of obligations. Nevertheless, some of the
regulation’s wording raises questions and issues, such as:
• To whom must a situation be reported?
• What form should the reporting take?
• What’s the difference between a danger to public safety and a danger
to public welfare?
• What if whomever the practitioner reports the situation to doesn’t
take any action? and
• What if someone else believes a danger may exist, but the practitioner
doesn’t agree?
Taking action
Beginning with the first question: PEO’s advice to practitioners is that
the situation must be reported to an individual or organization in a
position to take corrective action. This may be as simple as reporting
to someone more senior in the licence holder’s organization. However,
the individual or organization to whom a practitioner is considering
reporting a situation must be free from bias in the circumstances–
meaning the individual or organization should not have an interest in
not taking action.
Ideally, a situation should be reported to the regulatory authority
having legislated responsibility and jurisdiction, such as a municipal
building official, a government agency or ministry. There is no particular
15
format for a report of this nature, except that it should be in writing
and the practitioner making the report should keep a copy.
The reason for believing a danger exists should be clearly explained
as should the potential consequences of failure to take action. Sufficient
information, such as field data or photographs, should be provided
to the authority to properly convey the concerns of the professional
engineer and enable the authority to take corrective action.
The professional obligation to report relates only to matters that a
practitioner believes may endanger public safety or welfare. Generally,
a situation endangering public safety will have the potential for acute
harm or injury and present an imminent risk. A situation endangering
public welfare, on the other hand, is one that has the potential to have
negative consequences for society’s well-being in a range of areas,
such as health, the economy or public order, and may also include
safety, but that risk will be over the long term.
If the regulatory authority chooses to take no action, the decision to
further escalate a report to an even higher authority is at the discretion
of the practitioner and is not required as part of fulfilling his or her
professional obligation under Regulation 941.
PEO acknowledges that our licence holders do not have the final
say in all matters relating to public safety and welfare. Also, PEO
recognizes that their judgment may be overruled by a responsible
authority for reasons of public policy, economy or other considerations.
Indeed, even PEO’s registrar has no powers to compel a responsible
authority to heed the concerns expressed by a practitioner.
Engineering practitioners are the only regulated professionals
with a positive duty to act to correct or report a dangerous situation.
It is this selfless regard for the public welfare that sets professional
engineers apart and keeps them in high regard in the eyes of the public
and government.
Catherine Karakatsanis, P.Eng., is president of Professional Engi-
neers Ontario for 2009-2010. She is also a senior vice president and
board member at Morrison Hershfield Limited, where she heads up
the building and facilities division that provides multidisciplinary
engineering expertise to the commercial, institutional, residential,
industrial and public sectors. After graduating with bachelor’s and
master’s degrees in engineering science from the University of West-
ern Ontario, Karakatsanis became a research assistant at Western’s
Boundary Layer Wind Tunnel Laboratory. She has been an active
volunteer in the engineering community for more than a decade,
having served on the board of the Ontario Society of Professional
Engineers (OSPE) for five years and as OSPE president and chair. In
addition to her role as president of PEO, she is a member of the boards
of the Ontario Professional Engineers Foundation for Education and
Western’s faculty of engineering advisory committee.

The Green Energy Act and the future of sustainable electricity

in Ontario
By Colin Andersen

Editor’s note: This paper was presented at the
OCEPP policy conference in Toronto on May 8,
2009 prior to the passage of the Green Energy
Act on May 14.
Thank you, Kim Allen, registrar and CEO of
Professional Engineers Ontario, and Donald
Wallace, OCEPP executive director, for the
opportunity to join you today. Unlike [then]
Research and Innovation Minister John Wilkin-
son earlier, who had only had a half cup of
coffee before delivering his address, I have
managed to have two cups of coffee today.
However, I can’t promise that my speech will
be four times better!
I would like to begin by commending the
Ontario Centre for Engineering and Public
Policy and Professional Engineers Ontario
for your efforts to foster the connection
between engineering and public policy. Pro-
fessional engineers have a lot to contribute
to policy development, and it’s great to see
your organizations working to provide a strong
voice for the profession in this area.
For those unfamiliar with the Ontario
Power Authority (OPA), our mandate is to
secure a reliable and sustainable electricity
supply for the province. To that end, we focus
on three key areas of activity: promoting elec-
tricity conservation and efficiency; planning
the province’s electricity system for the long
term; and procuring new supply resources.
The [then] proposed Green Energy and
Green Economy Act has two tracks: increas-
ing the roles of conservation and renewable
energy in meeting Ontario’s electricity needs.
So our mandate and the goals of the [then]
proposed act are closely connected.
The act is truly leading edge in North
America and is providing an opportunity that
doesn’t come along very often. It’s bringing
together as partners governments, electricity
producers, distributors, transmitters, academ-
ics, industry, businesses, communities and
concerned citizens in developing solutions to
our energy challenges. The challenge for all
of us is to collaborate, to be ready and to not
miss this unique opportunity.
But, arguably, the Green Energy Act pres-
ents its greatest opportunities, in fact, to the
engineering sector. The [then] proposed act’s
focus on renewable energy sources and en-
vironmental sustainability coincides with the
need for a fundamental renewal of Ontario’s
energy infrastructure. It will stimulate new
industry and bring new opportunity. Engineers
will play a critical role in the design, construc-
tion and operation of both projects and systems
associated with this new infrastructure.
For the engineering sector, the act undeni-
ably brings challenges. Renewable generation
is quite different from coal-fired electricity
and other power sources. Unlike a large coal-
fired plant, for example, renewable energy is
by nature decentralized and geographically
distributed. It will require new approaches and

16 The Journal of Policy Engagement

innovative solutions to integrate these new
technologies into an existing system.
But, fundamentally, the engineering role
will not change. Problem solving and the drive
to maintain project integrity will remain at the
core of what you do.
And many of the changes in the Green
Energy Act have been implemented–success-
fully–in other jurisdictions. Western Denmark,
for example, currently meets 50 per cent of its
electricity needs through wind power. I have
full confidence that Ontario’s engineers will
be able to make renewables work here in an
Ontario context.
A major component of the [then] proposed
Green Energy Act is the creation of a Feed-
in Tariff Program (also known as FIT). The
OPA has been hard at work getting ready to
launch North America’s most comprehensive
FIT program next month. Some of you may
have participated in our weekly workshops
helping to design the program.
The FIT program is aimed at encourag-
ing investment in renewable energy projects
through the creation of a simplified contracting
process and standardized prices. These prices
are intended to cover all capital, operating and
maintenance costs, while offering a reason-
able rate of return over a 20-year contract
period. The act also [puts in place] a stream-
lined environmental approvals process that
will make it easier to bring valuable renewable
energy projects to life–another area where
engineers come in.
A second track in the act, but always first
on the list for the OPA, is conservation. You
may be aware that the province has set a con-
servation target that is the most aggressive
and ambitious in North America–and argu-
ably the world. Our target reduction of 6300
megawatts in peak demand by 2025 will take
care of three-quarters of our projected growth
in demand over the period. To put it another
way, it is equivalent to removing one in five
electricity users from the grid.
Assuming its passage, the Green Energy
Act will initiate concrete action that will help
us to meet–if not exceed–this target. Improved
energy-efficiency codes for buildings and stan-
dards for equipment and appliances have the
potential to contribute as much as 50 per cent

Hold that date! A photo from a

previous candidate
Information session
college. The October
Interested in running for public office? 14, 2009 event
October 14, 2009, Toronto presents another
Engineers who are interested in seeking election as an MPP, opportunity for
or assisting engineering colleagues to do so, are invited to engineers to learn the
attend the 2009 Engineers Candidate College co-hosted by tools and knowledge
Professional Engineers Ontario and Engineers Canada. Elected needed to get more
politicians and campaign specialists will offer valuable insight politically active.
as well as practical information gleaned from their many years
of experience.The session will be held at PEO’s Toronto office
(25 Sheppard Avenue West, Suite 1000) from 5:30 to 9:30 p.m.
To register, please contact kendra@brown-cohen.com.
Space is limited. No charge.

Symposium
Ground source heating and cooling
October 20-21, 2009, Woodbridge
This two-day event will explore a range of information and issues such as the history of ground source heating and cooling systems, an
update on provincial regulations and approvals, and environmental benefits. Guest speakers include Grant Ferguson, PhD,
(St. Francis Xavier University), Aart Snijders (IFtech, Netherlands) and Bill Wong (SAIC). The event is sponsored by the hydrogeologists of
the Conservation Authorities of Ontario and it will be held at the Kortright Centre for Conservation (9550 Pine Valley Drive, Woodbridge).
Symposium fees are $300 ($250 by September 20) and $50 for students. Online registration and conference details are available at
events.Signp4.com/geoscientists.

Presentation
The Arctic: Challenges and opportunities in Canada’s backyard
October 28, 2009, Ottawa
Peter Harrison, PhD, director of the School of Policy Studies at Queen’s University and a former federal deputy minister, will deliver a dynamic
and highly informative presentation on some of the issues and opportunities Canada faces regarding the Arctic. The event will be held at
the Canada Science and Technology Museum (1867 St. Laurent Blvd., Ottawa) from 6 to 8:45 p.m. Wine and cheese and a discussion of
fascinating Arctic artifacts with museum curators will precede the presentation. Space is limited and early registration is encouraged. For
registration information and other details, please see the flyer on the Events page of www.ocepp.ca. No charge.

Volume 1 • No 4 | September 2009 17

of the target reduction in peak demand. The
act will make energy efficiency a central tenet
in Ontario’s building code, and it will introduce
North American-leading Energy Star efficiency
standards for household appliances.
It also proposes steps to green our public
sector buildings, positioning these facilities as
positive examples for the rest of the province.
The act will also assign new responsibilities for
local distribution companies in meeting conser-
vation targets and planning their systems.
My father was an engineer; all my life I
seem to have been surrounded by them. As
OPA CEO, I work with a lot of engineers. And
when I was deputy minister of policy and fi-
nance–it’s nice to see [PEO councillor] Thomas
Chong here, who’s representing your largest
region–I dealt with a lot of big infrastructure
projects like the Toronto subway extension
and hospital planning.
In the lead-up to today, I talked to a few
engineers at the OPA and at other electricity
agencies–JoAnne Butler, our VP of procure-
ment, and Paul Murphy of Independent Energy
System Operator, in particular–about the evolv-
ing role of the engineer in what we do. There
once was a time when engineers talked almost
exclusively with engineers–benefiting from a
common language, background, expertise and
technical understanding. Now, when work-
ing on a project, the disciplines interact more
throughout the stages of a project, meaning
engineers may end up dealing with:
• business development–lawyers and finan-
ciers–on the contracting;
• economists–on the planning;
• communicators–on the stakeholder engage-
ment; and
• accountants–you certainly can’t forget
them.
You can imagine the fun that ensues when
we’re all in one room at one time.
All of these professions each have their
own language, perspectives, objectives,
ways of planning and consulting–even their
approach to solving a problem.
What does this mean for engineers (and
all the professions really)? It means you have
to be careful listeners. It means you have to
confirm understanding–don’t presume even
basic understanding. Realize that there are
many, many different ways of decision-making.
And the fact that it isn’t necessarily logically
18
and orderly laid out, the way an engineer may
approach it, isn’t necessarily a bad thing, but
is a reality. I’ll give you two examples.
The first is governments. It’s an easy and
regularly made mistake to pass off decision-mak-
ing uncertainty or slowness as “governments are
stupid; let’s throw rocks at them.” What people
don’t often realize is that so many planets have
to align before any government decision gets
made. A decision doesn’t just rest on the intrinsic
value of the proposal alone. It’s a real balancing
act of many competing objectives.
The second example ties in to [Waterloo
Provost Amit Chakma’s] comments earlier on
the need to be culturally sensitive. First Nations
and Métis are playing an increasingly important
role in all types of infrastructure. They have a
very different way of coming to consensus and
approving projects to go ahead.
What else does working more closely with
other professions mean? Well, training should
include as much multi-disciplinary interaction
as possible–I would certainly agree with the
provost there, too.
To tie this back to real life examples from
the Green Energy Act, we are experiencing a
paradigm shift in planning that will result in a
build-out of our system never seen before–an
open-ended FIT program, a smart grid with
two-way flows of electricity and information,
and electric vehicles. We are looking to double
intermittent renewable resources.
First, there is the physical reality–where
the engineers come in, operating the system
and planning it. Also, designing and building in-
dividual projects, both big and small. Then, there
is the intersection with contract design. How
do we integrate or marry the physical opera-
tion with the economic models or incentives to
achieve the best outcomes for the consumer and
the ratepayer (who are the same person)?
These both interact with social objectives.
Green resources may not be the cheapest or
the easiest to integrate, but other concerns
may take precedence (like jobs).
There is also interaction with the po-
litical. If engineers can’t figure out how to
integrate significant amounts of intermittent
resources into our system, the lights may
not stay on and companies won’t get paid.
Ontario consumers could end up subsidizing
the US consumer through cheap exports. All
issues with political implications.
If I was going to be frank to this audience–
and Donald said I should be–I would say this:
you have lots of “natural” advantages–you’re in-
novative; you’re involved in problem solving; you
like to figure out how to do things better; you
take the long-term view. But it’s not enough.
Sometimes, the input you provide, however
well intentioned, can come across as “This is
why you can’t do what you’re trying to do.”
This isn’t just engineers. It’s lawyers and other
professions, too, sometimes. I’ve seen it in all
sectors–hospitals, transit and electricity.
The engineers who come across as the
most relevant are those who change that to
“here’s how.” They don’t just answer strictly
the question asked (that means people have to
know enough to ask just the right questions).
They really try to think about what’s behind
the question, what the goal is.
Don’t expect to operate in a world of clarity
and logic. We’re operating in a world of unpre-
dictability and ambiguity. I encourage you to be
as collaborative–and patient–as you can.
So, these are exciting times for the electric-
ity sector in Ontario and for engineers in Ontario.
I believe we have great reason for optimism.
In introducing the [then] proposed Green
Energy Act, the Honourable George Smither-
man, minister of energy and infrastructure,
shared his vision of Ontario becoming the
world’s leading energy jurisdiction. Through
the dedication of professional engineers, and
the collaboration of individuals and organiza-
tions across the province, it’s a vision that I
believe will achieve reality.
Colin Andersen was appointed chief execu-
tive officer of the Ontario Power Authority
(OPA) in September 2008. Prior to joining
OPA, Andersen held a variety of senior finan-
cial and policy positions in the Ontario Public
Service. Among his most recent jobs: deputy
minister, ministry of fi nance; secretary of
treasury board; deputy minister, ministry
of revenue; chair of the Ontario Financing
Authority; and chair of the Ontario Electric-
ity Financial Corporation. He has also served
as deputy minister of policy, cabinet office,
and acting deputy minister in the Ministry
of Health and Long-Term Care. Andersen has
an MA in economics from the University of
Toronto and a BA (hons) from the University
of Calgary.
The Journal of Policy Engagement
What can engineers do to gain better access to the corridors of power?
By Tony Dean

Editor’s note: This paper is based on a presen-
tation made by Tony Dean at the OCEPP policy
conference in Toronto on May 8, 2009.
Executive summary
Once the top civil servant in Ontario, Tony
Dean knows first-hand what it takes for
an engineer to make an impression on a
government policy-maker, whether elected
or a government official. Speaking at the
inaugural Ontario Centre for Engineering and
Public Policy conference, Dean told his audi-
ence they are well placed to have influence
on government policy-makers. Governments
today are concerned about policy implemen-
tation and “you are terrific system thinkers,
terrific project managers.”
He added: “You build delivery chains for
a business. We don’t have as much of those
skills inside government as we used to. And
offering that expertise about implementa-
tion and execution is going to carry an awful
lot of weight.”
But engineers need to first market their
skills to the appropriate people. Relation-
ship building is key. “Find the assistant
deputy minister,” said Dean. “Find the di-
rector. Find the policy adviser who is the
key person on the file. Call them up and
say, ‘Let’s get together,’ or ‘Let’s chat on
the phone about our idea, or your idea, and
how we can help you.’”
I’m going to address the way that the
process of making policy is changing and
has changed very dramatically over the
last decade, and how the environment
for crafting policy has changed. The more
you know about how policy decisions are
made, the better placed you are to influ-
ence the process.
To start, policy is getting more complex.
When we think about safe water, when we
think about energy policy, when we think
about climate change, we’re talking about
intensely complicated policy that requires
relatively unique skills.
The other important thing is that policy
is becoming more responsive to citizen ex-
pectations and the interests of stakeholders.
Certainly during the 20 years that I was in
government, I saw a big transition from
stakeholders being viewed as people one
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is forced to deal with to thinking about them
as very, very important partners.
Governments are increasingly realizing
that they can’t do anything really well in
the policy or implementation area on their
own. There are many more opportunities for
influencing and collaborating now than there
would have been a decade or two ago…
these are opportunities, but they are also
necessities.
We used to think of policy as relatively
local or even provincial. It isn’t anymore. It
is local, provincial, national, international
and global. When you think about things like
climate change and energy and economic
development, you see very good examples
of that phenomenon. In order to come to
grips with these increasingly crosscutting
or “wicked” policy challenges and oppor-
tunities, governments have been forced to

Introduction
I love talking about public policy. I worked
HERE’S MY INFORMATION:
in it for about 20 years. It’s about how you
get things done in government, or how you Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
try to get things done through government.
For the last year or so, I have been out of Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
the country working in a number of develop-
ing countries in the areas of public policy Company: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
and public administration. When you come
back to Canada, certainly Ontario, you realize Title: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
very quickly how well endowed we are with
government and public administration and
Email: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
with democratic processes, but also with
terrific capacity for both developing policy
and implementing it. SEND TO: info@ocepp.ca or The Ontario Centre for Engineering and Public Policy,
25 Sheppard Avenue West, Suite 1000, Toronto, ON M2N 6S9

Volume 1 • No 4 | September 2009 19

operate much more as a corporation rather
than 25 or 26 individual ministries.
As a result, developing policy is becom-
ing much more horizontal. That’s important
to you because you can’t think any more
about just one ministry or one department.
Increasingly, we have to work collaboratively
across government, with municipalities, with
the federal government. When you think
about energy policy, when you think about
climate change, when you think about safe
drinking water or major health issues, this
requires collaboration across many levels
of government.
Such policy-making also involves the
professions. It’s not just an afterthought,
asking before launch: “What do the engi-
neers think? What do physicians think?” This
work has to be done upfront now involv-
ing the expertise of, say, the professional
engineering community at the design and
development stage.
Policy-making also includes the non-
profit sector, the voluntary sector, the private
sector and, yes, social enterprises as well.
In other words, we’re moving much more
towards a network or a collaborative ap-
proach to policy-making.
Another thing: policy-making is becoming
more integrative. Ten or 15, maybe 20 years
ago, a minister, a premier or a policy adviser
would have a good idea, and it would work
its way through the system over weeks and
months, go to cabinet and, at some last stage
in the process, somebody would ask “Well,
how much is this going to cost?” And then
the financial analysis would be done. And
then someone would ask “How are we going
to market it?” And then the communications
work would be done.
Over the last decade, policy-makers at
the front end of the process have to think not
just about how we implement an idea, but
how are we going to explain it? How are we
going to market it? How are we going to sell
it, and have we got the money to pay for it?
So that’s requiring more and more network-
ing and integration inside government and
that includes thinking about implementation
as well.
20
I want to return very briefl y to this no-
tion of a porous approach to policy-making.
Policy is being made now on a just-in-time
basis, reacting very, very quickly to emerging
events. Where we used to have months,
we’re sometimes given weeks and, in some
cases, days to turn around very complex
policy products. We can’t do that without
help, and we need to increasingly reach out
to you and others to get that help.
The important point here is that we
need to be consulting and working collab-
oratively at the front end of processes in
order to ensure that we’re getting the very
best product. That means partnerships. It
reflects the fact that government can’t do
it on its own anymore.
Twenty or 30 years ago, governments
were, for the most part, hegemonic–they
were the only game in town. There wasn’t
a 24/7 media, they didn’t have any powerful
stakeholders and powerful opposition. It
actually would have been much easier in
those days to be really inclusive as govern-
ment because the risk of being inclusive
was low.
The forces of the last couple of decades
have turned events on their head. You now
have massive transparency, instantaneous
news coverage, very emboldened, signifi -
cant and powerful interest groups. Those
are driving governments to be more open
and inclusive, but they actually make it
more difficult for governments to be open
and inclusive because the playing field isn’t
level. So every time the government goes out
with an open, blank canvas and says “Tell
us what you think,” it is trying to be open
and democratic, but the stakes are high. It
cannot be sure about what it will hear (pos-
sibly from small but very well-funded interest
groups) and how much control it will have
over the agenda.
While governments are trying really
hard to be more inclusive, they’re also doing
that in a field in which they’re in very tight
competition for ideas and the dominance of
ideas. The discourse has entirely changed
from where it was some time ago. And, for
that reason, it actually makes the notion
of democratic government a much more
complicated business than it would have
been two or three decades ago.
You’re not trying to break into a fortress
government of Ontario or a fortress federal
government. The doors are far more open
than they used to be. Bearing in mind two
or three things will probably be helpful in
figuring out how to successfully navigate
your way through those doors.
You’ll be far more successful, and the
road will be easier, if you think about the
financial implications and where the money
might come from as you develop your ideas
and your proposals. You should also think
about the marketing side. Why it’s a good
idea for government. Where’s the politi-
cal win in this for government? Supplying
those ideas to government makes a pretty
big difference.
Your demonstration of an understanding
of the complexity of an issue and your offer
to provide hard data and information on what
can help the decision-making process is a
very helpful and useful way to develop and
cement relationships with your colleagues
inside government. Your honesty about the
weaknesses of ideas and proposals dem-
onstrates integrity on your part. Stepping
forward and helping government shore up the
weaknesses of a particular policy proposal
as opposed to pretending they aren’t there
will be appreciated.
Every government now is focused on
implementation. If there’s one thing that’s
really changed in just about every govern-
ment, in every jurisdiction I’ve worked with,
is that the key decision-makers–premiers,
prime ministers, deputy ministers and cabi-
net secretaries–are all gripped with how
we can more effectively get policies off a
page and into municipalities, into schools,
into hospitals, into institutions. It’s all
about execution.
I know from having worked for the
predecessor organization of the Society
of Energy Professionals many years ago
that you are terrific system thinkers, terrific
project managers. You are trained to think
about how you get effectively from A to
Z in a project management process. You
build delivery chains for a business. We
The Journal of Policy Engagement
don’t have as much of those skills inside
government as we used to. And offering
that expertise about implementation and
execution is going to carry an awful lot of
weight.
Let me leave you with these thoughts:
1. Influencing public policy-making is all
about developing relationships, just as
is every other area of your life. Find the
assistant deputy minister. Find the direc-
tor. Find the policy adviser who is the key
person on the file. Call them up and say
“Let’s get together,” or “Let’s chat on the
phone about our idea, or your idea, and
how we can help you.”
2. Talk about the data. Talk about your
expertise. Talk about what you can
bring to the project and start an honest
dialogue. Just build relationships. It’s
critically important because that builds
trust. Demonstrate a feel and sensitivity
for how tough it is inside government.
It’s a crazy place to work. It’s a fantastic
place to work, but it’s very busy, it’s very
hectic, and people are trying to tackle
complex just-in-time policy conundrums
in increasingly short times.
3. Look for opportunities to chat, just for
the purpose of sharing information. If
you’ve done a study, an analysis through
your research department, ask those min-
istries if you can come in and present
it directly to key policy-makers. And I
would think that eight or nine times out
of 10, the answer is going to be “yes.”
They’re going to be pleased to have you
there. You’ve got lots to offer. Put your
best foot forward and offer it.
4. Offer your support, and don’t forget to
offer your willingness to be advocates
for a government initiative if indeed it’s
brought to implementation. Governments
are always looking for third parties to
stand up and say, “You know what, that’s
a hell of a good idea. We applaud it,
premier or prime minister.” Show up on
the day the legislation is introduced or
the regulations are passed. You can’t
estimate how much that is worth to just
about any government.
5. Another idea would be for PEO to target
the ministries with whom you do the most
business and offer to come in at a policy
advisor level and talk about the role of
the organization, what it does, how it
connects with government and how it
can help. I think there would be a lot of
interest and willingness to do that. When
you do write in, copy the minister’s chief
of staff. That might help to bring a little
bit of pressure, albeit tangentially.
6. When you’ve got a good idea, it doesn’t
have a time stamp on it. If you don’t get the
government to listen to you the first time,
it may just be that there’s not room on the
agenda for it. Keep that idea fresh. Wait
for the next round of budget consultations
or governments consulting on whatever.
Get your idea back on the table.
Time and time again I’ve seen that
whether in the later stages of developing a
budget or a throne speech or a potentially
new platform, governments are always look-
ing for good ideas. If you’ve got a good idea,
keep going back and you’re going to have a
pretty good opportunity to have that idea
accepted and implemented.
Tony Dean is a fellow in residence at the
University of Toronto’s School of Public
Policy and Governance and an advisor on
public administration and building capac-
ity for policy and delivery. From 2002 to
2008, Dean was secretary of the cabinet
and head of the Ontario public service,
a position that was preceded by appoint-
ments as deputy minister of labour and
deputy minister and associate secretary
of the cabinet responsible for policy. Dean
has extensive experience in public sector
leadership, public policy development, ne-
gotiations and mediation, and has written
on public administration and leadership for
the Public Policy Forum Canadian Gov-
ernment Executive magazine, and for The
Guardian newspaper’s magazine Public.
Dean was a recipient of the Order of On-
tario in 2008. He earned a BA in sociology
and social anthropology from the University
of Hull, UK, and an MA in sociology from
McMaster University.

What can engineers do to gain better access to the corridors of power?

By Matthew Mendelsohn, PhD

Editor’s note: This paper is based on a presentation Matthew Mendelsohn
made at the OCEPP policy conference in Toronto on May 8, 2009.
Executive summary
Another prominent speaker at the Ontario Centre for Engineering
and Public Policy’s first annual policy conference was former pro-
vincial deputy minister Matthew Mendelsohn. He told the group
governments are receptive to fresh ideas from outsiders, such as
engineers, despite conventional wisdom to the contrary. “People
with specialized expertise, people who can mobilize communi-
ties, people who have policy ideas, really can have an influence,”
Mendelsohn said.
Deputies, senior civil servants, cabinet ministers and their advisers
are constantly asked to do something or listen to a particular piece of
advice. The trick is to have your foot in the door beforehand. “If you
build relationships to provide information, to provide knowledge, to
provide expertise, to build dialogue, to provide access to stakeholder
communities,” Mendelsohn said, “then when the time comes for an
‘ask,’ when you do have a particular issue that you would like to raise,
you have already established that relationship of trust.”
Introduction
To outsiders, governments often look like a big black box, and it’s not
clear how you penetrate them. There is an easy cynicism within the

Volume 1 • No 4 | September 2009 21

public about how government makes decisions
and, speaking as someone who’s been outside
and inside government, I think it’s too easy to
fall into that easy cynicism.
While we may be sometimes disappoint-
ed in our governments, we should recognize
the great benefi ts and luxuries we have to
be able to influence public policy, influence
government decision-making, and to be living
in liberal democracies.
Indeed, our governments are remarkably
open. It is easy to say governments are closed
and I don’t know who to talk to, and that gov-
ernment just listens to a bunch of special inter-
est groups. It’s easy to fall into that patter, but
it’s not true. Just about every public servant
and elected official, and everyone who works
for them, is looking for good ideas.
You may disagree with their ideology or
their way of doing things, but they are genu-
inely interested in serving the public interest.
Governments are enormously responsive to
public opinion. Some people say, “That’s not
very good, governments are just listening to
polls,” but the flip side is that people with
specialized expertise, people who can mobilize
communities, people who have policy ideas,
really can have an influence.
I’d like to review where some of those
Engineers who build relationships and trust at Queen’s Park are more likely to
influence points are. If you visit government
be able to influence public policy and government decision-making.
websites, you will be amazed at how much
information you can find out about what it is delivered in boring language, but a lot in ways that show what’s in it for them, how
government actually does. They have posted of it is there online. it is helpful for them.
results-based plans or strategic plans–and If you also speak to people, they will be Every day, all kinds of people ask minis-
their budgets. You can see what various units remarkably willing to tell you what’s going on ters for things. Every day, all kinds of people
are doing and what policies and programs may with programs and delivery. I would encour- ask ministerial staffers for things. People usu-
be relevant to your work. You can see who’s age people to go into the issue of public policy ally do not frame their “asks” clearly enough
running them and how you can connect with with an open mind and an open spirit. There’s in the context of what is in it for the person
them and perhaps talk to them and influence actually a lot of information out there and a to whom they are speaking.
them. lot of levers that people can push. If you build relationships to provide in-
I recognize there’s lots that goes on within The main issues I want to talk about are formation, to provide knowledge, to provide
government that you can’t figure out when the roles of relationships and trust, perse- expertise, to build dialogue, to provide access
you look online, but if you want to find out verance, windows of opportunity and the to stakeholder communities, then when the
where legislation is in the legislative cycle, importance of knowledge. time comes for an ask, when you do have a
if you want to see an org chart of a ministry, particular issue that you would like to raise,
if you want to see what the various divisions Relationships and trust you have already established that relation-
are in, say, the Ontario Ministry of Training, Think about relationships and trust from the ship of trust.
Colleges and Universities, and who the direc- perspective of a mid-level public servant or Talking to mid-level public servants, ex-
tors are and what their strategic goals are, a political staffer or even a cabinet minister. ecutives and managers is important, as is
and what their accessibility plan looks like People are always asking them for things. making contacts with the political side. Min-
and what their major programs are, some of They are often under enormous pressure to isterial staffers and junior-level staff in the
deliver. Try to identify issues and frame them premier’s office are enormously accessible

22 The Journal of Policy Engagement

at all kinds of public meetings, at all kinds of
party meetings, even if you’re not a partisan.
They are out there in the public talking to
people, understanding public opinion, under-
standing stakeholders.
Every citizen has an enormous opportu-
nity to have conversations with these people,
build relations with them and call upon those
relationships when necessary. Governments
do consultations all the time. Some of those
are public, some of those are private, and
some of those are worth thinking about. If
there’s a new plan, a new piece of legislation,
and the minister or a senior official or aide
says, “I’m going to call up 12 or 15 people
I trust and who have some expertise,” it’s
great if you’re one of those 12 or 15 people.
If they say, “We should talk to some
engineers on this particular policy issue,
and I remember these people, they’ve given
me good advice in the past and they’ll be
giving me good advice in the future,” that
is a way to have an impact. Clearly, long-
term, enduring relationships, and being a
trusted partner rather than just a critic, are
very important.
Perseverance
As a senior public servant, I worked for years
on the issue of employment insurance. Bob
Rae, as an NDP premier, worked on it, and
Mike Harris, as a Conservative premier,
worked on it, and we didn’t make much prog-
ress. Now, all of a sudden, there’s a window
of opportunity given the dramatic change in
economic circumstances.
All of a sudden, the federal government
is paying attention, or opposition parties are
paying attention and, just because you don’t
succeed the first time, that doesn’t mean you
won’t succeed in the future. I can’t under-
state the importance of perseverance. And
that speaks to people outside and speaks to
people inside as well.
If you stick with your ideas, eventually
public opinion turns, the overall environ-
ment changes, and all of a sudden there
is opportunity. If you’re prepared to seize
those and take advantage of them, those
are good opportunities.
Volume 1 • No 4 | September 2009
Windows of opportunity
Let me also emphasize the importance of
opposition parties and changes of govern-
ment. Changes of government are enormous
opportunities for new ideas, but so is the
lead-up to an election campaign when politi-
cal parties set their party platforms. While
it’s tough for a random person to get a meet-
ing with, say, the premier’s chief of staff, it’s
probably easier to make contact with political
staffers in opposition parties. And it is those
political staffers, or the platform commit-
tees of opposition parties, who are thinking
about ideas, about the initiatives they want
to introduce in public policy terms, but also
in communication terms in preparation for a
next election.
So, as you think about relationship build-
ing, think not only about the bureaucracy and
the party in power. People usually have more
time and are not as inundated with demands
when in opposition. If you can establish rela-
tionships of trust at that time, the foundation
is set even more so for you to have influence if
political power changes hands.
Knowledge is power
When we teach people about intergovernmental
negotiations, the one thing that is most impor-
tant is that the person who knows more usu-
ally wins. Likewise, it’s enormously important
when lobbying on an issue or when trying to
persuade people to change policy platforms to
know your stuff as well as you can. You need
to know the whole range: the policy, the fiscal
impact, the communications, the operational,
but also who the players are. Who has power?
Who doesn’t have power? Are you talking to
the person who can make a decision or are you
talking to someone who supports someone who
can make a decision? If not, you’re talking to
the wrong people.
You also need to understand the machinery
of government, how decisions get made and
where things are in the process. If some-
thing’s already gone through cabinet, the big
decisions have been made. If something has
already gone through first reading in the leg-
islature, the big decisions have already been
made. You may be able to influence details at
a legislative committee, but you’re not going
to influence the overall policy direction. Still,
you probably could influence some operational
issues at second reading during a legislative
committee hearing.
Understanding the machinery of govern-
ment, the decision-making process, who
has power, who doesn’t have power and
understanding the cycles of government is
critical. Learn when there will be pre-budget
consultations. Those are enormously good
opportunities to have an influence.
Engineers have an enormous advantage
because you have technical expertise; you
have specific knowledge. But decision-makers
are going to also want to know that you have
thought your idea through. There is nothing
worse than saying this would be a great idea
and they say, “Well, will it work in practice?”
or “Have you thought these things through?”
If you haven’t, that’s a problem.
Before you seek out changes, make sure
you understand all of the various aspects of
the option you are advocating and understand
whose interest it’s in–and whose interest it is
not in. There is nothing worse than lobbying a
minister on something and finding out later that
they have a well-founded personal position in
opposition to your idea.
Matthew Mendelsohn is the founding direc-
tor of the Mowat Centre for Policy Innovation
in the School of Public Policy and Gover-
nance at the University of Toronto. Prior to
assuming this role, Mendelson served for five
years as a deputy minister in the Ontario
government where he held responsibilities
variously for intergovernmental affairs, the
democratic renewal secretariat, and the Of-
fice of International Relations and Protocol.
He also served as associate secretary of the
cabinet in the cabinet office. Prior to joining
the Ontario government, he was a member of
the political studies department at Queen’s
University for more than a decade. While
at Queen’s he published widely on Cana-
dian politics and also served as director of
the Canadian Opinion Research Archive.
Mendelsohn received his BA from McGill
University and his PhD from l’Université de
Montréal, and he held a postdoctoral fellow-
ship at the University of British Columbia.
He is actively engaged in many non-profit
organizations and serves as a board member
and advisor to several groups.
23
 Shaping Ontario’s energy future:
Charting a path to sustainable prosperity

A presentation by Jatin Nathwani, PhD, P.Eng.

Executive Director, Waterloo Institute for Sustainable Energy
October 29, 2009, at Hart House, University of Toronto

W hat cross-currents shape the issues and policies related to energy, the environment and
the economy? How do governments and the energy sector ensure a reliable energy supply
that is accessible and affordable to all, while forging policies that promote long-term sustainability,
prudent management of environmental impacts, and improved quality of life?

These are a few of the key themes that Nathwani will explore, while demonstrating that long-term
success requires the right mix of policies that build on innovation, human capital development, and reduced
social and political friction between business and industry, levels of government and the community.

During his presentation, Nathwani will investigate the key issues and challenges in understanding
the current global and North American energy sector trends, and how universities can foster
innovation to address the complex energy challenges. In addition, Nathwani will discuss specific near-
term technological innovations in Ontario to transform the energy industry.

Nathwani is a professor and the Ontario research chair in public policy and sustainable energy
management in the faculties of engineering and environment at the University of Waterloo. He
has extensive experience in the energy sector at the corporate level, and recently contributed to
the development of the Ontario Power Authority’s integrated power system plan. He holds a PhD in
chemical engineering and applied chemistry from the University of Toronto.

The event is presented by the Ontario Centre for Engineering and Public Policy, in conjunction
with its Policy Engagement Series. Please register early (registration deadline: October 15) as
seating is limited. More information can be found on the Events page and Events Calendar at
www.ocepp.ca.

The fourth and final Policy Engagement Series presentation for this year will be held in
late November.