IHSPR Newsletter - October 2012

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Table of Contents

Message from Dr. Robyn Tamblyn, IHSPR Scientific Director

Supporting Next Generation e-Health: A Focus on Patients as Partners

What will propel Canada toward next generation e-health innovation that supports improved health and health outcomes? We've come a long way from using telephones for appointment reminders and computers to send scanned pages of medical files or prescriptions. Even now, patients have the ability to harness greater understanding and control of their health and treatment processes with tools that play much more than just a supporting role. Patients, providers and industry are coming together to implement new strategies that are tailored to increase accessibility to health care.

The Sunnybrook Hospital in Toronto has launched MyChart, an online patient health record database. With the rapid expansion of mobile internet technology, this tool puts patients in the driver's seat by providing instant access to pertinent, detailed and technical medical information from any location or device with an available connection. When patients are referred to specialists or even in an emergency, they can access their complete medical history, ensuring the correct action is taken with their care. MyChart further encourages patients to actively track test results and to update their symptoms to maintain current records and keep their doctors in the loop.

In rural Saskatchewan, Dr. Deborah Morgan's targeted effort to enhance the quality of care for dementia patients led to the creation of a tele-health support system. CIHR funding allowed researchers to investigate the need and ability for alternate modes of communication between rural patients and their health care providers. From their local hospitals, patients are able to conduct specialist follow-up appointments via videoconferencing. This support strategy enables patients to remain engaged and connected with their specialists but with "close-to-home" convenience. This is an innovative service that enhances patient care and the communities' abilities to effectively manage the disease.

American Well – Innovations that Empower Patients
America Well, founded in 2006, is bringing healthcare into the homes and workplaces of patients. This web-based platform allows patients and providers to have live, clinically meaningful visits through video, secure text chat and phone. The online care platforms integrate claims, EMR, billing and other information from external systems to facilitate clinical interventions that are cost-effective and patient oriented. American Well aims to improve access to quality care by limiting barriers such as distance, mobility and time. The many key features of this approach to innovative care access the latest tools, techniques and technology.

My Health Manager – Kaiser Permanente
Patients want to be empowered to take charge of their health. Kaiser Permanente now has four million members (63% of eligible membership) using their My Health Manager to view their medical record, email their providers, check lab results, order prescription refills and manage appointments. This versatile tool is available on computers or handheld devices. For many patients, this connection to providers and access to health information improves quality outcomes, patient satisfaction and patient empowerment.

Each community will have a distinctive way of implementing e-health solutions to address system deficiencies and better meet patients' needs. The e-management of health records is a system-wide revolution that will increase practitioners' capacity to effectively diagnose, treat and monitor patients and track their practice populations. Let's not lose sight of the vast potential we have to integrate these solutions and define the new reality of health care in Canada.

Institute Advisory Board Update

Jean-Louis Denis
Thank you & Farewell!

IHSPR thanks outgoing Institute Advisory Board (IAB) Chair, Dr. Jean-Louis Denis for his exceptional leadership since 2009. A board member since 2006, Jean-Louis has consistently provided IHSPR with expertise related to the effective transformation of organizations and health systems. We thank Dr. Denis for his contributions to the IAB and wish him the best with future endeavours.





Anne Sales

Congratulations!
IHSPR welcomes the incoming IAB Chair, Dr. Anne Sales. An active presence on the board since 2008, Anne quickly rose to the position of Vice Chair in 2009, providing great support and coordination of board activities. Dr. Sales' specialty lies in implementing evidence based practice, studying implementation and general health services research to improve quality of care. We welcome Dr. Sales as the new IAB Chair and look forward to working closely to improve patient-centered care.




Jacques Magnan

Welcome!
The IHSPR IAB is proud to welcome new board member Dr. Jacques Magnan to the roundtable of health services and policy research experts. Jacques currently serves as the Chief Executive Officer of Alberta Innovates – Health Solutions, a National Alliance of Provincial Health Research Organizations (NAPHRO) member. Dr. Magnan brings significant experience from the field of pharmacology and medical research to council IHSPR in enhancing research processes for optimum impact. We welcome Dr. Magnan a fruitful first term on the board.



David Moher

Thank you!
The IHSPR IAB would like to thank outgoing board member Dr. David Moher for his dedication and contribution to health services and policy research.







Finally, thank you to all of our IAB Members for a making our September meeting in Vancouver a success. Your perspective and input are highly valued and help the IHSPR team to implement winning strategies that contribute to ensuring evidence-informed healthcare renewal across Canada.

Chair Showcase

Dr. Michael Schull - CIHR Applied Chair in Health Services and Policy Research

Practicing emergency physician, Dr. Michael Schull has always held effective and efficient patient-care front-of-mind throughout his career. Dr. Schull has extensive research and practical experience in emergency health service utilization, quality of care, emergency overcrowding and patient safety. Being the 2001 recipient of the prestigious CIHR/Peter Lougheed Award in conjunction with his CIHR New Investigator grant, he was only too eager to advance his professional experience through the Applied Chair position in Health Services and Policy Research.

Timely access to high quality health care in EDs has become a major concern for Canadians who ranked their EDs lowest in providing "good or excellent" care in a 2003 community survey of five countries (Australia, Canada, New Zealand, USA and UK). Every year in Canada more than 12 million ED visits are made and outnumber all hospital admissions by a factor of four. Given Dr. Schull's experience fulfilling multiple roles in emergency care at the Sunnybrook Research Institute and the Department of Medicine at the University of Toronto, he was intrigued at measuring, evaluating and enhancing Canada's emergency department (ED) system.

With this structure in mind, Dr. Schull has set out to lead research and policy work designed to make improvements in patient flow, system integration and quality and patient safety in Canada's EDs. "[Being Chair] was an opportunity to bring together researchers and policy makers to participate jointly," he reflects. The project's main objectives include close collaboration with decision-makers to conduct policy relevant research and develop effective knowledge translation strategies; ensuring evidence informs policies to restructure ED waiting times, quality and safety. The Chair similarly trains health service and policy researchers to understand policy priorities and develop relevant research.

"Every researcher wants their work to have impact," says Schull. Appreciating that his research is heavily based on broader decision making, he understands the need to effectively connect both schools of thought.

"As researchers we often just want to disseminate our information because of the importance we believe it carries," he acknowledges. "But two-way engagement and communication makes you a better researcher and makes [the research] more meaningful. You learn a lot from [policy makers] too."

Nearly halfway through his Chair appointment, Dr. Schull is already learning important lessons about the collaborative research process. "It's really tough to develop strong policy," he recognizes. He states that the strength of the program lies in the linkage between researchers and policy makers via knowledge translation efforts. "Research has its limitations when it comes to decision making – you also need an understanding of political attitudes and opinions."

Considering both the research and policy perspectives is important as Dr. Schull notes that research and evidence may not always spur decision makers into action but adds, "It's important to never give up". He further explains that given the policy realm's fluidity it is crucial to persistently pursue evidence that will benefit overall health care system and patients' quality of care.

Dr. Schull is interested in approaching policy implementation from a fresh new perspective despite the current focus on swift application. He believes that integration enablers and barriers need to be leveraged and mitigated, respectively, before policy can be successfully introduced. According to Dr. Schull an understanding of key factors such as governance, accountability of system change and scalability of ideas across jurisdictions and institutions is crucial.

The health services and policy research community continues to raise the profile of innovative and collaborative work by delving into new domains for data analysis. Dr. Schull explains that the new domains of health research in Canada will include social, genetic and environmental determinants. "These fit into a more holistic definition of 'health' that enables us to develop truly enlightened policies that enhance the quality of life for all Canadians"

For those ambitious individuals who aspire to breakthrough in health services and policy research, Dr. Schull insists that there is no substitute for research evidence to inform policy. He goes on to advocate that, "We can influence policy through rigorous research." And further encourages the current and emerging researchers to remain focused and ensure the provision of timely, relevant and responsive evidence to target optimal health service delivery.

"Finish the sentence" with Dr. Schull:

  1. My role model growing up was… my dad, an author and self-taught historian who believed we all have stories to tell.
  2. The one thing I can't live without is… a morning espresso.
  3. If I was not a health researcher I would be… living and working in Africa.
  4. My secret talent is… that I make exceptional fried eggs.
  5. If I had $1,000,000 I would… pay off my mortgage (I live in Toronto).

Upcoming events

The 8th Annual World Healthcare Innovation & Technology Congress
Arlington, USA. November 7-9, 2012.

Postdoctoral Fellowship
The Department of Community Health and Epidemiology and the Nova Scotia Cochrane Resource Centre at Dalhousie University are seeking a Postdoctoral Fellowship candidate to work within an evidence synthesis research program. The successful applicant will work on systematic review and rapid response research projects, and evidence synthesis methodological investigations.

Read the full position description [ PDF (336 KB) - external link ].

Advancing Population and Public Health Economics Invitational Workshop - Opportunity for Students and Post-Doctoral Fellows
The National Collaborating Centres for Public Health (NCCPH) and the Canadian Institutes of Health Research Institute of Population and Public Health (CIHR-IPPH), in collaboration with the Canadian Institute for Health Information-Canadian Population Health Initiative (CIHI-CPHI) and the Public Health Agency of Canada (PHAC) are hosting an invitational workshop Advancing Population and Public Health Economics Workshop on Tuesday, January 15th, 2013 from approximately 11:30 am to Wednesday, January 16th, 2013 until approximately 4:00 pm at the Delta Chelsea Hotel (33 Gerrard Street) in Toronto.

If you are aware of any graduate students or post-doctoral fellows who would be interested in attending this workshop, CIHR-IPPH is pleased to make a limited number of Institute Community Support (ICS) grants available to support their participation. Students interested in applying for a travel award to attend the Workshop should complete the ICS Application Form. For this award, students do not need to provide proof of acceptance to the workshop prior to submitting an application. The maximum amount per award is $1,000.The deadline for submissions is November 15, 2012. Please direct any inquiries to Kim Gaudreau at ipphfunding@cihr-irsc.gc.ca or 613-957-6128.

On the Horizon – EIHR in Rare Diseases

October is Evidence-Informed Healthcare Renewal (EIHR) month at CIHR where we are revealing the groundbreaking work of researchers from across the country. Emerging team grants are giving the research community an opportunity to investigate the health services and policy implications of rare diseases on specific patient-groups in the hopes of enhancing their care.

A University of Ottawa research team has begun an EIHR project focused on children with rare diseases. The group, led by Elizabeth Potter, Pranesh Chakraborty, Douglas Coyle, Jonathan Kronick and Kumanan Wilson, hopes to revolutionize care for children with an inborn error of metabolism (IEM). An IEM can manifest itself into rare diseases that significantly disrupt the quality of life for young children and their families.

The program will evaluate IEM patients' outcomes from a range of perspectives in collaboration with a diverse advisory board comprised of health services and policy research experts and community members. Further, the researchers intend to generate a detailed information system to study patients' care process including measuring use of health services, health outcomes as well as patient and guardian self-reported experiences. The plan aims to generate evidence for sustainable improvements in care and research for children with IEM and other rare diseases. This is a joint CIHR project funded by the Institute of Genetics and IHSPR.

Researcher's Corner - Simcare

The Simcare project was established to compare the outcomes of the surgical cardiac care process delivered under different policies in order to highlight the most effective options for improving the delivery of medical care. The project is based upon a computer simulation model which records variable factor inputs, including patient population, health care services and proposed policy alternatives, to generate specific care paths for various scenario combinations.

The Simcare project research team is led by Professor Boris Sobolev from the UBC School of Population and Public Health and is funded in part by the CIHR strategic initiative "Advancing Theories, Frameworks, Methods and Measurement in Health Services & Policy, Population and Public Health Research and Knowledge Translation."

The project truly exemplifies the nature of evidence informed healthcare research by analyzing the simulation of health system operations in conjunction with relevant policy initiatives. The Simcare model also reflects trends in broader e-health population management, ensuring the most effective and efficient care for all Canadians. Following the success of the cardiac care evaluation model, the researchers plan to follow new lines of investigation in orthopaedic surgery throughout Canada.

The Simcare research team has participated in knowledge translation conferences in Nova Scotia and British Columbia to engage with decision makers on the practicality of program implementation throughout these jurisdictions. The project has been featured in the UK's International Innovation Journal.

Publishing Opportunity

Preventative Medicine – "Population Health Intervention Research" Call for Papers

Preventive Medicine in collaboration with Guest Editors Mark Petticrew, London School of Hygiene and Tropical Medicine, and Louise Potvin, Université de Montréal, invite researchers to submit papers on population health intervention research for a themed section of the journal.

This themed issue will feature conceptual and theoretical papers about the foundations of PHIR, systematic and realist reviews of literature on population health interventions and related processes/outcomes and research articles describing the processes and/or results of population health intervention studies using a range of research designs and methods. We also encourage submissions involving multiple jurisdictions, sectors, disciplines and communities in high, middle- and low-income countries.

The deadline for submissions is November 30, 2012. Read more about the competition and submission guidelines.

This themed issue is co-sponsored by Preventive Medicine and the CIHR Institute of Population and Public Health, through the Population Health Intervention Research Initiative for Canada.

JAMA – "Genomics in Health Care" Call for Papers for the 2013 Theme Issue

In April 2013 the Journal of the American Medical Association (JAMA) and the JAMA Network of Publications will publish theme issues or articles devoted to genomics in health care. The organization is currently accepting submissions of original scholarly works related to this dynamic field.

Related genomics articles from three major thematic areas will be considered for publication:
Advances in the understanding of health and disease states; advances in prevention, diagnosis and treatment of health conditions; and advances in translation of genomics to improved health outcomes in individuals and populations, including issues related to a broader context of genomics in society.

JAMA will accept original research reports, authoritative review articles and scholarly viewpoints focused on genomics in health care.

Read more about the competition and submission guidelines.

October Quiz

This month's quiz is based on our National Alliance of Provincial Health Research Organizations (NAPHRO) member, the New Brunswick Health Research Foundation (NBHRF).

  1. How long has NBHRF been developing 'A Primary Health Care Framework'?
    1. 2 years
    2. 11 years
    3. 6 years
    4. 9 years
  2. Who is NBHRF's new CEO?
    1. Krista Connell
    2. Bruno Battsitini
    3. Diane Finegood
    4. Stephen Bornstein
  3. Which nonprofit organization does NBHRF partner with to advance New Brunswick's research opportunities?
    1. Kidney Foundation
    2. Heart & Stroke Foundation
    3. Breast Cancer Society
    4. MS Society
  4. When did NBHRF award the first Terry Fox Postdoctoral Fellowship?
    1. January 2005
    2. May 1990
    3. September 2009
    4. July 2012

Please send your answers back to info.ihspr@mcgill.ca for a chance have your name entered into this month's raffle to win cool prizes - if you have all answers correct!

Congratulations to our August quiz winner, Penny D'Agnone from Lethbridge, Alberta.

We would like to hear from you!
CIHR - Institute of Health Services and Policy Research
3666 McTavish, Second Floor, Montréal, QC, H3A 1Y2
Tel: 514-398-5736
Email: info.ihspr@mcgill.ca

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