IHSPR Newsletter - December 2012

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Message from Dr. Robyn Tamblyn, IHSPR Scientific Director

Welcome to the December edition of the IHSPR Innovator.

On behalf of the CIHR-IHSPR team, I would like to wish our entire community a happy and safe holiday season. We look forward to a new year full of opportunities to work together to transform the delivery of health care across Canada.

A Holiday Treat:
Dr. Robyn Tamblyn's vision for sustainable health care in 2013 and beyond.

Open Access

CIHR believes that greater access to research publications and data will promote the ability of researchers in Canada and abroad to use and build on the knowledge needed to address significant health challenges. Starting January 2013, CIHR-funded researchers will be required to make their peer-reviewed publications freely accessible within 12 months of publication – at the latest. Amendments to the CIHR Open Access Policy, formerly known as the Policy on Access to Research Outputs, modify current requirements to provide the public with freely accessible research articles while aligning with other major funding agencies, such as the US National Institutes of Health.

To facilitate compliance, CIHR funded researchers are encouraged to utilize PubMed Central (PMC) Canada, a stable and permanent online digital archive of full-text, peer-reviewed health and life sciences research publications. To create an account in PMC Canada please contact info@cihr-irsc.gc.ca.

For further information, please contact access@cihr-irsc.gc.ca

Canadian Foundation for Healthcare Improvement: Accelerating healthcare improvement

(The views expressed in this article are those of the authors and do not necessarily reflect the position of CIHR)

Change is needed in how healthcare in Canada is organized, financed, managed and delivered. This includes finding the best approaches for maximizing value for money in healthcare spending, providing a more coordinated approach to complex healthcare needs and, improving patient and family-centred experience and outcomes.

The Canadian Foundation of Healthcare Improvement (CFHI) collaborates with governments, policy-makers, and health leaders to convert evidence and innovative practices into actionable policies, programs, tools and leadership development. Building on its history as the Canadian Health Services Research Foundation, CFHI's evidence-based approach to assessment, design, implementation and evaluation facilitates the spread of healthcare solutions across the country.

In the North, CFHI is collaborating with the Northwest Territories Department of Health and Social Services to develop, implement and sustain an integrated, culturally appropriate and territory-wide plan to improve health services for people living with chronic diseases. The collaboration is entering its second phase focused on implementing redesigned care pathways for patients with mental health issues, renal disease and diabetes.

CFHI, Northern Health in British Columbia and the University of Northern British Columbia are using a pan-provincial healthcare collaboration to identify and spread improvements and transformations to health systems in northern, rural and remote regions across provinces, south of the 60th parallel.

In the East, CFHI recently launched the Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease; a collaboration including four ministries of Health and 17 regional health authorities in Atlantic Canada. Through the early part of this initiative, participants will delve into a gamut of challenges touching the patient/family continuum of care.

The new CFHI name reflects its mission and mandate as well as its expanded priorities as demonstrated in these recent examples of some of its work. However, CFHI no longer provides grant funding for health policy. CFHI does undertake research and evaluation related to key healthcare policy issues usually by commissioning research and analyses. These policy analyses are increasingly tied to collaborations with health regions, provinces and territories to provide them with the analysis they need to help them to accelerate, advance and implement their healthcare improvements.

CFHI is having an impact by working shoulder to shoulder with health leaders, with the support of an extensive network, providing change management mentorship and by using its tailored, evidence-based approach.

On the Horizon: Adventures in eHealth Science Policy Fellowship

It's an exciting time again for trainees and independent researchers at CIHR with opportunities like the Science Policy Fellowship program. The unique program grants student investigators the chance to develop an understanding of health policy though integration with a policy team.

Jason Millar recently completed a six month assignment with the eHealth Unit, Health Care Programs and Policy Directorate at Health Canada. Under the mentorship of Madeleine Li and a larger policy team, he had the opportunity to delve deeper into his eHealth focus, within the context of relevant policies affecting its use in the Canadian health care system.

Millar wields considerable engineering experience and is currently pursuing a doctorate in Applied Ethics and Bioethics at Queen's University. His interest in health care theories and technology intersected with the prospect of eHealth systems that drive patient-centered care.

eHealth goes beyond the realm of computer-based patient databases and luckily, Millar's placement exposed him to some of the latest innovations in the field, like the online, forum-structured website. The U.S. site is a hub for health patients, professionals, providers and technology developers to create an open network of knowledge and experience sharing, all with the intent of strengthening evidence-based care and health outcomes.

Effective buy-in and implementation are crucial success factors with any emerging technology and eHealth's will depend on patient and practitioner knowledge translation (KT). As described in his report, "Engaging and Empowering Patients With Consumer eHealth Solutions - Fostering Patient Expertise", Millar determines that a patient-centered approach to eHealth will drive increased practitioner system uptake. The inception eHealth solutions geared towards patient self-management are revolutionary as Millar notes that clinicians tend to be more responsive when given clear measurable evidence of the value in a process.

The deciding factors around widespread implementation of eHealth will not be made in isolation. At the decision-making table scientific data meets, social, financial and planning considerations. Effectively combining shared goals from different perspectives is at the core of KT as Millar recounts that the process "takes time". Similar to clinicians, policymakers are prompted by strong evidence that takes competing factors into account. The fellows are introduced to the real-world setting of discovering shared values and demonstrating that there is common ground. "Different groups are socialized into their professions with different terminologies or approaches to problem solving," Millar explains. Moving forward, issues and concerns can be addressed with an understanding of each perspective. In this vicinity true KT is possible and well-informed, evidence-based policies become a reality.

From conceptual theories to research projects and practice models, the CIHR Science Policy Fellowship completes the loop of what a successful health services and policy research career entails. By developing awareness and knowledge of policy issues that will affect how far their future projects will go in transforming Canadian healthcare, these promising researchers are well poised to do just that.

Ottawa Inner City Health: Utilizing Research & Knowledge to Inform Care of the Homeless

Recently, CIHR head-office staff welcomed Ottawa Inner City Health (OICH) for a presentation around community-based primary health care interventions for a segment of the city's homeless population.

Co-founders Jeff Turnbull and Wendy Muckle detailed their endeavours to appropriately target this oft-forgotten community. Concentrated to confined areas of the city, the homeless experience life expectancy, infection and mortality rates mirroring that of the developing world despite Canada's first-class health care system. Their complex community extends beyond the stereotypical white male battling alcoholism and addiction, but includes immigrants, families, adolescents and young women.

The OICHI uses an integrated, evidence-based approach towards effectively targeting the chronically homeless' barriers to accessing personal and public health services. Collaborations with health, social services, housing and criminal justice departments are key. The organization operates a myriad of services through their six shelter- based programs, including a primary care clinic and separate special care units for men and women where the focus is on personalized care.

OICH utilizes a combination of experiential learning and participation in formal research projects to evaluate and improve its programs. An evaluation of the program undertaken by Dr. Tiina Podymow and published in the CMAJ in 2006 found OICH's managed alcohol program (MAP) helped clients stabilize their alcohol intake and significantly decreased ED visits and police encounters.

Dr. Turnbull touts OICH's success to a "change in their philosophy and our approach". The organization prides itself on quality interventions and an understanding that each client's care must be personalized to deal with their physical, mental and emotional needs.

Guest Editorial: Reflections on the Romanow Policy Forum

(The views expressed in this article are those of the authors and do not necessarily reflect the position of CIHR).

The Canadian Association for Health Services and Policy Research (CAHSPR) held its policy forum "Ten Years Since the Romanow Report: Retrospect … and Prospect" on November 9th. It was a day of reflection where a range of speakers presented circumstances that gave rise to the report, the promise it held at the time of its release and factors shaping what has (or has not) happened since.

The Romanow report was released while most of the student attendees were still in high school, yet many of the recommendations are still relevant. During the forum, we heard exciting examples of progress like the establishment of the First Nation's Health Authority in British Columbia and the Pharmacare2020 initiative. Yet it was still clear that considerable challenges remain as attendees voiced frustration with circular discussions, finger pointing and the failure to implement policies that could improve health care quality, safety and spending. As young researchers, we were left wondering "what now?" What lessons could be gleaned from successes and missed opportunities? Throughout the day there were calls for innovation and excellence - but where and how should we focus our efforts?

Keeping with CAHSPR's commitment to student engagement, we were fortunate to be part of an intimate closing discussion with fellow student participants and the man himself, the Honourable Roy Romanow.

Perhaps unrestrained by experience or disenchantment, the frankest discussion of the day was in our informal huddle of hotel chairs around the candid Mr. Romanow. Among his recollections on the political conditions that led to the report, the most constructive reminder was that evidence in isolation is not enough to effect change. The missing link to achieving system transformation may be right in the report's title: "Building on Values." As researchers we do not define values for Canadians, but as a community can we do more to offer solutions that realize our shared national values? How do we engage citizens to hold government (provincial and federal) accountable for the provision of high-quality health care, informed by strong evidence? The forum did not answer these questions, but prompted us to find answers ourselves as we move forward with our careers. From our perspective, this was an important outcome of the day: catalyzing a new generation to reconsider Romanow's continuous call to action.

Ruth Lavergne and Saskia Sivananthan
Co-chairs, CAHSPR Student Working Group
Doctoral Candidates, Centre for Health Services and Policy Research,
School of Population and Public Health, University of British Columbia

Events & Reminders

CFHI Taming of the queue
March 21-22, 2012
Fairmont Château Laurier Hotel (Ottawa, Ontario)

This years' overall conference theme is "Beyond the Queue: A systems approach to addressing the root causes of wait times." The conference will include presentations and panel discussions by leading international, national, provincial and regional speakers in wait-time management from a variety of health sectors.

The Conference Steering Committee invites health care providers, students, researchers and others interested in improving timely access to care to present a poster at the conference.

Call for posters closes: Monday, January 21, 2013
Conference dates: Thursday, March 21, 2013 to Friday, March 22, 2013

For more information contact Brenda Trepanier at brenda.trepanier@cma.ca.

2013 Using Evidence Webinar Series
This new year the Canadian Cochrane Centre will hosts a number of webinars aimed at discussing prominent issues in health services and policy work in Canada. The four part-series will focus on the expanding role of health evidence in decision-making amongst patients and practitioners, policymakers and media.

Guest speakers include: Tamara Rader, Jordi Pardo Pardo, John Lavis, Julia Belluz and François-Pierre Gauvin

All Webinars are FREE.
Register

Pharmacare 2020
February 26-27, 2013
Sheraton Wall Centre (Vancouver, BC)

Pharmacare 2020 is a national symposium on the future of prescription drug coverage in Canada: an evidence- and experience-informed conversation on issues of innovation, equity, and affordability. Pharmacare 2020 will bring together diverse participants from across Canada to explore the policy challenges and innovations of today and map out what Canadians want from the system in the future. It is time to create a clear vision for Pharmacare in Canada.

Conference registration is open.
Early bird registration deadline: Thursday, January 31, 2013

December Quiz

This month's quiz is based on our National Alliance of Provincial Health Research Organizations (NAPHRO) member, Fonds de recherche du Québec – Santé (FRQS).

  1. Which anniversary will FRQS be celebrating in 2014?
    1. 60
    2. 33
    3. 40
    4. 50
  2. On average, how much CIHR funding does Quebec receive?
    1. 5%
    2. 30%
    3. 19%
    4. 41%
  3. How many thematic research networks does FRQS fund?
    1. 8
    2. 28
    3. 18
    4. 38
  4. On a given year, what is the average percentage of FRQS funds dedicated to training and salary awards?
    1. 33%
    2. 50%
    3. 25%
    4. 75%

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!

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

Happy Holidays!

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