Dress for Success: The power of linkages

Transcription

1 MANITOBA CENTRE FOR HEALTH POLICY Dress for Success: The power of linkages Patricia Martens PhD Director, MCHP; Professor, Community Health Sciences, Faculty of Medicine, University of Manitoba; CIHR/PHAC Applied Public Health Chair Harkness, Toronto: May 10 th, 2012

2 A bit of history and background of MCHP Department of Community Health Sciences, Faculty of Medicine Worldwide recognition (e.g. recent Wales visit) Funding: research grants from provincial and national agencies (like the Canadian Institutes of Health Research, CIHR) an ongoing grant relationship with Manitoba Health since 1990/91 a long history since 1970 s

3 MISSION Specific Objectives for each of the Goals VISION and VALUES Research pillar Repository pillar Knowledge Translation pillar GO Foundational resources to sustain MCHP The Manitoba Centre for Health Policy

4 Repository LBD? Justice, U of M, lab and diagnostics Census Data at DA level Hospital Home Care Family Services Pharmaceuticals Cost Social Housing Population-Based Health Registry ER Healthy Child MB data Education Provider Vital Statistics Immunization Medical Nursing Home Special data e.g. ICU, Metis cohort

5 Wikipedia little black dress A little black dress is an evening or cocktail dress, cut simply and often quite short. Fashion historians ascribe the origins of the little black dress to the 1920s designs of Coco Chanel, intended to be long-lasting, versatile, affordable, accessible to the widest market possible and in a neutral color. Its ubiquity is such that it is often simply referred to as the "LBD." The "little black dress" is considered essential to a complete wardrobe by many women and fashion observers, who believe it a "rule of fashion" that every woman should own a simple, elegant black dress that can be dressed up or down depending on the occasion

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7 Accessorize Handbag: keep stuff safe yet available, like our secure data laboratory, funded through CFI (it takes money!) Jewelry: dress it up, like our algorithms Belt: tie it all together and keep things in place, like our concept dictionary, glossary transferred to different outfits, people and times Shawl: avoid a chilly climate of data privacy and data breeches, like our de-identification process (so the data are not so revealing), efforts to explain the process to the public and ombudsman, our new accreditation process Shoes: do the walking (dissemination), like the website, conferences, public reports and summaries, publications, workshops

8 DATA SHARING AGREEMENT WITH MCHP (template available on request) Data Trustee: all 3 pieces Manitoba Department of Health Finds real PHIN, strips off name, encrypts PHIN MCHP sends this crosswalk file to MCHP = name, exact address = data of interest (e.g., health info) = some sort of file number = encrypted PHIN

9 MCHP Data file and crosswalk file stored separately, and only linked during time when a research project has approvals from Ethics, Health Information Privacy Committee, stakeholders ALL DATA ARE CRUNCHED IN MCHP S SECURE ENVIRONMENT either MCHP or one of the secure Remote Access Sites (no CDs, no laptops) = name, exact address = data of interest (e.g., health info) = some sort of file number = encrypted PHIN

10 MCHP All data crosswalk files can be used for only the duration of a project, to connect the data to the encrypted PHIN, and then to other databases allowed by Ethics, Health Information Privacy Committee, and stakeholders = hospital discharge files = registry files (e.g. postal code, M/F, date of birth/death) = social assistance The study file finally! = encrypted PHIN the KE

11 Successful environment for the little black dress taking the Repository research to new places! (linkages with decision-makers)

12 MCHP: What we do with the information - KT At the government level Deliverables (i.e., research reports); briefing of ADMs, DM, Minister of Health, other Ministers, Healthy Child Committee of Cabinet At the public/clinician level Four-pagers; clinician one-pagers; media interviews, op eds,, responses to news, website At the researcher level Research reports, publications, conferences etc. Concept Dictionary and Glossary, website At the RHA level Annual Workshop Days (WRHA, MH, non-winnipeg RHAs, Education/Family Services), dissemination of reports, website data The Need To Know Team

13 Involvement and influencing health policy MCHP s Annual Workshop Days Rural & Northern RHAs, Winnipeg RHA, Manitoba Health Days, Gov t Days Look for the STORIES! NTK facilitates round tables: Evidence-based stories lead to evidence-informed decision-making

14 The Need To Know Team: MCHP, with RHA & Manitoba Health top level planners Creation of new knowledge, capacity building, disseminate/apply research at the regional level, all undergirded with relationship building CIHR-funded, through the Community Alliances for Health Research (CAHR) program, CIHR/PHAC Applied Public Health Chair for Martens CIHR 2005 KT Award for Regional Impact Highlighted as 1 of 5 knowledge to action stories in the 2009/2010 annual report of CIHR

15 Examples of research findings that depend on linked data and linked researcher/decisionmaker relationships

16 100% 90% Grade 12 (S4) Performance by SES Group Language Arts Standards Test 2001/02 Pass/Fail rates of test writers 17/18 year olds who should have written 100% 90% Withdrawn 80% 70% 80% 70% In Grade 11 (S3 or lower 60% 50% 40% 30% 76% 87% 87% 90% 96% 60% 50% 40% 30% 61% 69% 81% In Grade 12 (S4), but no LA Test Mark Drop Course, Absent, Exempt, Incomplete 20% 20% 43% Fail 10% 0% 10% 11% 0% IA Low Lo-Mid Middle High IA Low Lo-Mid Middle High SES Brownell et al SES Pass

17 Initial analysis of Emergency Departments (EDs) Frequent users of ED (9+ visits per year): 54% have a history of 2+ mental illness diagnoses But they also have high use of other health care providers (2,400 people; 80,000 health care contacts) Very frequent users (18+/yr): 85% have 2+ mental illness diagnoses A different way to approach EDs for those living with mental illness WRHA vision Doupe et al. 2008

18 Hilderman et al. 2011

19 Evaluation of Healthy Baby Program (Brownell et al. 2010) Prenatal Benefit (PB) reaches the majority of low income women as an income supplement in their 2 nd and 3 rd trimesters, and is associated with positive maternal/child outcomes Decrease in preterm birth and low birth weight; increase in breastfeeding rates

20 Figure 7.6: Trends in Winnipeg Breastfeeding Initiation Rates 100% Maternal age-adjusted percent of newborns breastfeeding at hospital discharge 90% 80% 70% 60% 50% 40% 30% 20% 10% RATE DIFFERENCE 16.0% Wpg Most Healthy Wpg Average Health Wpg Least Healthy Winnipeg Manitoba Canada Prenatal Nutrition Programs, Healthy Baby and Family First RD 11.7% Significant jump at program onset, p<.003 0% 1988/ / / / / / / / / / / / / / / /04 Time Period What Works Report Martens et al source: Manitoba Centre for Health Policy, 2007

21 Well over $1 billion is spent on hospital care in Manitoba each year. Out of this total budget, where is the most money spent? A. Hip replacements B. Heart attacks C. Normal births D. Knee replacements C. Page viii of The direct costs of hospitalizations Finlayson et al. 2009

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23 Overweight and obese adults are admitted to the hospital substantially more than normal weight adults. True or false? A.True B.False Fransoo et al. 2011: trick question: mostly false but partially true the only BMI category where you see an increase is at 33 or higher BMI

24 Fransoo et al. 2011

25 Manitoba MCHP Deliverable: Centre for Who s in our Hospitals? Health Policy Randy Fransoo, Pat Martens, The Need To Know Team, Heather Prior, Ina Koseva, Leanne Rajotte To be released in late 2013 Randy_Fransoo@cpe.umanitoba.ca

26 The future is bright in Manitoba and Canada through linkages A woman without a little black dress has no future. -Coco Chanel

27 The future? CIHR DSEN CNODES model MB site Canadian Network of Observational Drug Effect Studies (already begun) Partnership of Manitoba Health and MCHP PATHS Equity for Children 14 different interventions for children did this program reduce inequity? Partners: 9 ministries, 11 RHAs, national and international researchers, United Way CFI: MCHP's LEADERS Initiative (Leading-Edge Access and Data Enhancement Research Strategy) In the midst of piloting 6 Remote Access Sites for MCHP 16 new databases With our environment in Manitoba, our Repository, our KT strategies and our Research, we have our little black dress for future success!

28 M C H P Manitoba Centre for Health Policy facebook.com/mchp.umanitoba twitter.com/mchp_umanitoba (@mchp_umanitoba) Youtube video about our workplace

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