Strategies for Patient Oriented Research: The PEI Primary and Integrated Healthcare Innovation Network. March 16 th, 2017 W.J.

Transcription

1 Strategies for Patient Oriented Research: The PEI Primary and Integrated Healthcare Innovation Network March 16 th, 2017 W.J. Montelpare

2 What is the SPOR PIHcI Network? SPOR: Strategies for Patient-Oriented Research PIHcIN: Primary and Integrated Healthcare Innovation Network Potential to develop both a physical and virtual environment for new ways of thinking about healthcare across a variety of cohorts and health conditions.

3 PEI PIHcI Network History Developmental Phase (2014/15)- increasing awareness and engaging stakeholders/partners General meeting of stakeholders April About 40 in attendance. Over 50 individuals on the PIHcIN member list Submission of proposal for Operating Grant to establish PIHcIN (August 2015) CIHR, Health PEI and Medical Society of PEI funding approved (Oct- November 2015)

4 National Focus: 12 Networks with Tri-partite Leads Current PEI Tri-partite Leads Clinical Dr. Peter Mckean Gov t/policy Mark Spidel, HPEI Research Dr. William Montelpare, UPEI

5 Objectives of the Network To develop and sustain effective alliances between research, health and other partners to conduct patient-engaged research; To create a practice-based learning and research network integrating horizontal and vertical care with a rapid assessment component using administrative and new data and focusing on scaling-up to improve care and reduce healthcare costs; To conduct research to assess the impact, cost-effectiveness, comparative efficiency and scalability of existing and new innovative, integrated primary health care delivery models (focus on patients with complex needs and vulnerable cohorts across the lifespan);

6 Objectives of the Network cont d To conduct research on upstream prevention strategies to prevent chronic disease, reduce exacerbations and complications from these diseases, and reduce preventable health care system utilization (e.g. enhanced COPD care, cardiac rehab, birth cohort, pre-diabetes); To provide evidence to support the provision of patient-centred care that is based on patient values and needs and is responsive to economic, social and cultural differences; and To work with the Maritime SPOR Support Unit to build research capacity of students, researchers, primary care and the broader health system and other community partners.

7 Patient Engagement is Critical to our Mandate A primary tenet of the SPOR PIHcI Network is that there will be patient engagementinvolvement at every stage of the research process This means that we will have patients working with us from the initial development of the research initiative through to the delivery of final reports and into the process of knowledge translation

8 Critical Tenets cont d A second critical tenet of the SPOR PIHcI Network is to develop Inter-professional education across the multiple stakeholders that make up the network partnership. Our goal is to make explicit within our professional culture: Collaboration, Engagement, Innovation, Integration, and practices that are Evidence-Informed.

9 Critical PIHcIN Linkages Links to MSSU PEI PIHcI Network Operational Management Committee Links to National SPOR Networks Links to Atlantic PIHcI Networks (NB, NS, NL)

10 Building Capacity Trained Students Stakeholders Research Ready PEI Strategies for Patient Oriented Research Fostering Engagement Input Citizens Patients Healthcare providers Researchers Policy Makers Driving Collaborative Research Reports Articles Infograms Newsletters New Healthcare Models Create a Communication Network Knowledge Translation Health Literacy National and International linkages e-access Improved Health outcomes for Islanders in a sustainable healthcare system! Skilled Participants Relevant Questions Informed evidence-based recommendations Understanding and Uptake

11 The 10 Essentials of CIHR-SPOR PIHcIN 1 Tri-partite leadership (science, policy, clinical) ( ) 2. Strategic scope: (i) individuals with complex care needs across the life course, showing capacity to evolve the network's scope over time to include age groups from children to older adults ( ); and (ii) multi-sector integration of upstream prevention strategies and care delivery models ( ) 3. Engagement of key stakeholders across the care continuum in primary and integrated care re-design ( ) 4. Citizen/patient/family engagement ( ) 5. Capacity for rapid monitoring, evaluation, feedback (linkages with SUPPORT Units) ( ) 6. University partnerships to develop primary and integrated health care research capacity ( ) 7. Capacity to implement and evaluate e-health solutions that could improve the cost-effectiveness of care delivery ( ) 8. Geographic scope: Coverage of practices and patients ( ) 9. Linkage to CBPHC Innovation Teams ( ) 10. Partnership funding (1:1 for infrastructure award and research priorities) ( ) KEY: accomplished ( ) developing ( ) to be developed (?)

12 The Maritime SPOR Support Unit (MSSU) Members of the network continue to sit on the committees of the MSSU and participate in MSSU working groups and subcommittees. Network involvement in the MSSU has strengthened the partnership and future collaborative opportunities between the PEI PIHcI Network and the MSSU. It is expected that such activities will continue and in so doing will develop the appropriate framework for rapid cycle evaluation and establishment of common metrics and measurement strategies.

13 Secure Data Repository The PIHcI Network is a founding partner in the development of a patient data management plan upon which the provincial data repository is being created. An important outcome in the SPOR initiative is the establishment of a mechanism for data access that was drafted in collaboration with and approved by Health PEI. This formalized policy guarantees confidentiality and security at all levels of data operations in SPOR activities.

14 Current Research Initiatives Agency / Partner CIHR Quick Strike (I) CIHR Quick Strike (II) CIHR Project Scheme PEI / NB / NS Network Project I (Health PEI) Network Project II (Health PEI) Network Project III CHANCES Project Title Children with Complex Healthcare Conditions NPI: Shelley Doucet Creation of a Comprehensive Health Profile of Children in NB & PEI and Development of Intra- Provincial Population-Based Birth Cohorts: NPI: Carole Tranchant Creating HeAlthy Transitions in MaRitimE Families/ Créer des transitions SAINES chez les familles des Maritimes: The CARE/SAINES Study NPI: WJM MAAP-PEI: Models and Access to Primary Care Providers in PEI (replication of NS Study) NPI: Emily Marshall Family Physician Abuse by Patients Seeking Controlled Substances PEI (replication of NB Study): Peter McKean and Health PEI Understanding Epigenetic development CHANCES Timeline July 2015 In progress December 2015 October CIHR Project Grant 2016 October CIHR Project Grant 2016 Ongoing development Ongoing development

15 Current Research Initiatives cont d Agency / Partner Project Title Timeline Network Project IV NS, NB, PEI, Quebec, MB AB, UBC Network Project V UPEI Clinic Workers Compensation Board Network Project VI (Health PEI) Network Project VII (Health PEI) Network Project VIII (Health PEI) Network Project IX (CIHR-NS/NB/PEI) Comparative Policy Analysis Grant: NPI Jeannie Haggerty - McGill Establishing the Baseline Measures For Concussion And Providing Evidence For Return To Work/Play Decisions COPD Enhanced (January 2016 Pilot) Jan 2017 full program Cardiac Rehabilitation (ongoing development) Jan 2017 full program Neonatal Abstinence Syndrome (in development) Integrating end of life care to help people stay in the community: the essentials for success April Ongoing delivery Ongoing delivery Ongoing development Dec 2016: SPOR Knowledge synthesis grant

16 Human Resources Post Doctoral Fellowship (QS I & QSII) PhD Student Researchers across the Maritimes Research Associate (FT) Network Coordinator Graduate students MN, MN-NP, MSc, MAHSR, PhD Undergraduate Summer Students

17 The Goal To enhance access and delivery of primary healthcare locally, regionally, and nationally The challenge is that projects must have matching funding at a 1:1 level

18 A community based primary health care clinic at UPEI Optimizing space and capital to enhance community based primary health care and provide opportunities for learning

19 Current Health Status of Islanders Islanders have higher than national average rates of Obesity Heavy drinking Inactivity Less likely to consume recommended amounts of fruits and vegetables per day One in three Islanders have at least one chronic disease One in five have hypertension One in 18 (over age 20) have diabetes Aging population will mean growth in chronic disease 47% of Islanders age are pre-frail and 29% are frail 43% of those age 65 and over are pre-frail and 43% are frail (CCHS, CHO, 2014)

20 Health Care Utilization Aging population and high rates of chronic disease and multi-morbidity High rates of ER visits and hospital admissions for potentially preventable health conditions Higher rates of hospitalizations for Ambulatory Care Sensitive Conditions than national average

21 Ambulatory Care Sensitive Conditions ACSC Rates in Prince Edward Island and Canada 2007/08 to 2010/ Rate per 100, * 497* 515* PEI Canada / / / /11

22 We have a physical home on the UPEI Campus We are developing a space for Patient Oriented Research in the lower level of the Steel Building on the UPEI campus

23 In the clinic we can develop programs to pursue the potential benefits of the PEI PIHcIN with patients Align research with Strategic Plan Access to Research Expertise Evidence to drive practice/policy Build research capacity. Staff training and education Testing new innovations and upstream prevention Respond to research interests of staff, clinicians, residents Enhance access to PEI data Support for existing program areas (HI Unit, Evaluation)

24 At UPEI we have the academic infrastructure for healthcare and patient oriented research Dietetics Interns Graduate students in Nursing (MN) Nurse Practitioner program Graduate students in research (M.Sc.)

25 Main Objective To create an environment that will foster enhanced learning opportunities for students while enabling care for selected primary care initiatives.

26 The punch line is to create an environment that will help to move ideas from the what if we did this -- to the what happens when we do this stage

27 Thank-you Questions?

28 Contact me Principal Researcher Professor William J. Montelpare, Ph.D. Margaret and Wallace McCain Chair in Human Development and Health Department of Applied Sciences, Faculty of Science University of Prince Edward Island (902)