Research

Proposed Program in eHealth Innovation

Dr. Alex Jadad, recent appointee to the Rose Family Chair in Supportive Care at the Faculty of Medicine and Professor in the departments of Health Administration and Anesthesiology, is leading the development of an ambitious research program. As Director of the Program in eHealth Innovation, a joint initiative of the University of Toronto and University Health Network, he has assembled an impressive team of researchers from across both the University and its affiliated teaching hospitals, to develop this program.

Dr. Jadad is a 37-year old Colombian-born physician, patient advocate, researcher and educator. In 1994, he received a Doctor of Philosophy degree at the University of Oxford (Balliol College), becoming one of the first physicians in the world with a doctorate in knowledge synthesis. In 1995, he moved to Canada and joined the Department of Clinical Epidemiology & Biostatistics at McMaster University, where he was Professor and Chief of the Health Information Research Unit and Director of the McMaster Evidence-based Practice Centre. In October 2000, he moved to Toronto. His research focuses on the development and evaluation of unique strategies to enhance the health system, through state-of-the-art technology, to help people access and use the knowledge and services they require to meet their health-related needs, regardless of who or where they are. In 1997, Dr. Jadad received a National Health Research Scholars Award, from Health Canada; in 1998 one of 'Canada's Top 40 Under 40' awards, and in 1999 a Premier's Research Excellence Award, in recognition for his efforts to improve our understanding of the role of knowledge and technology in health-related decisions. Alex is married, with two children (and enjoys spending time with them more than anything else). He also likes to play the piano, scuba dive and perform close-up card tricks (all at a basic level).

He would like the new Program in eHealth Innovation to:

• Create a strong platform for the UHN and U of T to nurture existing relationships, create new collaborative opportunities, promote a more efficient and effective research, development and commercialization environment around eHealth innovations.
• Provide an environment that expands the research, development and evaluation settings from traditional university- or laboratory-based locations, to a network of sites that include the community, classrooms and clinical settings, encouraging active participation of the public, educators, students, health care providers and other key stakeholders in all the steps of the process.
• Promote a needed shift in the research, development and evaluation processes from the traditional bench-to-bedside model to the point of need along the continuum of care, i.e. research and development conducted in homes, community-based organisations, consulting rooms, classrooms, hospital libraries.
• Foster the development of innovative methodologies and research tools to evaluate new technological developments in real-enough-time.
• Support the development and growth of a strong eHealth cluster of research and development projects at the UHN and U of T.
• Become a leading institution recognized internationally for its contributions to education, research and training in eHealth.
• Foster strong collaborative links with other academic institutions as well as with government agencies interested in eHealth, community and professional organizations, media representatives and the private sector.

However, the immediate priority of the program is to secure funding through sources such as the Ontario Research and Development Challenge Fund (ORDCF) and the Canada Foundation for Innovation.

Funding from these agencies is important since Canada is in a unique position to lead the world in the transformation of the health system in the information age. The three key infrastructure components included in the proposal submitted to these agencies will support the most innovative eHealth research and development in the world, and act as a magnet to promote and strengthen collaborative research worldwide, with the epicentre in Canada.

We are seeking support to develop:

• The Centre for Global eHealth Innovation: This will include 10,000 sq. ft. of renovated space at the Toronto General Hospital, which will enable economies of scale to support eHealth innovation research. It will host physical, human and virtual resources to support five core functions (idea/knowledge exchange; research and development; education and training; business development; and research administration). It will also include the first standard usability laboratory dedicated to support research in eHealth innovations in Canada.
• The Health-oriented Flexible Simulation Environment: This will be a unique laboratory designed like a movie set in an area of 5,000 sq. ft. to simulate real world settings, such as consulting offices, nursing stations, classrooms, boardrooms, waiting rooms, homes, and other decision-making environments. This will allow controlled experiments and economies of scale for the efficient pre-testing, refinement and development of new information technologies, human-computer interaction, evidence-based decision-making and computer-assisted learning tools.
• Living Laboratories: This will be a series of networked environments in health care institutions (institutional laboratories in hospital wards, consulting rooms, waiting areas and libraries) and the community (non-institutional laboratories in family physician offices, waiting rooms, community centres, schools and homes) to support research and development activities in real-world decision-making settings.

This unique infrastructure will foster the development of a 'mini-model of the world' in Canada, with the capacity to recreate any health decision-making environment in any region of the world, bring research to the point of care, promote input from all groups of decision-makers, and accelerate the rigorous evaluation of eHealth innovations. It will act as an engine for trans-disciplinary research on the transformative effects of information and communication technologies on health systems, positioning Canada as a leader in eHealth innovation and its health system at the forefront of the information age.

For more information, please contact:

Dr. Alex Jadad Director, Program in eHealth Innovation University Health Network and University of Toronto Toronto General Hospital, Eaton Wing EN6-240A 200 Elizabeth Street Toronto, ON  M5G 2C4 e-mail: ajadad@uhnres.utoronto.ca

From Hospital to Home and Community: An Expanding Research Agenda

Professors Raisa Deber and A. Paul Williams have recently received several major grants for their research analyzing the ongoing shift in Canadian health care out of hospitals and institutions and into home and community. A 5 year project entitled M-THAC (From Medicare To Home And Community) was ranked first (of 78 proposals) in the new Community Alliances for Health Research program, funded by the Canadian Institutes for Health Research (CIHR) and the Social Sciences and Humanities Research Council (SSHRC). M-THAC establishes the infrastructure for multidisciplinary teams of researchers, graduate students and community partners to investigate the costs and consequences of this shift for providers, consumers and governments.

Deber and Williams have also received a number of major awards for related projects examining particular aspects of the shift from hospital to home and community. These include a 3 year grant to examine the capacity of not-for-profit community-based agencies to respond to the growing numbers of Canadians with higher levels of health care needs now in home and community; this research was ranked 2nd nationally and is funded under SSHRC's Society, Culture and the Health of Canadians II Strategic Grants. A 3 year project funded by NHRDP/CIHR is assessing the implications of the Maritime provinces' natural experiment on expenditures for such services as home care, public health, and mental health; the provinces vary in which services are incorporated within regional budgets and which have remained at the provincial level. The Hospital for Sick Children Foundation has funded a 2 year project to examine the funding and delivery of home care for children with complex care needs, focusing particularly on how services vary across Community Care Access Centres in different parts of Ontario.  Finally, under its Standard Grants program, SSHRC has funded a 3 year project examining changes to rehabilitation services as they also shift out of hospitals to home and community.

This expanding research agenda brings together scholars from different universities and departments as Health Administration, Nursing, Rehabilitation Sciences, Law, Economics, Public Administration, and Sociology along with community-based researchers and partners at the national, provincial, and local levels.  Strong links already exist with the Home Care Evaluation Research Centre and with the Nursing Effectiveness Unit.  A number of Health Administration alumni are associated with this research as researchers and partners, and the different projects have already catalyzed doctoral dissertations for 8 of our current students.

SSHRC October 2000 Competition Grant Results for Health Administration Department Faculty

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