Sharing Innovative Practices

Mark Dobrow, Director, Analysis and Reporting, Health Council of Canada

I attend many meetings across the country on the good, the bad and the ugly of our health care system. In recent years, it is rare that at one of these meetings or conferences, I won’t hear someone say pejoratively that ‘Canada is the home of the pilot study.

To be frank, I’m growing a little weary of hearing it. While I appreciate the message that we need less study and more action, this anti-pilot study chorus also creates, however unintended, an underlying message that the testing and evaluating of innovative ideas is in some way sub-optimal.

Personally, I would encourage more pilot studies of innovative ideas and practices, but at the same time I would also expect that the results of those pilot studies be made available where others can benefit from them. Unfortunately, this is where things break down in Canada. Even though we live in the digital age, we don’t always take full advantage to facilitate the exchange of ideas. While most innovative practices are not going to be written up in academic journals, if you’re contributing to innovation in this country, where do you share this information? If you are seeking innovative ideas, where to you look for this information?

The federal, provincial and territorial governments have highlighted this challenge, making the identification of best practices and the highlighting of health innovation a key part of the Health Council’s mandate. The Health Innovation Portal represents a key part of our effort to address this, putting in one place all things related to health innovation that we do.

A key part of the Health Innovation Portal is the searchable database of innovative practices. It currently includes over 240 innovative practices representing a wide range of health care themes from across the country. Our goal was to create a user-friendly search tool with useful outputs that can be tailored to your needs.

We will be updating the Health Innovation Portal on an ongoing basis, so your feedback is welcomed and encouraged. But more than that, your contributions to the database are what will make this tool of value to the Canadian health care system. If you are making extra efforts to improve health care in your area, you need to let others know.

Please send us details on your innovative practices along with information on what you have learned from them to innovation@healthcouncilcanada.ca and we will review them for the database. The result – better ideas for better health care.

Health Innovation Portal connects

Ingrid Sketris, Councillor, Health Council of Canada

I am pleased to see the launch of the Health Council’s Health Innovation Portal. It will be a mechanism to both identify innovative practices and programs across Canada and facilitate their dissemination. Once these practices are identified, this portal will allow interested individuals to follow new developments and updated evaluations.

I am a member of an innovative program in Nova Scotia- the Drug Evaluation Alliance of Nova Scotia (DEANS). DEANS is a multidisciplinary, multisectoral alliance to optimize drug use in Nova Scotia (NS). DEANS includes representatives from the Nova Scotia Department of Health and Wellness (DHW), health professionals, program administrators, e.g., from the Nova Scotia Prescription Monitoring Program (PMP), and academic researchers and their trainees.

DEANS encourages appropriate drug use by identifying areas where optimization of drug use is needed, developing interventions to provide targeted, evidence- informed information to patients and providers and evaluating the impact of the interventions. DEANS supports the development of interventions based on a rigorous review of the literature, knowledge of the local context and the experience of committee members and other local experts. DEANS sponsored interventions include live and web based interprofessional educational programs, academic detailing and the provision of prescribing profiles to physicians.

Evaluation is a component of all DEANS initiatives. Some evaluations assess participant satisfaction with the delivery of the program and have participants identify how they will use the information to optimize patient care. Other evaluations have been more extensive, including examining the effect of the intervention on drug utilization and hospitalizations. A new initiative is the Katie program which assists clinicians in appraising new information and applying it to their practice. The website also has links to other sources of information about knowledge translation and effective continuing health professional education.

Examining the impact, uptake and adaptation of innovative practices and programs by other jurisdictions is complex and requires diverse evaluation approaches that employ methodologies such as quantitative, qualitative, and mixed research methods. The Health Innovation Portal will enable decision makers and researchers working in innovative areas both with the ability to find others working in the same program and policies areas and to identify appropriate methods to evaluate the success of their innovative approaches.

Health Innovation – the importance of measurement

Dr. Anne Snowdon, Professor and Chair, International Centre for Health Innovation, Richard Ivey School of Business

Each province and territory in Canada faces unique challenges as they struggle to meet growing demands for health services and escalating costs of health care. To ensure sustainability, we need to be innovative, meaning we must re-design health services to achieve greater quality and be more effective. But we must do more than just innovate - we need to measure the impact of innovation at the health system level, and disseminate our findings widely.

While no single jurisdiction has completely redesigned their health system to achieve sustainability, some have made progress through innovative practices to improve the quality of care and health outcomes. The question for health care leaders is: how do we learn from the success and failures of others to adequately address challenges within our own health systems?

Despite changes in health systems in Canada and around the world, we have limited evidence of the impact of these changes from a health outcomes or cost effectiveness perspective. Strategies for innovation must be supported by empirical evidence. In short, we have to measure innovation impact to understand how it is working and how we can build on success. Evidence-based innovation of this kind would generate best practices that could be shared across the country and around the world through dynamic knowledge translation models - a virtual network of partners working together and sharing evidence so that other countries can learn from, adopt or adapt proven solutions for their own health systems.

At the same time, we must also develop a performance management system that examines and captures the impact of innovation adoption on both system performance and population health across the continuum of care.

In Canada, each province and territory across the country is a living laboratory ripe with the potential for innovative best practices. For example, innovation to support primary care and integration is emerging independently in three Canadian provinces: Ontario, Quebec and Alberta. So far, there has been almost no measurement of the impact of these innovative primary care models. The resulting lack of knowledge transfer between these jurisdictions has meant missed opportunities for sharing lessons learned that could benefit all health systems across the country.

Without measurement of the impact of innovation, there continue to be missed opportunities for sharing lessons learned that could benefit other jurisdictions, not only within Canada, but internationally. Therefore it is important that we continue to build platforms for sharing in order to drive system innovation to support sustainability.