As trial balloons go, this one has the potential to alter radically the way research findings are made known to physicians at the bedside. But whether the concept will float out of the overheated health care atmosphere is going to depend on whether decision-makers are actually interested in finding more cost-effective ways of delivering health services, the president of the Canadian Institutes of Health Research (CIHR) says.
At issue is Alan Bernstein's embryonic proposal to create a number of “National Centres of Health Innovation” to help caregivers, policy-makers, hospital administrators and others become more aware of both new discoveries and new information about the efficacy of alternative forms of therapy.
Bernstein floated his balloon during a 2-day November summit on innovation and learning in Toronto. He argued that innovative means of translating research findings into action are desperately needed in the face of the coming “tsunami of change” that will be triggered by the genomics revolution.
“Think of DNA testing, pre-symptomatic testing for single gene diseases,” Bernstein told CMAJ. “We can do that now for breast cancer, colon cancer. For the complex disorders like cardiovascular disease … we're soon going to know what the predisposing alleles are to disease and their interplay with lifestyle factors. That has to be incorporated into our health care system.”
Health innovation centres could be established around specific diseases such as cancer or specific population groups such as children. For instance, a centre for child health could link Toronto's Hospital for Sick Children, the Children's Hospital of Eastern Ontario and the Montreal Children's Hospital “together with their host universities and other parties into a virtual network for knowledge translation. It would actually effect change in the health care system.”
CIHR is investigating similar initiatives in the United Kingdom and US in hope of finding a suitable model for Canada. Regional consultations and a national summit will be held early this year to identify the best way to promote knowledge transfer. CIHR hopes to roll out some form of national initiative for fiscal year 2003/04.
“I want to ask questions,” said Bernstein. “How do we turn research into action in the health care system? Does [the idea concerning centres] make sense? How would you see yourself reflected in it? How would you mutate it to make it better?
“These are purposely half-baked ideas. I'm throwing them out to get a reaction.” — Wayne Kondro, Ottawa