Bridging Silos : Fostering Collaborations for

Digital Health Research

David Plug, Michael Smith Foundation for Health ResearchGRAND-NCE Digital Health Forum

Nov. 24, 2014

• Is digital health viewed as important?

• A new opportunity to bridge sectors in BC/Yukon & join up for a new national eHealth competition

• Why bridges are needed to foster collaboration & make real change

• Why researchers are key bridge-builders

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Outline

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Discover. Connect. Engage.

HealthcareDelivery

TechnologyDevelopment

AcademicResearch

GovernmentPolicymaking

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www.bchealthresearchstrategy.ca

Develop and enhance key foundations that support the creation and use of knowledge.

Create a culture of inquiry and innovation across sectors that encourages health research and its use.

Make BC a hub for world-class research that makes a difference.

• More than 1,000 participations in consultations with all sectors

• Published October 2014

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www.bchealthresearchstrategy.ca

Develop and enhance key foundations that support the creation and use of knowledge.

Create a culture of inquiry and innovation across sectors that encourages health research and its use.

Make BC a hub for world-class research that makes a difference.

REGISTER at: www.msfhr.org/digital-health-forum

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Feb.5 - BC & Yukon all-sector forum

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Patient & System Problems

Innovative Solutions

System Barriers

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Feb.5 Forum Topics

$12M national funding opportunity for 2 themes:

1. Early detection of and intervention for Youth (11-25 years of age) with mental health conditions.

2. Seniors with complex care needs in their homes and communities

Health needs & solutions; Addressing system challenges across sectors

• Registration April 2015• Full Application June 2015

• More info: www.cihr-irsc.gc.ca/e/48614.html

HealthcareDelivery

TechnologyDevelopment

AcademicResearch

GovernmentPolicymaking

Paradigm

Goals

Structure

Feedback & delays

Structural elements

Bridges help connect silos.

But to be successful, silos need common

goals, approaches

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Silos need to face the same way

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Shared Success Factors

• Shared goals, outcome measurement

• Readiness & Risk tolerance• Process management, timelines

& reviews• Leadership commitments &

governance

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• Industry brings a 'Return on Investment' focus to the team, concentrating on how the system will work and what it requires to be successful.

• Academic research teams provide exposure to multiple perspectives and create evidence for value and impact, potential scalability, and ensure scientific neutrality.

• Policy makers create the environment to support the implementation of innovation and evidence-based policy.

• Health System leaders create a culture of innovation. Clinicians re-design care models.

• Patients use the tools produced through innovation to connect with their health care providers and manage their health.

Source: Anne Snowdon, Ivey International Centre for Health Innovation, Western University

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Benefits of Partnerships

COOL !

Tech takes you

uphill fast on new

routes

A Decade or more?Traditional turnaround to make discovery, perform trial, evaluate innovation and translate into clinical practices

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Aaah!

No guarantee that

COOL equals GOOD

TECH about HEALTH topic HEALTH about TECH Unable to get access to health’s data, services, decision-makers

CONNECTING Too many innovators asking for access; No method to compare/evaluate asks

Glacial PACE Too rushed Reluctant to test option unless compatible with standard tools across whole region or province

BROAD SYSTEMS

Customized products don’t interact with rest of system. Rush to sell product internationally. Driven by competition.

Too focused on providing day-to-day services to fund innovation; Overly concerned about public-private partnerships

COSTS Needs to prove equipment & development will eventually decrease health system costs

Lacks dedication to customer service and appreciation for ‘consumer revolution’ & public’s interest in pursuing digital health

PATIENT IMPACT

Needs to demonstrate actual benefits to patient outcomes and not rely on popularity

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What Health & Tech Sectors Say About Each Other

• Follow NHS official long-term plan: “Five years forward view“. • Be clear about what your value proposition is, with supporting

data. Data and evidence is key. A proper outcomes-focused study is very important

• Understand what your customer’s problem is, not what your technology can do

• Get someone who understands the NHS on board• Understand and respect clinicians – learn from them. Get a clinician

onboard: clinicians like speaking peer-to-peer• Never apply on your own, because multidisciplinary stakeholder

approach allows for fast-shared decision-making in solving the needs of people. Partner up to show you are targeting clinicians and patients.

Source: NHS head of partnerships Tracey Watson Digital Health: Co-creation the key to the future: LE Web Blog Nov 2014

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Advice to start-ups from NHS

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Health: Telemedicine Important but Implementation not Mature

Health executives think telemedicine important, but work still in progress and question actual use by patients

• Development of telemedicine services is either very important (52 %) or important (32 %) to their organizations. Just 3 % said unimportant.

• More (8 %) had no telemedicine programs at all than those (6 %) categorizing theirs as “mature”.

• Remainders are clustered somewhere in the middle: 34 % are under consideration or in development, 18 % are in the optimization phase, and the remaining 36 % are being piloted or implemented.

# of patients using it in 10 yrs Survey Response

More than 50% 11%

10% to 50% 64%

Less than 10% 23%

• Most executives predicted a minority of patients would benefit from telemedicine in next decade.

Source: 57 [USA] executives surveyed by 2014 Telemedicine Survey Executive Summary by Foley & Lardner LLP

|GFMER on-line training course on mHealth

mHealth Drivers & Barriers: 2012 survey

• 1 in 4 health organizations (provider, insurer, etc) pursuing mHealth initiative without a specific driver

• Top drivers were “Increased member/customer/patient engagement” followed by “Pressure to compete with other organizations.”

• #1 barrier to achieving mHealth objectives is, “No clear strategy or objective,” followed closely by, “Lack of leadership for the initiative.”

• Other barriers include "Lack of funding" and “Lack of skillset in-house.”

Source: 2012 Medullan mHealth survey of 106 organizations

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Why Researchers are Key Bridge-builders

• Key to partnerships as often have pre-existing connections with each other sector & funders.

• Can play vital role in navigating health innovation from idea to solution by:

• Identifying important & legitimate research questions & quantifiable measurements

• Discovering potential solutions and changes in clinical practice & policies

• Neutral, evidence-based evaluation of opportunities (and their performance) for greatest gain in addressing health and system challenges

• Digital health seen as an important catalyst for change, provincially and federally

• Improving quality of cross-sectoral collaborations is essential to effectively advance digital health research

• Researchers are a key component for successful partnerships for digital health innovation

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Conclusion

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Thank you!Contact information:

• David Plug – dplug@msfhr.org

• Feb. 5 Forum - www.msfhr.org/digital-health-forum