RPP Profile: Dr. Debra Morgan

Dr. Debra Morgan's research is inspired by the needs of Saskatchewan's aging population. The province is home to the highest proportional population of seniors in Canada, and the majority of these seniors live in rural areas. According to the Canadian Study on Health and Aging, the prevalence of dementia among the members of this aging population will continue to increase, making proper treatment and care a challenge for rural communities.

"We know there is a large number of people with dementia in the province – over 18,000 – and that number is growing all the time as our population ages," she explains. "There is limited access to speciality services for dementia-related care?both in the community for those with early-stage dementia, and in long-term care facilities for those with more advanced dementia."

To address the need for improvements in the delivery of rural dementia care, Dr. Morgan, a researcher with the Canadian Centre for Health and Safety in Agriculture at the University of Saskatchewan, led a multidisciplinary research team as the Principal Investigator of a $1.25 million CIHR New Emerging Team grant. Over the course of the five-year funding (which also included contributions from the University of Saskatchewan, the Saskatchewan Health Research Foundation, and the Alzheimer Society of Saskatchewan), Dr. Morgan and her team designed and evaluated a special new Rural and Remote Memory Clinic that uses videoconferencing and other innovations to improve access to diagnostic and treatment services for seniors living in rural areas.

The clinic itself, which has been in operation since 2004, is "one-stop shopping" for dementia assessment and diagnosis. It is located on the University of Saskatchewan campus next to Royal University Hospital and includes assessments by a neurologist, neuropsychology team, geriatrician, and physical therapist. Patients get referred to the clinic by their family physician and all interested family members of the patient are invited to participate. This family-centred approach also allows the clinic team to assess the psychological health and caregiver burden experienced by those supporting the patient. At the end of the full-day assessment, patients and family members meet with the neurologist and neuropsychologist to discuss the probable diagnosis and consider recommendations for management and care.

This exposure to an interdisciplinary team of specialists saves patients and their families from multiple hours-long trips to the city to visit various doctors. Pre-clinic assessments and follow-up appointments are conducted via Telehealth, which is the name given to videoconferencing technology used to help deliver health-care services and education from a distance.

Not surprisingly, the Memory Clinic has garnered rave reviews from patients and their families, and has been noted as an excellent model of care within the Saskatoon Health Region by surveyors from the Canadian Council on Health Services Accreditation. This flagship project may not have been possible, however, without the funding that Dr. Morgan first received through CIHR's Regional Partnership Program (RPP). From 1999-2004, she was a CIHR New Investigator through RPP, which is designed to help build health research capacity in less populous regions of Canada.

"Receiving RPP funding definitely gave me more credibility for other competitions," recalls Dr. Morgan. "The time and research support that came from that funding enabled me to publish five papers from my Ph D work, which is also helpful for future grant applications. Being a CIHR-RPP New Investigator really helped build my momentum as a researcher."

That credibility and momentum went a long way. In 2002, Dr. Morgan received a New Investigator Establishment Grant from the Saskatchewan Health Research Foundation, and in 2003, she and her team received the CIHR New Emerging Team grant that led to the development of the Memory Clinic and a number of related projects.

"Our team's success [in the CIHR competition] was directly related to the work I accomplished as a CIHR-RPP New Investigator," explains Dr. Morgan. "I'm still working with the same colleagues. To qualify for the New Emerging Team grant, we needed a team of six researchers – two of which needed to be senior researchers. The senior researchers on our team now are actually people that I worked with during my Ph D and as a New Investigator."

The connections that Dr. Morgan made as a CIHR-RPP New Investigator also extended beyond the research community and into the world of decision makers. "As a post-doctoral fellow [funded by the Alzheimer Society of Canada, 1997-99] and as a New Investigator, I met with all of the health regions in the province – and there were 30 of them back then! I met with their Boards and held a workshop to identify issues and needs. They really appreciated being included in the research process and those relationships are ongoing."

In fact, the relationships that Dr. Morgan had already established with the health regions ended up facilitating further discussions under the New Emerging Team grant for the Memory Clinic. "I think the whole team travelled about 10,000 kilometres to discuss the clinic with the health regions [there are 13 in the province now]," she chuckles. "It took the first year of the project to complete those consultations, but the time investment was well worth it. We used their input for the clinic's design and had a chance to discuss its feasibility and sustainability in the long term."

Far from being finished, Dr. Morgan's momentum is continuing to grow. Dr. Morgan recently won an Applied Chair in Health Services and Policy Research. The chair is being co-funded by CIHR and the Saskatchewan Health Research Foundation, and it will provide $925,000 over five years to continue work with the Memory Clinic and further pursue ways to improve diagnosis and treatment for dementia. Dr. Morgan's Chair program is guided by a Decision-Makers Advisory Council representing formal and informal caregivers, administrators, and other stakeholders. In addition, a Scientific Advisory Committee has been struck to provide the program with strategic direction.

Dr. Morgan and her team have already made – and will continue to make – remarkable advances in developing strategies for increasing access to specialized dementia care for Saskatchewan's seniors. "The RPP support enabled me – and our team – to be successful," she emphasizes. "It helped me (and other co-investigators) to get established, and it allowed us to give students exposure to programs of research. We've made a lot of progress over the last decade. The whole experience has been very transformative."