Pan-Canadian SPOR Network in Primary and Integrated Health Care Innovations



Overview

The pan-Canadian SPOR Network in Primary and Integrated Health Care Innovations is a key CIHR initiative under the Strategy for Patient-Oriented Research and the Community-Based Primary Health Care Signature Initiative.

The pan-Canadian SPOR Network in Primary and Integrated Health Care Innovations (herein called the pan-Canadian Network) is a Network of networks that builds on regional and national assets in community-based primary and integrated health care. It will foster a new alliance between research, policy and practice to create dynamic and responsive learning systems across the country that develop, evaluate and scale up new approaches to the delivery of horizontally and vertically integrated services within and across sectors of health care (e.g., public health, home and community care, primary, secondary, and tertiary care) as well as outside the health sector (e.g., education, social services, housing). The pan-Canadian Network will initially focus on individuals with complex health needs (a relatively small subgroup of the population with high health needs that accounts for a significant amount of health care utilization and costs) where integration of care along the continuum and where upstream approaches to prevention linked to integrated care delivery systems are critical to improve patient experience and health, health equity, and health system outcomes.

The pan-Canadian Network is rooted in community-based primary health care (CBPHC), which comprises a broad range of primary care and primary prevention services horizontally integrated within the community (including public health, community pharmacy services, rehabilitation support, home care and more), and which is recognized as playing an essential role in addressing the health challenges of this century. Recognizing the importance of facilitating transitions across the care continuum, the pan-Canadian Network incorporates a focus on horizontal integration of CBPHC services; vertical system integration through primary, secondary, and tertiary care; and multi-sector integration of upstream prevention strategies and care delivery models.

The pan-Canadian SPOR Network’s overall goal is to support evidence-informed transformation and delivery of more cost-effective primary and integrated health care to improve patient experience and health, health equity, and health system outcomes for individuals with and at risk of developing complex health needs.

Objectives

  1. Create cross-jurisdictional opportunities to conduct research on the comparative efficiency, cost-effectiveness and scalability of innovative and integrated models of care that build on the foundations of community-based primary health care and facilitate transitions into and along the care continuum.
  2. Foster the creation of learning health systems across the country that accelerate the timely investigation of new interventions and approaches in primary and integrated care across multiple jurisdictions and sectors.
  3. Catalyze research on and scale-up of cost-effective and innovative approaches to primary and integrated care.
  4. Support capacity building among researchers, clinicians, decision-makers and citizens/patients/families for timely generation and use of primary and integrated health care knowledge.
  5. Foster the exchange of information and evidence on successful and unsuccessful interventions and innovative models of primary and integrated health care across jurisdictions to inform policy development.

The pan-Canadian Network will initially focus on new approaches to the delivery of primary and integrated health care (including upstream primary prevention) both horizontally and vertically across the care continuum to address:

  • individuals with complex needs across the life course, including age groups from children to older adults; and,
  • multi-sector integration of upstream prevention strategies and care delivery models. A key element of this focus is the assessment of upstream predictors of high system use and subsequent identification and targeting of prevention strategies and interventions.

Within these priority focus areas, the pan-Canadian Network will support cross-jurisdictional research that addresses horizontally and vertically integrated care priorities shared by several member networks and where there is value-added in a cross-jurisdictional approach, including:

  • Knowledge of the comparative effectiveness and efficiency of different jurisdictional approaches to the same health or health system challenges;
  • More rapid and/or generalizable response to a priority area by employing a cross-jurisdictional approach; and/or
  • A more comprehensive evaluation of a priority area through the use of expertise and resources in multiple jurisdictions.

Background

The pan-Canadian Network will accelerate the pace of innovation in integrated care solutions for high system users with complex care needs (including but not limited to older adults with multiple chronic conditions), and children by enabling rapid cross-jurisdictional learning about successful and unsuccessful features of integrated health prevention and care solutions and developing capacity to implement change and scale-up successful innovations.

Guiding principles: The pan-Canadian Network will operate on the following principles:

  • Inclusivity: the pan-Canadian Network will include all stakeholders that are interested in participating
  • Co-investment: the pan-Canadian Network will maximize co-investments in integrated health care innovation occurring at provincial and territorial levels
  • Collaboration: the pan-Canadian Network will establish a research agenda that addresses issues that are relevant to some or all of the jurisdictions, and are most effectively carried out by a cross-jurisdictional network
  • Coherence: the pan-Canadian Network will foster the conditions for provinces and territories to improve coherence in addressing priorities in the production and translation of research in integrated health care
  • Impact: the pan-Canadian Network will evaluate the clinical, cost-effectiveness, population health, health equity and health system outcomes of its research in integrated health care
  • Continuous innovation and improvement: the pan-Canadian Network will foster the conditions for continuous innovation and improvement in cost-effective care delivery by requiring research, practice and policy to be integrated into networks to enable continuous practice and system learning

Stakeholders

  • Clinicians and healthcare professionals
  • Policy-makers and health system managers
  • Patients/citizens, families, communities
  • Researchers
  • Health research funders
  • Professional and regulatory associations

Network research priorities: The pan-Canadian Network will initially focus on new approaches to the delivery of integrated health care (including primary prevention and primary health care) both horizontally and vertically across the care continuum to address: high system users with complex care needs (including but not limited to older adults with multiple chronic conditions and children with complex care needs); and, multi-sector integration of upstream prevention strategies and care delivery models for children. A key element of this focus is the assessment of upstream predictors of high system use and subsequent identification and targeting of prevention strategies and interventions.

Within these priority focus areas, the pan-Canadian Network will support research that addresses horizontal and integrated care priorities shared by several provinces/territories/federal jurisdictions and where there is value-added in a cross-jurisdictional approach, including:

  • Knowledge of the comparative effectiveness and efficiency of different jurisdictional approaches to the same challenge;
  • More rapid and/or generalizable response to a priority area by employing a cross-jurisdictional approach; and/or
  • A more comprehensive evaluation of a priority area through the use of expertise and resources in multiple jurisdictions.

Research priorities for the agenda of the pan-Canadian Network are expected to be those where several member networks share a common challenge, and where they are using different service delivery approaches, and are investing substantially in these areas, including in evaluation. This approach affords opportunities to provide a more comprehensive and informative evaluation of the particular attributes of approaches that are effective across jurisdictions, and how these are influenced by context (e.g., policy, health system delivery context). The use of common measures and outcomes will allow for more direct comparisons of promising approaches.

Tripartite Leads

Each member network within the pan-Canadian SPOR Network in Primary and Integrated Health Care Innovations is co-led by clinical, research and policy leads that collectively cover the continuum of care (prevention, primary, secondary, tertiary, and home care). The names of the leads can be found in Table 1

Table 1: Tripartite Leads

Jurisdiction Title Lead Lead Area Lead Institution
Alberta The Alberta SPOR Primary and Integrated Health Care Innovations Network Neil Drummond Research University of Alberta
Thomas Noseworthy Policy Alberta Health Services and University of Calgary
Maeve O’Beirne Clinical University of Calgary
British Columbia BC Primary Health Care Research Network Sabrina Wong Research University of British Columbia
Anne Junker Clinical BC Children’s Hospital/University of British Columbia
Fiona Duncan Clinical University of British Columbia
Heather Davidson Policy BC Ministry of Health
Shana Ooms Policy BC Ministry of Health
Manitoba The Manitoba SPOR Primary and Integrated Health Care Innovation Network (MPN) Annette Schultz Research University of Manitoba
Tamara Buchel Clinical Manitoba College of Family Physicians
Marcia Thomson Policy Government of Manitoba
Newfoundland and Labrador Primary Healthcare Research and Integration to Improve Health System Efficiency (PRIIME) Kris Aubrey-Bassler Research Memorial University
Kevin Chan Clinical Eastern Regional Health Authority
Beverly Clarke Policy Government of NL
New Brunswick New Brunswick SPOR Network: Primary and Integrated Community Care Shelley Doucet Research University of New Brunswick
Nancy Roberts Policy New Brunswick Government
Joan Kingston Clinical University of New Brunswick
Northwest Territories Development of a Northern-Based SPOR Network in Primary and Integrated Health Care Innovations Susan Chatwood Research Institute for Circumpolar Health Research
Jim Martin Policy Tłıc̨ hǫ Government
Nathalie Nadeau Clinical Yellowknife Health and Social Services Authority
Nova Scotia Nova Scotia Primary and Integrated Health Care Innovations Network Frederick Burge Research Primary Care Research Unit, Dalhousie University
Richard Gibson Clinical Central Zone (Halifax, Eastern Shore, West Hants), Nova Scotia Health Authority
Lynn Edwards Policy Nova Scotia Health Authority
Charmaine McPherson Policy Nova Scotia Department of Health and Wellness
Ontario Better Access and Care for Complex Needs (BEACCON) Geoffrey Anderson Research University of Toronto
Onil Bhattacharyya Clinical Women’s College Hospital
Patrick Dicerni Policy Ministry of Health and Long Term Care
Prince Edward Island The SPOR Network in Primary and Integrated Health Care Innovations William Montelpare Research University of Prince Edward Island
Peter MacKean Clinical Primary Health Care (Summerside)
Mark Spidel Policy Health PEI
Quebec Quebec Knowledge Network in Integrated Primary Health Care (Réseau-1 Québec) Jeannie Haggerty Research McGill University
Denis Roy Policy Institut national d'excellence en santé et en services sociaux (INESSS)
Michèle Aubin Clinical University of Laval
Saskatchewan SPOR Network in Primary and Integrated Health Care Innovations: Saskatchewan LOI Nazeem Muhajarine Research University of Saskatchewan
Cory Neudorf Clinical Saskatoon Health Region
Margaret Baker Policy Government of Saskatchewan
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