A Platform for Innovation at Alberta Health Services (AHS)

Don Juzwishin PhD, MHSA, BADirector, Health Technology Assessment &

InnovationCAHI Meeting Winnipeg Manitoba

April 12, 2011

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Objectives of Presentation• To describe the development and progress of the Alberta

Health Services Health Technology Assessment & Innovation (HTAI) Program

• To provide insight into how the HTAI Program aligns with provincial goals and initiatives

• To describe the progress of AHS in encouraging research and development activities both internally and with industry partners

• Provide opportunity for feedback

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AHS Mission Statement • To provide a patient-focused, quality health system that is

accessible and sustainable for all Albertans

• Our goals– Quality: health care services are safe, effective and

patient-focused – Access: appropriate health care services are available – Sustainability: health care services are provided

within available resources both now and into the future

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Key AHS data• Operating Budget $11B• Capital Assets $9 B• Construction Projects $5 B plus

• Employees: Approx 8 5,000• Physicians Approx 7,200• Volunteers Approx 13,000 • Emergency visits: 1.9 million • Urgent care visits:  163,000 • Hospital discharges:  354,000 • Surgeries:  247,000 • Births:  50,000

• Acute care hospitals: 97 and 5 stand alone psychiatric facilities

• Acute care / subacute hospitals beds (including psychiatric facilities): 9,000 as of March 31, 2009 

• Long-term care & supportive living beds / spaces (includes palliative beds): 19,300 as of March 31, 2009*

• Commitment for 5 years of funding

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What is Health Innovation?• Health Innovation is the ability to change the conditions in a care setting to improve

the achievement of intended results (effectiveness) or the ability to deliver them (efficiency). Innovation can involve a new technology used to improve access, quality, and sustainability or it could use a well-established technology in a new way.

• The concept of Innovation can also be considered as a pathway with at least three key stages:

• 1. *Invention (identification) – where new ideas are generated. Increasingly it is recognized that this invention stage works best when responding to the identification of unmet needs.

•  • 2. *Testing and Piloting – seeing how ideas work in practice and learning from this.

This phase is inherently different for different types of innovations, e.g. drugs require large multi-phase trials, devices require smaller iterative trials, and service improvements may be best introduced with rapid Plan-Do-Study-Act cycles if small scale or in pilots if larger scale.

•  • 3. Adoption and Diffusion – process whereby new ideas that have been proven

elsewhere are ideally pulled into new areas with appropriate adaptation.

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The AHS Health Technology Assessment &

Innovation (HTAI) Programs1. Assessment & Appraisal Program: Will review and make recommendations on health

technologies, identify and prioritize emerging health technologies and coordinate outcomes monitoring and reporting.

2. Reassessment Program will examine technologies toward the end of their life-cycle and technologies scheduled for routine reassessment at a pre-determined time after their acquisition.

3. Access with Evidence Development Program will manage field trials or clinical trials of emerging technologies that use AHS resources.

4. Innovation Program will identify and help develop new and innovative technologies and processes to improve the access, quality and sustainability of health care delivery.

5. Knowledge Management and Translation Program will disseminate recommendations and results of projects from all 4 programs above, provide skills to use evidence through the application of the knowledge cycle and engage stakeholders through knowledge transfer activities.

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The HTAI Innovation Program• The HTAI Innovation Program, (PM: Mona Motamedi) is currently in the process of

developing a program to encourage uptake of health innovation at AHS. This program called “single portal of entry” will:

 • Develop methods to scan the health care horizon to identify ways in which access and

quality of health care to Albertans can be improved.

• Develop methods, processes and enablers to actively solicit innovative ideas from within AHS, such as from Local HTA Units, Clinical Networks, "site miners", and health care practitioners.

• Help pair innovators within AHS with appropriate research and development partners

• Provide a venue for primary product testing and validation.

• Bring together major contributors to innovation and partnership in Alberta and facilitate the development of a “memorandum of cooperation” in order to create an environment for innovative health care in Alberta.

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The AHS Centre for Health Innovation:Single Portal of Entry

1. Provide a focal point for driving health innovation within the organization. This includes a single portal of entry for industry to engage with AHS on research and development activities.

2. Coordinate activities related to identification, prioritization, selection, implementation, and evaluation of health innovations.

3. Identify relevant resources and clinical champions to support these innovations and provide some expertise.

4. Develop an outcomes evaluation tool to measure the performance of the AHS Innovation Center and associated programs.

5. Develop and maintain a guide/road map for innovators within AHS.

Efforts are currently underway to establish the AHS Centre for Health Innovation. The objectives of this centre are to:

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The AHS Platform for Innovation• This document identifies the strategic priorities of AHS with

respect to innovation over the coming years. It also:

– Describes a Hub & Spoke Approach and a new ‘pull’ model of health innovation.

– Describes the role of the HTAI team as well as the role(s) of key stakeholders such as government, industry, academic centres, and others.

– Lays out the strategy through which the AHIS goals will be met.

Hub & Spoke Approach

AHS Center for Innovation

Campus Alberta

iRSM

Glenrose

AITF & AIHS

Centre for Pop and

Public HealthBioVant

ageAICML

Clinexus

TRLabs

W21C

IHE

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Internal vs. External ommercialization

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AHS Virtual Network of Innovation CentersPurpose and Scope• The Virtual Network of Innovation Centers will discuss challenges, issues, barriers and successes

related to innovation at AHS; brainstorm ideas for opportunities to create synergy for the future; develop plans to promote innovation across AHS; and provide advice and feedback on the challenges and opportunities facing the innovators. This will in turn inform the broader Health Innovation Summit.

Membership/Co-Chairs• Membership will be composed of existing innovation teams or centres, which function within or in

association with AHS in some way. The following organizations are invited to be represented - this list is not exclusionary to others.

• iRSM• CAMIS• BERRI• Clinexus• Ward of the 21st Century• ZeidlerLedcor Center• CPSM• Dept of Research, AHS• U of A, U of C Biomedical Departments• TEC Edmonton

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Examples of Innovation at AHS• IRSM• Glenrose Hospital• W21C: Clarity, XSENSOR, Clean Keys• Continuing Care Technology Innovation Pilot Project

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Role of CPSM at AHS • Contracting, Procurement & Supply Management (CPSM) is

responsible for contracting, procurement, warehouse management and distribution of all supplies and services for Alberta Health Services. Accountability for Activity Based Funding methodology was recently added to CPSM.

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Clinical Leadership• Clinical champions• Clinical engagement• Formation of clinical networks

– Purpose– Performance indicators

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The 3 Pillars of AHRIS 1. Knowledge translation (KT)— develop a culture of inquiry and knowledge

translation at all levels of the health and health research systems. A strong KT system will help generate new discoveries that will result in improved health for Albertans through new practices and policies, accelerated commercialization of new products and services, and increased public understanding of health research and technology.

2. Highly skilled people — develop the province’s critical mass of talented researchers, innovators and entrepreneurs throughout the health research system. Programs are needed to retain and attract talent; increase cross-disciplinary expertise; keep pace with the latest advancements; and facilitate cross-linkages among all professionals involved in health.

3. Innovation platforms — develop a supportive environment for people working in health research, provide them with the programs and tools to do their best work. Programs are needed to improve clinical trials processes, incorporate personalized medicine capabilities within the health system, improve computing capability to process and interpret data, and accelerate technological and policy innovations.

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Catalytic Elements• TEC Edmonton: A unique not-for-profit a business service provider that helps

transform technologies into business opportunities. TEC Edmonton is joint venture between the University of Alberta and the Edmonton Economic Development Corporation (EEDC).

• Clinexus: A not-for-profit product commercialization centre that helps Alberta’s health technology companies grow. Clinexus is funded by the Government of Alberta with the mandate to expand key technology sectors in Alberta.

• Calgary Technologies Inc: The mission of CTI is to accelerate the success of the advanced technology community by helping companies to build, grow and connect.

• Alberta Ministry of Advanced Education & Technology-Connector Service: The

Connector is a new Government of Alberta service that gives you a one-window approach to accessing Alberta's exciting research and innovation community.  It offers innovative businesses, entrepreneurs, researchers, investors, and business service providers a helping hand to guide them through Alberta's research and innovation network.

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AiiMiT Approach• AiiMiT is a ‘Campus Alberta’ initiative championed by the University of

Alberta’s Faculty of Rehabilitation Medicine and Faculty of Medicine, and Biovantage at the University of Calgary.

• Successful technology development programs require access to a wide range of specialists, including clinicians technologists, regulatory specialists, project managers, business development experts, health economists, marketing specialists and so on. The cost of these resources are substantial and well beyond the capacity of most academics and clinicians.

• The AiiMiT concept is to generate “pull” for unmet clinical needs into forums rich with technological expertise.

• Therefore, AiiMiT comprises the following key components: – An interface to clinical healthcare delivery settings is provided by

“clinical prospectors” who are responsible for identifying and communicating unmet clinical needs and expressing them as “clinical challenges” for resolution using innovative health technologies, systems, and processes. A forum for the synthesis of ‘clinical challenges’ into ‘solutions’

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How Will We Know If We Are Successful?

Performance Indicators• A streamlined approach for industry partners to partner with

AHS • Successful industry partnerships where AHS provides support

for product development, testing, and validation within clinical settings– For small and medium enterprise that are Alberta based– For larger, more established companies

• Expertise and support for development of viable health innovation for internally-based innovators

• Linkages between clinical champions and industry

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AHRIS-What is Different?• Greater alignment is required. Health research needs to be

aligned with the health needs of Albertans and with the strategic priorities set out for Alberta’s health system in Vision 2020 and other significant strategic initiatives.

• There is a need for greater focus. As a relatively small player in the global context, Alberta needs to focus its research efforts in those areas where it can achieve excellence and make a substantial contribution to achieving better health outcomes and a better health system.

• Health research should be viewed from a broader perspective. Health status or well-being is determined from the intersection of a number of factors – economic, social and environmental.

• Knowledge must be more effectively translated into action. Realizing system, economic, individual and community benefits from investments made in health research and innovation is crucial.

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Summary• Opportunities for

alignment and confluence• Collaborations within AHS• Partnerships with external

stakeholders• Platform for Innovation• Single portal on entry• Climate of innovation

• New IP Policy• Performance indicators