Stuart MacLeod Child & Family Research Institute British Columbia Children’s Hospital

1. Leveraging our research investments in health and health research  Association of Canadian Academic Healthcare Organizations  Ottawa – November 3, 2006 Stuart MacLeod Child & Family Research Institute British Columbia Children’s Hospital

2. My perspective  clinician scientist  academic career – McGill, U of Toronto, McMaster, UBC  former dean of Health Sciences at McMaster  director, Child & Family Research Institute, BC Children’s Hospital  VP, BC Provincial Health Services Authority  Premier’s Council on Health Strategy 1988-1991  Advisory Committee, HPFB, Health Canada, 1996 – 2006  Board Member, Research Canada, 2005 -

3. 1978 2006  generalist  bridges  clinical policy  RCTs  basic/theoretical  generalizable diagnostics  education  public funding  social contract re care/education  specialized  networks  public policy  population outcomes  population/applied/pragmatic  individual biomarkers  communication  public/private  defined research deliverables The research environment in academic health

4. Desired research environment for Canada • enthusiastic support for innovation • strong academic institutions • access to highly qualified personnel • development of clusters • protection of IP rights • ability to commercialize new technology • consistency in application of science to decisions  sound regulatory, purchasing and reimbursement framework Recent “report card” on Canada from Academies

5. Innovations spring out of interactions Innovationsystem Set of rules, interactions, and reward system generators of ideas influencers innovators productivity enhancers École polytechnique de Montréal, 2002

6. Trends in total health R&D funding in Canada From: Strengthening the Foundation of Canada’s Health Research Enterprise: A Backgrounder. 2004

7. Sources of health R&D funding in Canada (2003) From: Strengthening the Foundation of Canada’s Health Research Enterprise: A Backgrounder. 2004

8. The PHSA research investment total research funding 2005-2006: $140 million basic & discovery research 40% 20% 25% population health & public health health services & QI research 15% clinical research

10. ACAHO knowledge translation & commercialization Is Canada competitive? Are university colleagues receptive to private sector opportunities? c) Will evidence-based care be more or less costly? d) Can we afford innovation?

12. competing expenditure changing tax structure demography HEALTH CARE DRUG POLICY OUTPUTS OUTCOMES INPUTS evolving values expanded expectation productivity The health policy environment6 drivers of reform

13. A critical variable:Access to health care service across Canada demographics technology providers entitlement innovation ACCESS DEMAND SUPPLY COST QUALITY FINANCING

14. Some hot buttons • F/P/T relationships • impact of expanded research funding on service sector • growing provincial emphasis on research/innovation strategies • need to employ research evidence in prioritization and decision-making • compounding problems of unequal access across Canada

15. ACAHO Potential returns on research investment • improved decisions (prioritization) • improved health outcomes • enhanced reputation • stronger recruitment and retention • income from commercialization

16. Conclusion ACAHO members are the majority shareholders in Canada’s Health Research Enterprise • discovery research • delivery research • technology assessment • medical decision-making Attention to deliverables is essential!

17. If you’re not the lead dog …...