Implementing Knowledge Tools in Community-Based Primary Care 

If we want Canadians to benefit from valuable patient-oriented research, we need to move proven technology into stable, funded programs across jurisdictions. In Canada, the provinces/territories are responsible for setting health policy and organizing health services in accordance with core principles for the Canada Health Act. In all 13 provinces and territories, delivery of health care services is decentralized to the local/community level and, in some cases, allocation of resources has been to regional health authorities.

Our team members, Adalsteinn Brown, Mathieu Ouimet, and Michael Hillmer will lead health policy integration for Diabetes Action Canada. The decentralized nature of health systems in Canada makes macro-level policy interventions aimed at scaling up promising technologies and health care solutions in primary care very challenging. Our objective is to conduct macro-level policy analysis aimed at scaling up an effective KT intervention for the delivery of knowledge tools in Canada.

Research questions include the following:

  1. What are the core institutional and legal constraints on provincial policy interventions aimed at scaling up evidence-based technologies in primary care at the clinical practice level in Canada?
  2. What are the macro-level policy options for promoting and implementing new technologies in primary care at a micro/clinical level?
  3. What are the relative merits of competing options and their feasibility, given institutional and legal constraints, costs and key stakeholders’ attitudes towards the options?
  4. What do senior provincial health policy advisors, deputy ministers/assistant deputy ministers need in order to establish future primary care Health Technology Assessment units?

Methods: Using policy analysis at macro-level options (development of options or alternatives to address problems with the aim of helping decision-makers reach policy decisions), we will deploy three phases:

Phase 1– identify existing core institutional/legal constraints on provincial policy interventions;

Phase 2 – Identify effective macro-level policy options for scaling up primary care interventions;

Phase 3 – Analyze relative merits of policy options and their feasibility given institutional/legal constraints and costs.