Dr. Robert Reid: building health systems through innovative change
In the first episode of my new podcast, The Next 100, Dr. Robert Reid, an expert in population-based innovation in primary care, joins me to discuss how health system research, paired with innovative thinking, is informing the transformational change in healthcare delivery in Ontario today. ?In addition, Dr. Reid himself is a Type-1 diabetic who has directly benefitted from innovative advancements in diabetes care and the original discovery of insulin 100 years ago.
Dr. Reid’s life and career experiences have taught him the importance of empowering people who live with chronic diseases, including diabetes, to manage their illnesses. The health system needs to adapt to provide a spectrum of primary care that places the patient at the centre of its approach, equipping them with skills for self-management.
?“One thing I have learned having diabetes for over 30 years now is that it is not a disease of my doctor, it is not a disease of my diabetes team … I am in control of that diabetes. I make the care decision every minute of my day. So we really need to equip patients across the spectrum in terms of self-management for their own diabetes because that is at the true heart of what diabetes is all about."
?During his time at the University of Washington and Group Health Cooperative, Dr.?Reid and his colleagues developed the early iterations of the chronic care model focussed on supporting diabetes patients. This has since expanded to what is now called the “patient-centred medical home” to deliver care for patients with many chronic conditions, not just diabetes.
This work on redefining primary care for patients with chronic conditions has directly informed where Ontario is heading today with the creation of Ontario Health Teams (OHTs). Announced in 2019, OHTs are largely based on accountable care models from the United States, found to be successful in improving patient outcomes and achieving system efficiencies. Today, we have 50 approved OHTs in Ontario all at varying stages of maturity. Dr. Reid has been integral in informing the model and approach to managing populations of patients served by this new model.
?On this episode, Dr. Reid shares his thoughts on the root aim of the OHT model, the necessity for a strong and supported primary-care workforce to enable this model, and the importance of an integrated health system across primary care, home care and specialty care to truly support patients and ensure they do not fall through the cracks.
?“The OHT at its heart is about redeveloping primary care in many respects with the patient-centred medical home at its baseline. It is also about how to bring in and support hospitals, home care, and specialty care so care is organized across the full spectrum of patients rather than piecemeal in its approach. It really is about developing local systems of care. That’s what OHTs are all about.”
?We also discussed the importance of infusing research and innovation into the transformational change that is occurring in Ontario. Dr. Reid is a proponent of the “learning health system” and explains how this is necessary to adopt and adapt innovative models of care.
?“The learning health system is the idea about how we insert research right into healthcare operations so that we learn to design research that is patient-centred. We learn how to adapt it for the localities that we are working in because everybody has a different set of resources.”
?People with chronic illnesses typically face several health issues, which makes navigating the health system challenging. Having a spectrum of care that connects different levels of healthcare helps people navigate various referral networks and streamline waitlists. It ensures that no one is left behind to deal with complications on their own.
“There are many things that impact people’s health. Only one of them is medical care – education, income, housing, those types of things. We have systems around that, but we do not integrate across the spectrum ... That is where we will have the most equitable impact.”
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?While Dr. Reid is hopeful that Canada will continue to innovate in care, he emphasizes that technological innovation will unevenly benefit populations, reinforcing inequities in our healthcare system. With innovations like OHTs, operators develop change through public consultation built around local units and their specific needs, eventually learning from other areas and adapting the methods to meet local resources and inadequacies.
?To learn more about the need for innovative care to improve health systems in Canada, listen to the full episode of The Next 100 with Dr. Robert Reid.
?Apple Podcast: https://podcasts.apple.com/ca/podcast/the-next-100/id1586179256
Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkLnBvZGJlYW4uY29tL2NhbmFkYW1lZHRyb25pYy9mZWVkLnhtbA
?About Dr. Robert Reid, MPH, MD, PhD
Hazel McCallion Research Chair in Learning Health Systems; Chief Scientist, Institute for Better Health; Senior Vice President, Science, Trillium Health Partners
?Dr. Robert Reid is applying his passion for health system transformation to helping Trillium Health Partners' Institute for Better Health deliver a new kind of healthcare through research and innovation. He is internationally recognized for his research developing and testing population-based innovations in primary care delivery, prevention services and chronic care. Dr. Reid has published nearly 140 articles in refereed journals and given over 130 scientific and policy talks.?
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