Editorial: The Research Issue

Research can boost the informed decision-making needed to improve healthcare

“Peace, order and good government.” It’s a phrase baked into the British North America Act of 1867 (now called the Constitution Act, 1867), which created Canada out of a British colony. It is sometimes seen as the perhaps less-sexy Canadian counterpart to the American “life, liberty and the pursuit of happiness,” but really, the British used the phrase widely in the colonial context (it appeared in New Zealand’s and Australia’s constitution acts, too).?

The Fathers of Confederation, of course, distributed powers between the federal government and the provinces, placing “hospitals” and other local affairs as provincial responsibility. However, the Constitution Act specified that in cases where the division of responsibility is unclear, Ottawa holds jurisdiction and should be guided by the principle of legislating for the “peace, order, and good government of Canada.”?

Because we have 13 provincial and territorial healthcare insurance plans that are partially supported by the federal government (with strings attached), healthcare is deeply political and somewhat multi-jurisdictional in Canada.

Many of us in the physicians’ interests community want to see more of that foundational Canadian value: good government. It would be wonderful to hear a candidate for premier or prime minister declare, “My foremost priority will be enhancing the efficiency of government services and promoting long-term planning.” The leadership of provinces and the nation may shift with changing political parties, but there must be a way to support our political leaders in making better decisions.?

Toronto family medicine researcher Dr. Tara Kiran and others are trying an innovative approach along these lines with the OurCare research project, where they brought together groups of Canadian citizens, educated them about the challenges facing primary care and let them develop consensus recommendations. Findings from the deliberations will be integrated with findings from peer-reviewed literature into a final report summarizing a vision for primary care.

This kind of innovative research into how our healthcare systems can best operate efficiently is needed to help governments make good decisions about the way ahead for healthcare in Canada.

With all this in mind, we put together the Research Issue. Our Medical Post writers went deep on the topic: On page 12, we look at “Knowledge translation”—just how does info best go from bench to bedside? “You can’t improve what you don’t measure” on page 15 looks at how to participate in EMR-based primary care research.