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Translational research in troubled times 1


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Translational research in troubled times 1

  1. 1. Translational Research in Troubled Times: thinking about ‘implementation’ in health services under pressure Carl May
  2. 2. <ul><li>Personal introduction </li></ul><ul><li>Empirical research </li></ul><ul><ul><li>Professional knowledge and practice </li></ul></ul><ul><ul><li>Technological innovation </li></ul></ul><ul><li>Theoretical development </li></ul><ul><li>Policy relevance: translational gaps </li></ul><ul><li>Future focus of my work </li></ul>
  3. 3. basic interests <ul><li>basic science: sociology </li></ul><ul><li>methods and materials: ethnography </li></ul><ul><li>policy application: evaluation </li></ul><ul><li>processes: integration </li></ul>
  4. 4. research interests: fields evidence (generalized knowledge) randomized trials, pragmatic evaluations, development. innovation (intervention trajectories) informatics, telemedicine, shared-decision-making tools, medical devices. chronicity (illness trajectories) back-pain, diabetes, medically unexplained symptoms interaction (individualised knowledge) interaction processes, genetics, rheumatology, terminal care
  5. 5. research interests: over time <ul><li>understanding professional-patient interaction in terminal and chronic illness </li></ul><ul><li>interrogating policy and practice relating to the design and delivery of innovative health technologies </li></ul><ul><li>developing explanatory models for the evaluation of healthcare technologies and other complex interventions </li></ul><ul><li>seeking to promote minimally disruptive healthcare in the face of increasing treatment burdens </li></ul>
  6. 6. next five years <ul><li>White Paper: </li></ul><ul><ul><li>reorganization of NHS and refocusing of public spending </li></ul></ul><ul><ul><ul><li>in service organization and delivery </li></ul></ul></ul><ul><ul><ul><li>relationships between universities, NHS and local authorities </li></ul></ul></ul><ul><ul><li>research may be refocused , research funding will change </li></ul></ul>
  7. 7. next five years <ul><li>understanding innovation </li></ul><ul><ul><li>policy changes and spending cuts will force NHS and other providers to seek technological solutions to problems of organization and delivery </li></ul></ul><ul><ul><li>call for rapid answers to complex problems around new ways of thinking, acting, and organizing in healthcare systems under stress </li></ul></ul>
  8. 8. example: telemedicine and telecare <ul><li>longstanding programme of work, focused on: </li></ul><ul><ul><li>design and evaluation </li></ul></ul><ul><ul><li>workability in clinical practice </li></ul></ul><ul><ul><li>integration within NHS providers and across health/social care boundaries </li></ul></ul><ul><li>work with Mair (Glasgow), Murray (UCL), Finch (Ncl) </li></ul>
  9. 9. next five years <ul><li>understanding implementation </li></ul><ul><ul><li>NHS and other providers will need to find ways to embed solutions to problems in organization and delivery </li></ul></ul><ul><ul><li>crossing translational gaps, supporting professionals in the face of dynamic as healthcare providers seek to maximize value of new technologies and complex healthcare interventions </li></ul></ul>
  10. 10. example: delivering clinical trials <ul><li>complex intervention trials in connecting community, primary care, and specialist services </li></ul><ul><ul><li>complex dynamics of inter-professional co-operation </li></ul></ul><ul><ul><li>contingency in knowledge and practice </li></ul></ul><ul><ul><li>problem of process evaluation </li></ul></ul><ul><li>work with McColl (Ncl), Shah (Mayo Clinic), Gunn (Melbourne), Mort (Lancaster) </li></ul>
  11. 11. next five years <ul><li>understanding integration </li></ul><ul><ul><li>radical changes in the organization and delivery of healthcare will have important implications for patients and carers as the boundaries between home and healthcare are shifted </li></ul></ul><ul><ul><li>Exploring the changes in the experience and management of illness for patients and carers as their responsibilities are redefined </li></ul></ul>
  12. 12. example: changing burdens of healthcare <ul><li>Reconfiguring ideas about healthcare, ‘future patients’ and ‘shared burdens’ </li></ul><ul><ul><li>Refocusing patient/carer expertise </li></ul></ul><ul><ul><li>Redrawing boundaries between home and healthcare </li></ul></ul><ul><ul><li>Maximizing effectiveness, minimizing disruption and treatment burdens </li></ul></ul><ul><li>Work with Montori (Mayo Clinic), Mair (Glasgow), Rogers (Manchester) </li></ul>
  13. 13. transforming health <ul><li>transdisciplinary research </li></ul><ul><ul><li>old disciplinary boundaries provide no future security </li></ul></ul><ul><li>translational research </li></ul><ul><ul><li>jumping the gap between fundamental and applied research </li></ul></ul><ul><li>transformational research </li></ul><ul><ul><li>making the links between fundamental and applied research, real-life healthcare, and professional knowledge and practice </li></ul></ul>
  14. 14. the kind of work I want to do <ul><li>great science </li></ul><ul><ul><li>objectives, collaborations, imagination </li></ul></ul><ul><li>visible contribution </li></ul><ul><ul><li>clarity, direction, quality </li></ul></ul><ul><li>acknowledged impact </li></ul><ul><ul><li>evidence, analysis, value </li></ul></ul>
  15. 15. thank you