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