Introducing O'Brien Institute’s "Shaping the Future of Healthcare" series

At the O'Brien Institute for Public Health, we are privileged to work alongside some of the brightest minds in healthcare research. Our members are dedicated to advancing knowledge and developing innovative solutions that address the most pressing health challenges in Alberta and beyond.

We recognize that as Albertans, we are in unprecedented times as our healthcare system undergoes restructuring. In light of this, we are excited to launch O'Brien Institute’s Shaping the Future of Healthcare series, where we will be highlighting some exceptional researchers who are driving change and making a profound impact in the following key areas:

1. Primary care
2. Continuing care
3. Acute care
4. Mental health and addiction

Each week, we will feature dedicated members from these categories, showcasing their groundbreaking work, achievements, and the positive influence they have on our community. These individuals exemplify the O'Brien Institute’s spirit of innovation, compassion, and excellence.

Join us in celebrating these healthcare research innovators and learning more about the incredible strides they are making to improve health outcomes for all Albertans. Stay tuned for inspiring stories, insightful research, and a glimpse into the future of healthcare.

Let’s honour the people behind the progress. Together, we can foster a healthier, brighter future.

Primary Care:

Primary care includes all of the services and resources we have as Albertans to support our daily health needs. Often times, it is our point of access to the healthcare system. Primary care is the foundation of our healthcare system, and it is important that all Albertans have equitable access to primary care. Read about some of our members who are transforming the quality and delivery of primary care in Alberta.

Dr. Terrence McDonald: Ensuring continuity of care: Addressing family physician supply to inform policy

Dr. Terrence McDonald, MD, is a leading health services researcher in primary care. His research explores the supply of family physicians (FP), their practice patterns and the relationship between daily patient visit volume, provider continuity on health services utilization and patient health outcomes. Dr. McDonald’s research aims to inform current and future policy discussions on the design of the primary care system and physician payment model including how physicians are optimally remunerated for the patient care they provide.

The impact of continuity of care on patient health outcomes:

A recent study by Dr. McDonald and his team found that patients seen in primary clinics where multiple family physicians work together as a team and provide a ‘buddy-system‘ for caring for their patients had less emergency department visits.

There is extensive research on the benefits of physician continuity, but less is known is about the impact of clinic continuity on patient health outcomes and health system utilization. The trend of family physicians offering less direct patient care and choosing more part-time practice, coupled with a physician shortage and a growing population—many of whom are older and have multiple, complex health conditions—means that not all patients have access to their own family physician. Dr. McDonald’s research provides evidence to help policymakers design a primary care system that addresses the shortage of services by implementing team-based or shared care models within our communities.

Addressing concerns about the supply of family physicians:

In examining the supply of FPs in Ontario and Alberta using a service day methodology his team developed, Dr. McDonald found that while the number of FPs increased over time, many are providing less direct patient care. Furthermore,  the number of new FPs (i.e., graduates) has declined and the supply of FPs has not kept pace with the growing and aging population. These findings are important because they highlight the gaps in the FP workforce and overall primary care model that need to be filled.

Why does this work matter?

Dr. McDonald’s research aims to address some of the major issues faced by many patients in Alberta and throughout Canada. The current shortage of family physicians  creates major problems with access and continuity of care, which in turn places an enormous pressure on the health system including the inappropriate use of emergency departments for medical conditions normally managed by community family physicians. Through his research, Dr. McDonald aims to offer valuable insights into how best to address these issues and ultimately improve patient care, lower health systems costs, and reduce family physician burnout. 

Dr. McDonald is a family physician and an assistant professor in the departments of family medicine and community health sciences. He is a member of the O’Brien Institute for Public Health.

 

Dr. Stephanie Garies and Dr. Kerry McBrien: Harnessing advanced technology to address social determinants of health in primary care

Dr. Kerry McBrien, MD, is a clinician researcher and associate professor in the departments of family medicine and community health sciences at the University of Calgary. Her research focuses on developing and evaluating innovative models of care that improve the quality and efficiency of primary care by addressing social determinants of health and overcoming barriers to care. She is the Co-Director of the Southern Alberta Primary Care Research Network (SAPCReN), alongside Dr. Stephanie Garies.

Dr. Stephanie Garies, PhD, is a primary care scientist and epidemiologist with the Department of Family Medicine at the University of Calgary. For over a decade, she has been involved with the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), the first and only pan-Canadian repository of primary care electronic medical record (EMR) data. Her research focuses on improving primary care data and outcomes through EMR data science, digital health, and artificial intelligence.

Using digital health tools & AI to understand and address social determinants of health in primary care

Our well-being hinges significantly on factors beyond healthcare, including socioeconomic status, housing, gender identity, race/ethnicity, and more—collectively termed social determinants of health (SDoH). While these factors profoundly influence health outcomes, healthcare providers often lack comprehensive information about social determinants for their patients. Drs. McBrien and Garies’ new research initiative aims to rectify this gap.

They are at the forefront of a novel project, aiming to enhance SDoH data in primary care by using a standardized electronic survey to capture this information from patients directly and by developing machine learning models to predict social need at an aggregate or regional level. This approach will support family physicians in the provision of tailored, comprehensive care for both social and medical factors, as well as enable better planning and resource allocation by health system leaders.

Why does this work matter?

Drs. McBrien and Garies’ research is vital as it addresses one of the most significant factors influencing health outcomes beyond the healthcare system itself: the conditions in which people are born, grow, live, work, and age. This innovative work has the potential to transform primary care by ensuring more equitable and effective healthcare delivery, ultimately improving health outcomes for diverse populations.

 Dr. McBrien is an associate professor in the departments of family medicine and community health sciences. She is a member of the O’Brien Institute for Public Health. Dr. Garies is an adjunct assistant professor in the Department of Family Medicine. She is a member of the O’Brien Institute for Public Health.

Dr. Rita Henderson: Enhancing Indigenous health through intersectoral research and community collaboration

Dr. Rita Henderson, PhD, is a models of care researcher and associate professor at the University of Calgary’s Department of Family Medicine. Her work is focused on enhancing Indigenous health outcomes through community-oriented initiatives. Her research spans areas such as community health, policy development, medical education, and culturally relevant healthcare practices. By engaging with service providers, technicians, and policy/decision-makers, Dr. Henderson tackles challenges such as the opioid crisis, leveraging community strengths to promote integrated support systems aligned with primary health care. 

She co-stewards the Alberta Region First Nations Opioids & Drug Poisoning Crisis Task Force, which seeks to strengthen First Nations responses to mental health and substance use challenges by mobilizing resources and empowering community efforts.

Improving support for the primary health care workforce beyond clinical settings

Dr. Henderson is working with the Trauma-Informed Health and Cultural Support Program (TIHCSP). This workforce funded by Indigenous Services Canada was originally known for providing support to Indian Residential School (IRS) survivors since the 1990s, to enhance Indigenous healing through culturally grounded care. Today, TIHCSP workers play a vital role in addressing the psychosocial, emotional, and cultural needs of communities, improving health outcomes while also fostering resilience.

These workers assist with legal statements, informal intakes for families in need of connecting to healthcare, education, and housing resources, and support individuals testifying for IRS survivor and other benefits. They also address critical issues like the overdose crisis, particularly in remote communities with limited healthcare or mental health services.

Dr. Henderson and her team recently published the Guided Divinely: Workforce Report of the Alberta Region Health & Cultural Support Program to profile the workforce and mobilize resources for TIHCSP workers. Key recommendations include funding full-time coordination staff, advocating for inter-organizational collaboration, and developing measures to track the social return on investment when community needs are met instead of escalating to other systems.

Why does this work matter?

The Guided Divinely report not only underscores the vital role of Alberta's Indigenous community-based workers, but also provides essential strategies to sustain and enhance their efforts. These recommendations call for stable, long-term funding to support workforce coordination and training, emphasizing the importance of collaborative initiatives across government, non-profit, and community organizations. By advocating for these measures, the report reveals that primary health care is far more than just clinical treatment—it encompasses a broader, community-focused approach that requires increased support and resources. This work is crucial for reinforcing healthcare systems that truly meet the needs of Indigenous communities and ensure healing and well-being.

Dr. Henderson is an associate professor in the departments of family medicine and community health sciences. She is a member of the O’Brien Institute for Public Health.

Dr. James Dickinson: Advancing public health through research and prevention

Dr. James Dickinson, PhD, is a family physician and professor in the Department of Family Medicine at the University of Calgary. His training emphasized evidence-based medicine and public health, and throughout his career he has worked at the intersection of both. His research interests are in infection, population health, and vaccination. He is not just a primary researcher, but a research interpreter (also known as knowledge translation), helping family physicians and the public to use and apply the results of research to improve health.

Enhancing viral epidemiology and vaccine efficacy research

Since 2003, Dr. Dickinson has run the TARRANT Community Viral Respiratory Surveillance System. This network of family physicians spread across Alberta takes viral samples from patients attending with cough, fever, and other respiratory symptoms. By systematically collecting these samples, the network provides information on viruses circulating in the community. This adds to understanding that is normally gained only from those admitted to hospitals who may be there because of other illnesses. In addition, the data from this network is collated with that from BC, Ontario, and Quebec in the Sentinel Practitioner Surveillance Network. This network calculates the effectiveness of vaccines – initially for influenza and now for COVID-19 as well. For over 10 years, Dr. Dickinson and this network have done this work, and these estimates of effectiveness are used by the World Health Organization to inform the selection of the strains of virus to be incorporated into the next season’s vaccines.

Preventive screening for chronic diseases

Dr. Dickinson works to advance preventive screening for chronic diseases. As part of Alberta's cervical screening advisory committee, he helped shift the policy from annual Pap tests starting in the teenage years to screening at three-year intervals from age 25, with future changes expected as HPV testing evolves. The committee also developed a screening program with reminder letters and feedback to empower women.

Nationally, Dr. Dickinson served on the Canadian Task Force on Preventive Health Care, guiding family physicians on evidence-based preventive screening. He led their cervical screening recommendations and continues to write about applying preventive activities in medical practice. He has also contributed to debates on screening for breast and prostate cancers.

Why does this work matter?

Dr. Dickinson’s work helps advance public health through prevention. His contributions with the TARRANT group deepen our understanding of viruses and vaccines at the provincial, national, and international levels, shaping strategies to prevent future outbreaks. Additionally, his work in screening for chronic diseases testing expands knowledge on early detection, helping to refine screening policies. His writing about these topics informs both physicians and patients on effective preventive measures for the right people at the right frequency, to reach a balance of benefits and harms between too much and too little. 

 Dr. Dickinson is a professor in the Department of Family Medicine. He is a member of the O’Brien Institute for Public Health and the Alberta Children’s Hospital Research Institute.