2012/13 mchp annual report - university of manitoba...annual report 2012/13 | page 5 dr. clyde...

2012/13 MCHP ANNUAL REPORT

UNIVERSITY OF MANITOBA, FACULTY OF MEDICINE umanitoba.ca/faculties/medicine/units/mchppage 2 | Annual Report 2012/13

WHO WE AREThe Manitoba Centre for Health Policy (MCHP) is located within the Department of Community Health Sciences, Faculty of Medicine, University of Manitoba. The mission of MCHP is to provide accurate and timely information to health care decision-makers, analysts and providers, so they can offer services which are effective and efficient in maintaining and improving the health of Manitobans. Our researchers rely upon the unique Population Health Research Data Repository (Repository) to describe and explain patterns of care and profiles of illness, and to explore other factors that influence health, including income, education, employment and social status. This Repository is unique in terms of its comprehensiveness, degree of integration, and orientation around an anonymized population registry.

MCHP complies with all legislative acts and regulations governing the protection and use of sensitive information. We implement strict policies and procedures to protect the privacy and security of anonymized data.

Members of MCHP consult extensively with government officials, health care administrators, and clinicians to develop a research agenda that is topical and relevant. This strength, along with its rigorous academic standards, enables MCHP to contribute to the health policy process. MCHP undertakes five major research projects every year under contract to Manitoba Health. In addition, our researchers secure external funding by competing for research grants. We are widely published and internationally recognized. Further, our researchers collaborate with a number of highly respected scientists from Canada, the United States, Europe and Australia.

MCHP VISION, MISSION AND VALUESVisionThe Manitoba Centre for Health Policy sets the international standard for using population-based administrative data to create new knowledge that informs health policy, social policy and service delivery.

Values• Innovation and Excellence • Collaboration and Teamwork • Social Relevance and Stewardship

Mission The Manitoba Centre for Health Policy (MCHP) is a research centre of excellence that conducts world class population-based research on health services, population and public health, and the social determinants of health. MCHP develops and maintains the comprehensive population-based data repository on behalf of the Province of Manitoba for use by the local, national and international research community. MCHP promotes a collaborative environment to create, disseminate and apply its research. The work of MCHP supports the development of evidence-informed policy, programs and services that maintain and improve the health and well-being of Manitobans.

The University of Manitoba’s mission is to create, preserve and communicate knowledge, and thereby, contribute to the cultural, social and economic well-being of the people of Manitoba, Canada and the world. MCHP is situated within the University of Manitoba Strategic Plan Framework and the Faculty of Medicine Strategic Framework.

UNIVERSITY OF MANITOBA, FACULTY OF MEDICINE umanitoba.ca/faculties/medicine/units/mchpAnnual Report 2012/13 | page 3

TABLE OF CONTENTSDr. Clyde Hertzman | 1953-2013 ................................................................................................................................................5

Message from our Director ..........................................................................................................................................................6

MCHP Workgroups..........................................................................................................................................................................8

MCHP Faculty & Staff......................................................................................................................................................................10

Advisory Board Membership ......................................................................................................................................................13

MCHP Awards & Honours .............................................................................................................................................................14

Data Repository and Research ...................................................................................................................................................16

Highlights: ..................................................................................................................................................................................16

Data Repository........................................................................................................................................................................16

Repository Access Unit ..........................................................................................................................................................16

New Data Acquisitions in the Leaders CFI Initiative ...................................................................................................18

Feature: Infrastructure for Sharing Knowledge (ISK) .................................................................................................19

Data Access and Accreditation ...........................................................................................................................................20

Highlights: ..................................................................................................................................................................................20

Visitors with Data Related Interests ..................................................................................................................................22

Remote Access Sites ...............................................................................................................................................................22

Funding for Research Accessing the Repository..................................................................................................................23

MCHP–Administered Research ..........................................................................................................................................23

Online Research Resources ..........................................................................................................................................................25

MCHP Concept Dictionary and Glossary ........................................................................................................................25

Research at MCHP ...........................................................................................................................................................................26

Highlights: ..................................................................................................................................................................................26

MCHP Research Scientists ....................................................................................................................................................27

Deliverables ........ .............................................................................................................................................................................30

Top 10 Deliverable Downloads in 2012 ...........................................................................................................................30

Key Deliverable Research Findings ...................................................................................................................................31

Deliverables in Progress ........................................................................................................................................................34

Research Partnerships & Collaborations .........................................................................................................................35

Featured Projects .....................................................................................................................................................................37

Knowledge Translation: ................................................................................................................................................................42

Highlights: ..................................................................................................................................................................................42

Informing Planners & Stakeholders .........................................................................................................................................43

The Need To Know Team .......................................................................................................................................................43

Workshops & Events ...............................................................................................................................................................45

Informing Government ................................................................................................................................................................46

MCHP/Manitoba Health Workshop ...................................................................................................................................46

MCHP/Manitoba Government Annual Workshop .......................................................................................................46


MCHP Legislature Breakfast October 9, 2012 ................................................................................................................47

Briefings ......................................................................................................................................................................................48

Informing the Public ......................................................................................................................................................................49

MCHP Website ..........................................................................................................................................................................49

Highlights: ..................................................................................................................................................................................49

In the News ................................................................................................................................................................................49

EvidenceNetwork.ca ...............................................................................................................................................................50

Educational Contributions and Investment .........................................................................................................................51

Highlights: ..................................................................................................................................................................................51

Student Outreach ...................................................................................................................................................................51

Student Supervision by MCHP Research Scientists ....................................................................................................51

Ongoing or Completed Thesis Projects Accessing the Repository .......................................................................52

Student Recognition ..............................................................................................................................................................52

Financial Report ...............................................................................................................................................................................55

Appendix 1: Publications & Presentations .............................................................................................................................57

Appendix 2: Population Health Research Data Repository: Available Years of Data ..............................................68

Appendix 3: Ongoing Projects ...................................................................................................................................................71

Appendix 4: Student Research Projects ..................................................................................................................................76

Appendix 5: Courses Taught by MCHP Research Scientists .............................................................................................80

Appendix 6: Media Features and Releases .............................................................................................................................81

Appendix 7: Committee Involvement by MCHP Research Scientists ...........................................................................85


DR. CLYDE HERTZMAN | 1953-2013Clyde Hertzman’s sudden and unexpected death came way too soon. He was a powerfully committed individual who has done so much, and of whom we were expecting so much more. He was only 59. Clyde was a passionate advocate for early childhood development. He worked closely with Healthy Child Manitoba and was scheduled to be doing more – helping to make things better for children and families. He was also a champion for using data linkages to monitor child development, and held MCHP’s Repository up as an example for other jurisdictions to emulate. Clyde also worked with many of us at MCHP, and was a co-investigator and Advisory Board member on our CIHR PATHS Equity for Children program of research.

We will greatly miss his valuable input, enthusiasm, commitment and seemingly boundless energy.

“All of the new insights we’re getting into how the interactions of genes and environment drive development reinforce the importance of a society that helps families”

“If we were to invest according to what the biology of brain development is telling us, there would be a lot more investment in children early on.”

-Dr. Clyde Hertzman The Globe & Mail, January 25th, 2013

Thanks Clyde for all you accomplished.


MESSAGE FROM OUR DIRECTOR When I look back over the past year, I can’t help thinking of connections -- connections between data points and data sources as well as the connections we make with data providers, stakeholders and policy makers. Our whole approach at MCHP revolves around our three pillars of the Repository, the Research, and Knowledge Translation (putting that research into action) – all important in connecting the dots.

We have the privilege of housing the Population Health Research Data Repository at MCHP. This Repository contains billions of “dots” of data from 67 databases. These “dots” represent every Manitoban’s encounter with the health care system, and even extend into the education and social areas. While many of our data represent discrete encounters, by forming connections we can get a picture of health, as health is more than healthcare. I think of those connect-the-dot pictures my grand-daughter enjoys so much, which, with a few points can be very simple, but as more points are used, can become quite complex. This puts us in a unique position as:

“A lot of people in our industry…don’t have enough dots to connect, and they end up with very linear solutions without a broad perspective on the problem.” (Steve Jobs).

By connecting the “dots”, a picture is formed that can answer our research questions. To create this picture, we first need to identify the “dots” and find information related to them before organizing and connecting, testing and reconnecting, allowing a picture to emerge. For many questions, our concept dictionary provides us with a starting point in forming these connections. We can look at what “dots” have been previously connected and how they were connected, building on the picture that emerged from that work. It is because of the concept and data dictionaries that we can effectively identify and query these “dots” without being overwhelmed. The first pictures that are formed are often not complete, but as we test hypotheses and evaluate the results, the connections are modified and a clearer picture emerges. Such a process would not be feasible if it were not for our diverse teams that work together in forming these connections. To form more complete pictures we need more data. That’s why we continually work with various agencies and government departments who have data that could enhance our understanding of health in order to bring the information into the Repository.

It is very important to us that the picture that is formed from these connections is logical and practical. It is why we connect with those who know both the “dots” and the people behind the “dots” through our Advisory Groups and The Need to Know Team, our collaborative with the health authorities and Manitoba Health. These groups help us put the “dots” and the final picture that emerges into perspective.

Through our workshops, briefings, and outreach, we create connections that allow us to not only put the pictures that emerge into action, but also to receive feedback, to help us refine our pictures. These are never final, and as our Repository grows, we can refine our pictures further.


These “dots” are what make MCHP world class. None of these “dots” would be possible without our relationship with Manitoba Health and a growing list of government agencies. We value these connections and as I travel around the world, I see how truly privileged we are.

As you flip through the pages of this report and read highlights of the results of the various connections, know that you have likely had a role in making them possible. Perhaps you provided a dot or two by visiting your doctor or perhaps we connected with you as owner of some of the data we use. In whatever way you were involved, thank you. None of the ‘dots’ and ‘connections’ that make MCHP world class would be possible without you. We value you.

There are numerous people who I wish to thank for their commitment and support. Please accept my apologies for anyone that may have been overlooked:

• Dr. Brian Postl, Dean of Medicine• Dr. Sharon Macdonald, Chair of our MCHP Advisory Board (and Department Head for Community Health

Sciences during part of this past fiscal year)• Dr. Stephen Moses, Department Head for Community Health Sciences and Member of our Advisory Board• Hon. Theresa Oswald and Milton Sussman, Minister and Deputy Minister of Health• Hon. Jim Rondeau and Cindy Stevens, Minister and Deputy Minister of Healthy Living, Seniors and Consumer

Affairs• Hon. Nancy Allan and Gerald Farthing, Minister and Deputy Minister of Education• Hon. Jennifer Howard and Jeff Parr, Minister and Deputy Minister of Family Services and Labour• Hon. Kevin Chief and Jan Sanderson, Minister and Deputy Minister of Children and Youth opportunities• Hon. Dave Chomiak and Grant Doak, Minister and Deputy Minister of Innovation, Energy and Mines• Hon. Peter Bjornson and Hugh Eliasson, Minister and Deputy Minister of Entrepreneurship, Training and Trade• Hon. Kerri Irvin-Ross and Joy Cramer, Minister and Deputy Minister of Housing and Community Development• Deborah Malazdrewicz, Executive Director of Health Information Management, Manitoba Health – our “right

hand person” who bi-weekly liaises with me on MCHP/Manitoba Health relationships• Dr. Rob Santos, Executive Director, Science and Policy, Healthy Child Manitoba Office • Dr. Mike Moffatt and Landis Esposito, Executive Director of the Research and Applied Learning Division in the

WRHA and WRHA Chief Privacy Officer• Members of the Healthy Child Committee of Cabinet• Numerous individuals who have provided input and feedback for our deliverables, especially those who

have served tirelessly on our advisory groups or as part of deliverable research teams• All of the people who attend our workshop days• The MCHP Research Coordinator group under the direction of Ruth-Ann Soodeen, who took on the task of

helping with the annual report this year – stellar job, and kudos to all of you!!• The research scientists, staff and students who ensure the success of MCHP

Patricia J. Martens

Director, Manitoba Centre for Health Policy; CIHR/PHAC Applied Public Health Chair; Professor, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba


MCHP WORKGROUPSFrom our data to our deliverable reports and Knowledge Translation, MCHP has continued to thrive based on the work of its dedicated and talented staff. The people at MCHP indeed serve as the foundation to bring about many of the Centre’s successes. Below are the workgroups formed to provide such supports – with each group designed to perform a unique function to help make MCHP a successful research unit.

Research ScientistsThe Researcher Scientists at MCHP design and manage the research projects pursued by the Centre. Projects include deliverables for Manitoba Health, studies funded through peer reviewed research grants, peer-reviewed journal articles, educational and public presentations, briefings to government, op-eds and radio and television interviews. The researcher scientists also teach medical students; courses, mentor graduate students at the University of Manitoba, and apply for research grants in their areas of expertise.

Research Project Coordinators This group coordinates deliverable project activities, through all phases of the project. Duties include a) ensuring the MCHP procedures are followed for data access use, report structure, and knowledge translation; b) helping develop analysis plans, documenting decisions for project methodology, creating and monitoring timelines, taking notes, providing background literature on research project topics; c) contributing to the presentation of results, including writing some sections of the report, presentations and posters; d) and facilitating communication within project teams and with external contacts.

Research AssistantsMCHP Research Assistants are students who provide support primarily to the Research Coordinators and Support Staff. They may carry out a variety of tasks such as: creating and editing graphs, tables, and presentations, literature searches, pulling various types of project specific information, creating reference lists, proof-reading documents, checking data, updating documents and occasionally, reception relief.

Data ManagementThis repository group supports the development and use of the Population Health Research Data Repository including the initial acquisition, conversion and installation of databases, annual updates, and ongoing maintenance of over 67 administrative database groups in several areas. Through the development and dissemination of data dictionaries, data quality assessments, data models, and other web-based resources such as MCHP’s Concept Dictionary and Glossary, the Data Management Group provides detailed information about the Repository to researchers, analysts, and Remote Access Site (RAS) Users.


Data AnalystsAnalysts provide data analysis and statistical support for research project being carried out at MCHP. Analysis and data tasks fall in 5 general categories: 1) sampling strategies to identify and select relevant records; 2) techniques for aggregating person-level records to form longitudinal histories of health care utilization; 3) the integration of information from records maintained in different databases 4) application of tabulation and summary procedures and 5) the application of inferential statistical (significance testing and modeling to make inferences about populations) procedures of a range of complexity.

Information TechnologyThis unit manages all information technology services within MCHP. This includes end user support, application development, hardware, software, networking, partner access, security and related services. The MCHP environment consists of over 120 endpoints and 40 servers/appliances supporting research and operational requirements. All services are self-contained within MCHP in order to maintain a privacy compliant environment.

CommunicationsProvides communication and marketing support to MCHP, develops and implements communication plans, provides media relations expertise and advisement.

Finance Grants AccountantsThe MCHP Finance team provides the accounting and personnel administration in the management and maintenance of MCHP finances. This involves the set up and day-to-day administration of 46 grants and approximately 65 employees/students in the 2012/13 fiscal year. The MCHP Finance team ensures all granting agency and payroll guidelines are met on. The team also acts as the on-site support for all travel and purchasing related inquiries.

Research SupportThis group provides administrative, research and clerical support to researchers in the completion of deliverables, peer-reviewed journal articles and grant proposals. Support group members perform tasks that fall under 3 general categories: 1) deliverable support for the production of report figures and tables, editing and preparing MCHP reports for publication, 2) ensuring the production of promotional and information-based materials and all printing requirements of MCHP, 3) providing services integral to the Centre’s image including front desk service and planning knowledge translation events.


MCHP FACULTY & STAFFThe following is a list of all staff who worked at MCHP at any point between April 1, 2012 and March 31, 2013.

ExecutiveDr. Patricia Martens, Director, Professor, Senior Research Scientist Dr. Alan Katz, Associate Director, Research, Professor, Senior Research Scientist Mark Smith, Associate Director, Repository, Research Scientist Charles Burchill, Associate Director, Data Access & Use John Dziadek, Associate Director, Administration Carole Ouelette, Executive Assistant

Research ScientistsDr. Marni Brownell, Associate Professor, Community Health Sciences, Faculty of Medicine, Senior Research Scientist Dr. Mariette Chartier, Research Scientist Dr. Dan Chateau, Research Scientist/Statistician Dr. Malcolm Doupe, Associate Professor, Community Health Sciences, Faculty of Medicine, Senior Research Scientist Dr. Greg Finlayson, Research Scientist Dr. Randy Fransoo, Assistant Professor, Community Health Sciences, Faculty of Medicine, Research Scientist Dr. Alan Katz, Associate Director, Research, Professor, Community Health Sciences, Faculty of Medicine, Senior Research Scientist Dr. Patricia Martens, Director, Professor, Community Health Sciences, Faculty of Medicine, Senior Research Scientist Dr. Leslie Roos, Founding Director, Professor, Community Health Sciences, Faculty of Medicine, Senior Research Scientist Dr. Noralou Roos, Founding Director, Professor, Community Health Sciences, Faculty of Medicine, Senior Research Scientist Mark Smith, Associate Director, Repository, Research Scientist Dr. Colette Raymond , Department of Pharmaceutical Services, Health Sciences Centre Hospital Dr. Lisa Lix, Professor, Community Health Sciences, Faculity of Medicine, Research Scientist Dr. Colleen Metge, Director, Research and Evaluation Unit, Winnipeg Regional Health Authority, Research Scientist

Research Project CoordinatorsRuth-Ann Soodeen, Lead Research Coordinator Chun Yan Goh, Research Coordinator Ina Koseva, Research Coordinator Chelsey McDougall, Research Coordinator Kari-Lynne McGowan, Research Coordinator Jennifer Schultz, Research Coordinator

Research ManagerDr. Elaine Burland, Research Manager


Research AssistantsAynslie Hinds, Research Assistant Jessica Jarmasz, Research Assistant Susan Burchill, Research Assistant

Data AcquisitionJ. Patrick Nicol, Lead Data Acquisition Officer Say Hong, Data Management Analyst Tyler Ostapyk, Documentation Coordinator Dave Towns, Data Acquisition Officer Angela Tan, Data Acquisition Officer Ken Turner, Repository Data Analyst

Repository Access and DocumentationRuth Bond, Manager of Repository Access and Documentation Jo-Anne Baribeau, Repository Access Coordinator Emily English, Repository Access Assistant Marianne Wishnowski, Repository Access Assistant

Program and Analysis SystemsCharles Burchill, Associate Director, Data Access & Use Wendy Au, Data Analyst Bogdan Bogdanovic, Data Analyst Hui Chen, Data Analyst Matt Dahl, Data Analyst Shelley Derksen, Data Analyst Natalia Dik, Data Analyst Oke Ekuma, Data Analyst Sazzadul Khan, Data Analyst Leonard MacWilliam, Data Analyst Heather Prior, Data Analyst Joykrishna Sarkar, Data Analyst Carole Taylor, Data Analyst Randy Walld, Data Analyst Marina Yogendran, Data Analyst

Information TechnologyRod McRae, Information Technology Manager Darrin Halabuza, Information Technology Support

Communications Jack Rach, Communications Officer


FinanceSophie Buternowsky, Senior Grants Accountant Ariel Bautista, Grants Accountant Linda Kostiuk, Grants Accountant Nora Platte, Grants Accountant Kirsten Giroux, Grants Accountant

Research SupportCarole Ouelette, Executive Assistant Elisa Allegro, Research Support Angela Bailly, Research Support Eileen Boriskewich, Research Support Theresa Daniuk, Research Support Kara Dyck, Research Support Wendy Guenette, Research Support Shannon Lussier, Research Support Leanne Rajotte, Research Support


ADVISORY BOARD MEMBERSHIPMembers by Position: • Director of the Manitoba Centre for Health Policy: Dr. Patricia Martens• Deputy Minister of Health: Milton Sussman• Founding Directors: Drs. Noralou Roos and Leslie Roos• Head of the Department of Community Health Sciences, Faculty of Medicine, University of Manitoba:

Dr. Stephen Moses • One representative from Treasury Board: vacant • Dean of the Faculty of Medicine, University of Manitoba: Dr. Brian Postl• Manitoba Health Liaise: Deborah Malazdrewicz• Board Chair: Dr. Sharon Macdonald

Appointed Members: Up to seven appointees of Manitoba Health1. Harvey Bostrom, Deputy Minister, Aboriginal and Northern Affairs2. Grant Doak, Deputy Minister, Innovation, Energy and Mines3. Gerald Farthing, Deputy Minister, Education4. Monique Vielfaure Mackenzie, Executive Director, Regional Health Authorities of Manitoba5. Jan Sanderson, Deputy Minister, Children and Youth Opportunities6. Jeff Parr, Deputy Minister, Family Services and Labour7. Cindy Stevens, Deputy Minister, Healthy Living, Seniors and Consumer Affairs

Appointed Members: Up to seven appointees of the University of Manitoba1. Dr. David Collins, Vice Provost, Academic Planning and Programs, University of Manitoba2. Dr. Digvir Jayas, Vice President, Research, University of Manitoba3. Dr. Terry Klassen, Director of Research, Manitoba Institute of Child Health, U of Manitoba4. Dr. S. Leonard Syme, Professor of Epidemiology and Community Health (Emeritus) University of California,

Berkeley5. Dr. Michael Moffatt, Executive Director, Research and Applied Learning Division, Winnipeg Regional Health

Authority6. Reg Toews, Member of the Community7. Kevin Kavanagh, Member of the Community

Ex Officio Members:Dr. Alan Katz, Associate Director, Research, MCHP Mark Smith, Associate Director, Repository, MCHP Charles Burchill, Associate Director, Data Access and Use, MCHP John Dziadek, Associate Director, Administrative, MCHP

MCHP Staff Support to Advisory Committee:Carole Ouelette, Executive Assistant


MCHP AWARDS & HONOURSDr. Malcolm Doupe, recipient of the 2012 Rh Institute Award for Outstanding Contributions to Scholarship and Research in the Health Sciences Category ($12,000).

Dr. Mariette Chartier, recipient of an Honoray Diploma from l’Université de Saint-Boniface.

Dr. Patricia Martens recipient of the 2012 Una Ridley Health Sciences Lecture award, University of Lethbridge ($5,000)


Charles Burchill (left), recipient of the Leadership Award in the Support Staff Awards of Excellence, University of Manitoba

Dr. Alan Katz, recipient of Manitoba Research Chair in Primary Prevention from the Manitoba Health Research Council and the Heart and Stroke Foundation of Manitoba ($100,000 per year for 5 years)

Congratulations also to MCHP staff who recently graduated:

Greg Finlayson, PhD from Department of Health Policy and Administration from the University of Illinois Angela Tan, Ph.D. from the Department of Statistics, University of Manitoba Chun Yan Goh, MSc. from the Department of Human Nutritional Sciences


DATA REPOSITORY AND RESEARCHHighlights:• 170 active projects at MCHP• Nine new active projects across seven Remote Access Sites• 61 projects submitted for costing• 27 projects with a newly completed MCHP Researcher Agreement• 48 people attended a live MCHP accreditation session

Data RepositoryThe Population Health Research Data Repository (Repository) housed at MCHP is a comprehensive collection of administrative, registry, survey and other databases primarily composed of residents of Manitoba. It was developed to describe and explain patterns of healthcare and profiles of health and illness, facilitating research spanning a number of databases such as health, education, social services, and justice.

Repository Access UnitThis unit ensures that all the requirements for secure access, use and disclosure of data from the Repository are met for each research project. The unit monitors the various processes and puts them in place to ensure compliance with existing data sharing agreements, applicable privacy legislation and any other mandatory regulations for appropriate research use of the Repository. They keep track of the following: : 1) proposal reviews including feasibility and financial quotes; 2) project specific approvals and researcher agreements, and 3) ongoing project requirements. This group ensures adherence to MCHP policies and procedures as well as the documented requirements from other organizations such as data providers, the Health Research Ethics Board and the Health Information Privacy Committee.


Total Number of Databases in MCHP Repository

Number of Databases Added to the MCHP Repository by Year

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1618 18 19 19

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New Data Acquisitions in the Leaders CFI InitiativeAs part of the 2010 Canadian Foundation for Innnovation (CFI) Initiative awarded to MCHP, six new data acquisitions are being added to the Data Repository. As is the case with all MCHP data there are no names in any of the databases. These data can be linked to the other data in the Repository using the scrambled PHIN attached to each record.

Manitoba Justice DataA complete copy of charges from the prosecutions department (PRISM), appearances in court (CCAINS) and provincial incarcerations (COMS) for the period beginning 2002 to the present. Records include information on perpetrators, victims, witnesses, and youth justice.

National Rehabilitation System DataAdult clients (18 years and over) receiving services in specialty rehabilitation facilities or general (acute care) facilities that provide rehabilitation services through designated units. Detailed clinical and functional information scores are included from 2007 to the present. This data is currently only for Winnipeg sites: Concordia Hospital, Deer Lodge Centre, Grace Hospital, Health Sciences Centre, Riverview Health Centre, Seven Oaks General Hospital, and St. Boniface Hospital.

In-Hospital Pharmaceutical DataPrescription drugs dispensed in Winnipeg’s two tertiary care facilities (Health Sciences Centre and St. Boniface Hospital) for the period 2000 to present, including drug costs.

Manitoba Social HousingInformation on clients in provincially owned and managed social housing (Tenant Management System) from 1995 until the present. This includes approximately 30,000 clients annually.

Diagnostic Services Manitoba (DSM) Laboratory DataLaboratory data (chemistry to start with, and then eventually immunology, hematology, and microbiology) from the Health Sciences Centre, St. Boniface Hospital, Misericordia Health Centre, Concordia Hospital, Seven Oaks General Hospital, Grace Hospital, Victoria General Hospital, Deer Lodge Centre, Riverview Health Centre, Beausejour Health Centre and Westman Lab in Brandon, for various start dates between 2001-2006 to the present.

University of Manitoba Student DataEnrollments, qualifications, programs, grades, awards, and degrees for University of Manitoba students, from 1947 until the present have been added.


FEATURE: INFRASTRUCTURE FOR SHARING KNOWLEDGE (ISK) The ISK was formed in September 2009 with the purpose of advancing and promoting best practices in administrative data documentation, developing common tools for documentation and data quality assurance, and facilitating communication of new developments in data management among researchers, analysts, and data managers from data centres across Canada. Participants include provincial and national organizations such as the Public Health Agency of Canada and Statistics Canada, as well as observers from several centres throughout the world. Meeting annually, our goal is to improve metadata documentation and enhance the understanding of the science of data management both nationally and internationally.

Recent Events In March 2013, MCHP’s Mark Smith and Say Hong hosted a webinar to discuss data quality procedures and present MCHP’s data quality framework and toolkit. Nine organizations participated in this event. The event provided the unique opportunity for MCHP to introduce the formalized data quality evaluation process it has recently implemented for all incoming repository data at MCHP. ISK members recognize the important role data quality evaluation has to play in ensuring that data held in various data centres across Canada can be used effectively by researchers and other data users.

During the session, members also acknowledged the impact of poor data quality on research projects, such as creating additional work and, in some cases, producing incorrect, inaccurate, or incomplete findings. This webinar offered a forum for discussing the various organizations’ challenges in evaluating data quality and enabled the group to offer solutions to these problems including the consideration of how data quality evaluation tools (such as MCHP’s) can be further improved.

MCHP plans to host an ISK webinar on data documentation in the fall of 2013. Other ISK members also indicated interest in hosting similar webinars.

Data Providers MeetingThe Data Providers Meeting, held annually in December, is a gathering of contacts from the various government departments and health authorities which provide MCHP’s Repository with data, and those whom provide support to and work with them at MCHP. The various government departments and regional health authorities invited were: Manitoba Health, Healthy Child Manitoba, Manitoba Family Services and Labour, Manitoba Education, Winnipeg Regional Health Authority, and Manitoba Housing and Community Development. This meeting focuses on deliverables and investigator-driven research and covers topics such as: approval process used, requirements for processes, and the updates or changes that have occurred over the past 12 months. This meeting also gives an opportunity for processes between data providers and their MCHP contacts to be simplified or openly discussed to be bettered.

“Our goal is to improve metadata documentation and enhance the

understanding of the science of data management”


DATA ACCESS AND ACCREDITATIONHighlights: • Over the 2012/13 fiscal year, 48 people attended a live MCHP Accreditation session. • In total, 264 people have attended a live Accreditation session to date.

MCHP Accreditation sessions are held to provide a consistent overview of MCHP, and the data access and use process. They cover the MCHP mission, available data (Data Repository), and requirements for data use and publication of results developed from the MCHP Repository. The accreditation process includes signing a pledge of confidentiality as well as an agreement that you understand and will follow the process for doing research at MCHP. Accreditation is a requirement for all researchers and analysts working on approved projects accessing the Repository, and must be completed annually. Each person’s first Accreditation session must be a live session.

Research Projects and Proposals Researchers interested in accessing the Repository for their own grant-funded research projects must follow three key steps:

1. Submit research proposals to determine if (a) the objective(s) comply with MCHP’s mission and mandate; (b) the required data are or can be housed in the Repository; and (c) the data can address the research proposal’s objectives. Once the review is complete, a cost estimate is provided to the research scientist for use of MCHP resources/Repository based on information received from the reviewing data analyst. • In 2012/13, 61 projects were submitted to MCHP for costing.

2. Once funding confirmation is received acquire approvals from the appropriate providers of the required data.3. Attend an Accreditation session and complete a Researcher Agreement.

• In 2012/13, there were 27 projects that had a newly-completed MCHP Researcher Agreement.


Active Research Projects that use the MCHP Repository via Remote Access Sites

New Research Projects that use the MCHP Repository

The number of active projects at MCHP has continued to increase over time, reaching 195 active projects in 2012/13, of which 37 were deliverables. Of particular interest is the continued active use of the remote access sites, with almost 30 active projects using them.

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VISITORS WITH DATA RELATED INTERESTSExternal groups and individuals are often interested to learn about various aspects of the data at MCHP, including our approach to data agreements, data management, documentation, etc. The following are two visiting groups from 2012-2013

Swansea University, WalesIn September 2012, two groups visited MCHP: David Ford (Professor of Health Informatics) and Simon Thompson (Chief Technology Officer) from Swansea University in Wales, UK, and Kelly Alke (Lead of the Researcher Liaison Unit) and Jim Mintha (Lead of the Systems and Security Unit) from Population Data BC in British Columbia, Canada. While here they met with many MCHP researchers and staff. Additionally, David Ford made a presentation, entitled “Basic Overview and Future Direction of SAIL (Secure Anonymised Information Linkage) Databank,” and Kelly Alke presented “Population Data BC: Overview and Outline of Current Initiatives.”

Royal University of BhutanIn March 2013, Dr. Chencho Dorjee (Director) and Dr. Neyzang Wangmo (Dean, Research and External Linkages) from the Royal Institute of Health Sciences, Royal University of Bhutan, visited MCHP. In addition to touring MCHP and meeting with researchers and staff, they also made a presentation at a departmental colloquium, entitled “Bhutanese Health Care System.”

REMOTE ACCESS SITESRemote Access Sites (RAS) enable data analysis to occur securely in a remote or non-MCHP office. In its most basic form, a RAS office has a locked door, a desk, a network connection, and a computer without any capabilities to store data or run complex applications, but serves merely as a secure conduit to the MCHP data centre. All analysis and processing resides at all times within MCHP, and after vetting by MCHP staff, the RAS user is able to use the results for their research.

There are currently seven RAS locations:

• Room T155, MCHP, Department of Community Health Sciences, University of Manitoba• Faculty of Human Ecology, University of Manitoba• Faculty of Pharmacy, University of Manitoba• Manitoba First Nations Centre for Aboriginal Health Research (MFN CAHR), University of Manitoba• Centre for Global Public Health (CGPH), University of Manitoba• Concordia Hospital, Winnipeg Regional Health Authority• Health Sciences Centre (HSC), Winnipeg Regional Health Authority

There are 27 active projects across these RAS locations, an increase of nine from last year. One to two new project proposals are received by MCHP weekly, and approximately half of these indicate future RAS usage.


FUNDING FOR RESEARCH ACCESSING THE REPOSITORYThere are many research projects, conducted by MCHP research scientists or external researchers, which access the Repository for research data. Below lists the funding which supports with these projects.

MCHP–Administered Research The following research projects were awarded funding to one or more MCHP research scientist(s). All funds are financially and administratively managed through MCHP. The primary source of the research data is the Population Health Research Data Repository, but projects may access data from other sources as well. (Listed in alphabetical order by funding organization.)

Canadian Foundation on Fetal Alcohol ResearchBrownell M, Hanlon-Dearman A, Elias B, Chateau D, Phillips-Beck W, Roos N, Chudley A, Longstaffe S. $50,000, 2011-2013. “Utilization of Health and Social Services by Manitoba First Nations Children with FASD”

Canadian Foundation for InnovationMartens PJ. $1,453,780, 2010-2014. “Leading Edge Access and Data Enhancement Research Strategy”. Matching funds provided by MRIF.

Canadian Institutes of Health ResearchMartens PJ. CIHR/PHAC Applied Public Health Chair. $925,000, 03/2008-02/2013. “What works at the population level? An Applied Public Health Chair program of research focusing on population & public health issues.”

Martens PJ, Caetano PA, Alessi-Severini S, Chateau D, Katz A, Mahmud S, Metge C, Raymond C, Vercaigne L, Bugdan S, Targownik L. $320,000, 2011-2015. “Canadian Network for Observational Drug Effect Studies (CNODES), Database Team”

Martens PJ, Caetano PA, Levy A, Sketris I. 75,000, 2011-2015. “Canadian Network for Observational Drug Effect Studies (CNODES), Knowledge Translation Team”

Martens PJ (nominated PI), Co-PIs: Brownell M, Katz A, Chateau D, Chartier M, Fransoo R, Lix L, Metge C, Roos L, Santos R. Co-applicants: Bolton J, Doupe M, Hertzman C, Jutte D, Katz L, Raymond C, Roos N. CIHR Operating Grant on Programmatic Grants in Health and Health Equity. Title: PATHS Equity for Children: A program of research into what works to reduce the gap for Manitoba’s children. Term of Funding: 2011-2016 (5 years). Amount: $2.0 million ($350,000 years 1 and 2; $400,000 years 3-5, $100,000 from Heart & Stroke Foundation

Roos NP, Martens PJ, Cassels, AK, Hirst N, Driedger SM, Katz A, et al. $370,800, 2009-2013. “Injecting evidence into Health Policy Coverage: ‘KT’ing the Mythbusters’.” Matched grant with Manitoba Health Research Council.

Roos LL, Roos NP, Samuel SM, Bolton JM, Katz L. $98,984, 2011-2014 “Childhood Social Factors in Development – the CHILDSOC Project.”

Roos NP, Martens, PJ, Nuamah O, et al. $397,321, 2012-2015 “Injecting Evidence into Health Policy Coverage: Working with the Media.”

Manitoba HealthMartens PJ. $11,625,000, 2010–2015. Manitoba Centre for Health Policy contract.


Manitoba Health Research CouncilBrownell M, Yallop L. $3725, 2011-2013. “Attention-deficit/hyperactivity disorder in Manitoba adults: A population-based study.” Dissertation award

Doupe M, $100,000, 2011-2014. “Linking unique clinical and health care use files to better understanding nursing home quality care.”

Fransoo R, $51,580, 2010-2013. “Temporal Trends and Sex Differences in Acute Myocardial Infarction (AMI) incidence, mortality, and treatments in Manitoba 1985 to 2010.”

Roos NP, Martens PJ, Cassels, AK, Hirst N, Driedger SM, Katz A, et al. $97,000, 2009-2013. “Injecting evidence into Health Policy Coverage: ‘KT’ing the Mythbusters’.” Matched grant with Canadian Institutes of Health Research.

Roos NP, Martens, PJ, Nuamah O, et al. $94,000, 2012-2015 “Injecting Evidence into Health Policy Coverage: Working with the Media.” (matching fund with CIHR award)

Manitoba, Innovation, Energy and MinesBrownell M, Elias B. $15,000, 2011-2013. “Incident Mapping”

Manitoba Research and Innovation FundMartens PJ. $1,453,780, 2010-2014. “Leading Edge Access and Data Enhancement Research Strategy”. Matching funds provided by CFI.

Public Health Agency of CanadaBrownell M, Hanlon-Dearman A, Shooshtari S, et al. $150,000, 2012-2014, “Validation Study on Manitoba Administrative Data for the Purpose of ASD Surveillance.”

Chartier M $2,584,085, 2011-2015 “Towards Flourishing: Improving the Mental Health Amount New Mothers in the Manitoba Families First Home Visiting Program”, Phase II.

Sunnybrook Research Institute (CIHR collaborative sub-agreement)Stukel TA, Katz A. $132,216, 2011-2012 “Health Care System Sustainability Through Longitudinal Efficiency: Improve Quality and Lower Costs”

University of Toronto (sub-agreement of CIHR)Katz, A. $60,000, 2012-2016 “Paying for Primary Care: Relationship Between Incentives and Patient/Provider Characteristics

Winnipeg Rh Institute Foundation Inc.Doupe, M. $12,000, 2013-2018 “2012 Rh Award”

York University (sub-agreement of SSHRC)Doupe M. $6,000, 2010-2017 “Re-imagining long-term residential care: An international study of promising practices.”


ONLINE RESEARCH RESOURCESMCHP Concept Dictionary and GlossaryThe Concept Dictionary and Glossary represent a series of research tools that were developed at MCHP to permit application of a variety of theoretical frameworks, analytical techniques, statistical approaches and mapping resources appropriate for use with administrative data bases.

This past year 239 terms were added to the glossary, resulting in a total of 2327 terms now available. Ten new concepts and 31 updated concepts were added to the Concept dictionary. The total number of concepts in the Concept Dictionary is now 275.

The Concept Dictionary describes over 200 research concepts developed at MCHP for analysing data contained in the Repository housed at MCHP. These detailed operational definitions of variables or measures used in MCHP research include a discussion of the issue(s) involved, approaches used, programming tips/cautions, SAS code (where not restricted for internal use), additional readings, and references.

The Glossary documents terms commonly used in population health and health services research. Each Glossary term contains a brief definition (and its source), links to related Glossary terms and concepts in the Concept Dictionary, as well as links to external sites.

Glossary terms and concepts used in the following Deliverables, released in 2012/13, were added to the on-line resources:

• The Epidemiology and Outcomes of Critical Illness in Manitoba• The Early Development Instrument (EDI) in Manitoba: Linking Socioeconomic Adversity and Biological

Vulnerability at Birth to Children’s Outcomes at Age 5• Health and Healthcare Utilization of Francophones in Manitoba

NOTE: This deliverable was translated and released in French under the title “La santé et l’utilisation des services de santé des francophones du Manitoba”. French terms are not included in the on-line glossary.

• Projecting Personal Care Home Bed Equivalent Needs in Manitoba Through 2036• How are Manitoba’s Children Doing?• Perinatal Services and Outcomes in Manitoba• A Systematic Investigation of Manitoba’s Provincial Laboratory Data• Understanding the Health System Use of Ambulatory Care Patients


RESEARCH AT MCHPHighlights:• One new research scientist joined the MCHP team• Eight deliverables were released• 1st deliverable on Francophone health was released

Research at MCHP is a team effort. Deliverables (research reports done under contract with Manitoba Health) are our major research outputs; each of these projects takes about two years to complete. They involve teams that typically include research scientists, a research coordinator, research support, and data analysts. Teams meet regularly to discuss the direction of the study, methodological decisions, interpretation of the results, and to help determine how to best present them and tell the “stories” that emerge from the analyses. Several times over the course of a deliverable, the team also meets with an advisory group of researchers and representatives from both government and non-government agencies who have relevant expertise and can provide valuable feedback.

Some of the research questions explored this year include:

How does the health of Francophones compare to that of other Manitobans? How has ICU use changed over time? What role do specialists play in the provision of ambulatory disease management? How healthy are people who live in social housing? What is the epidemiology of chronic kidney disease and end-stage renal disease in Manitoba?

This section provides information on the research interests of MCHP research scientists, on recently released and ongoing deliverables, as well as other academic publications and presentations of research using MCHP Repository data.


MCHP RESEARCH SCIENTISTS

Dr. Marni Brownell Research Focus: Child health and well-being, with a particular focus on the social determinants of health, developmental disabilities, children in out-of-home care, developing population-level indicators of child health, and evaluations of programs designed to improve childhood development.

Dr. Mariette ChartierResearch Focus: Prevention and early intervention programs for children and their parents, mental health promotion, child abuse and neglect, perinatal health, health risk behaviours, and health of vulnerable populations.

Dr. Dan ChateauResearch Focus: Population Health Research Methods, Area Based Socioeconomic Measures, Social Determinants of Health, Health Equity Analysis, and Population Health Intervention Effectiveness

Dr. Malcolm DoupeResearch Focus: Health services utilization and the aging population, risk factors of home care and nursing home use, factors that influence quality care in in nursing homes; and health services utilization of emergency departments.


Dr. Greg FinlaysonResearch Focus: funding methodologies, cost of health care for chronic conditions.

Dr. Randy FransooResearch Focus: Indicators of population health and health service use, rural health, obesity, cardiac care, and critical care

Dr. Alan Katz Research Focus: Primary Care health service delivery, quality of care indicators, knowledge translation, and disease prevention

Dr. Patricia MartensResearch Focus: Health status and healthcare use of Manitoba’s rural & northern residents, mental health, use of healthcare services by those with mental illness, the health of Aboriginal people, child health (including evaluating community intervention strategies to increase breastfeeding rates), and health inequities.


Dr. Leslie RoosResearch Focus: Uses of information-rich research environments, longitudinal studies, child development, and research methods.

Dr. Noralou RoosResearch Focus: Use of administrative data for managing the health care system, relationship between health care use and population health, child health and wellbeing, with a particular focus on the social determinants of health. As Director of EvidenceNetwork.ca she attempts to communicate evidence on these issues through the media.

Mark SmithResearch Focus: Administrative data, mental health, chronic disease surveillance, social housing, homelessness, and poverty.

In addition to conducting research, MCHP Research scientists also teach and supervise students, as well as contribute to numerous committees. A list of this committee involvement can be found in Appendix 7 of this report.


DELIVERABLESTop 10 Deliverable Downloads in 20121. Perinatal Services and Outcomes in Manitoba (2012)

58,435 downloads2. Projecting Personal Care Home Bed Equivalent Needs in Manitoba Through 2036 (2012)

23,291 downloads3. Assessing the Health of Children in Manitoba: A Population-Based Study (2001)

22,831 downloads4. The Health and Health Care Use of Registered First Nations People Living in Manitoba:

A Population-Based Study (2002) 17,740 downloads

5. Patterns of Regional Mental Illness Disorder Diagnoses and Service Use in Manitoba: A Population-Based Study (2004) 14,111 downloads

6. Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time? (2010) 11,589 downloads

7. Defining and Validating Chronic Diseases: An Administrative Data Approach (2006) 10,064 downloads

8. Issues in the management of specialist physician resources for Manitoba (1997) 9,885 downloads

9. Pharmaceutical Use in Manitoba: Opportunities to Optimize Use (2008) 8,230 downloads

10. What Works? A First Look at Evaluating Manitoba’s Regional Health Programs and Policies at the Population Level (2006) 8,002 downloads


KEY DELIVERABLE RESEARCH FINDINGSManitoba ICUs are Busy but CopingIn this first comprehensive assessment of ICU care in Manitoba, Dr. Allan Garland and his team combined administrative health data with the ICU clinical database to examine how ICU use has changed from 1999 to 2008. Manitoba had fewer ICU beds per 1,000 than the national average (9.8 vs. 13.5 people) but was still able to meet demand; they were completely full less than 5% of the time. Other highlights include the finding that the number of admissions dropped slightly over time, while the number of patients with long ICU stays increased. Characteristics of ICU patients (mostly men) and the illnesses that brought them to the ICU (mainly cardiovascular related) were also examined.

Report: The Epidemiology and Outcomes of Critical Illness in Manitoba - Allan Garland, Randy Fransoo, Kendiss Olafson, Clare Ramsey, Marina Yogendran, Daniel Château, Kari-Lynne McGowan (released April 2012)

Preparing for School Begins at BirthHow well are children prepared for school? How can we ensure that they are ready? Administrative health and social data together with results from the Early Development Instrument (EDI) were used by Dr. Rob Santos and his team to measure children’s readiness for school. The EDI focuses on five factors: physical health & well-being, social competence, emotional maturity, language & cognitive development and communication skills & general knowledge. Results showed that poorer EDI scores were strongly linked to health from very early on, even as early as birth (e.g. very low birth weight, longer ICU stay). They were also related to living in a poorer neighborhood, being born to a teen mother, living in a family that received income assistance, or being in the care of Child and Family Services. Having more than one of these risk factors increased children’s vulnerability, and therefore their need for attention, if they are to succeed at school and later in life.

Report: The Early Development Instrument (EDI) in Manitoba: Linking Socioeconomic Adversity and Biological Vulnerability at Birth to Children’s Outcomes at Age 5 - Rob Santos, Marni Brownell, Okechukwu Ekuma, Teresa Mayer, Ruth-Ann Soodeen (released May 2012)

Francophones’ Health Improving with Each GenerationThis was the first large-scale study of the health of Francophones in Manitoba, comparing them to non- Francophones on 76 health indicators. One key finding by Dr. Mariette Chartier and team was that although older Francophones seem to be less healthy than non-Francophones, while younger Francophones were healthier than non-Francophones. Life expectancy was similar between Francophones and non- Francophones, but Francophones did better in terms of such measures as graduation rates, and screening for breast and cervical cancer, and flu immunizations. They fared worse in readiness for school in Kindergarten, and they waited longer to be admitted to a personal care home.

Report: Health and Healthcare Utilization of Francophones in Manitoba -Mariette Chartier, Gregory S Finlayson, Heather J. Prior, Kari-Lynne McGowan, Hui Chen, Janelle de Rocquigny, Randy Walld, Michael Gousseau (released June 2012)


Planning for an Aging PopulationAs more Manitobans age into their golden years, the need for long-term care also increases. Using population projections combined with patterns of use, this study, led by Dr. Dan Chateau, estimated that due to population aging, Manitoba will need to provide long-term care for about 5,100 to 6,300 extra seniors by 2036. Many of these spaces can be provided by relatively new alternatives to traditional personal care homes such as supportive housing and extended home care. These alternatives could divert at least 12 per cent of seniors out of personal care homes. Other factors – such as being married or having children - can also reduce demands for formal long-term care. Chateau quips, “On average, a husband is almost as good as one child and a wife is better than three.”

Report: Projecting Personal Care Home Bed Equivalent Needs in Manitoba Through 2036 - Dan Chateau, Malcolm Doupe, Randy Walld, Ruth-Ann Soodeen, Carole Ouelette, Leanne Rajotte (released October 2012)

Manitoba Kids – Doing better or worse? Are the lives of Manitoba’s children improving? If not, are there ways that we can try to make things better? These and other related questions were addressed in this study, led by Dr. Marni Brownell. The team measured children’s well-being in four areas: physical and emotional health; safety and security; education; and social engagement and responsibility. In general, over the last 10 years, Manitoba children have made some gains in health and social outcomes (e.g. more children completed high school, fewer were hospitalized, got pregnant, or sustained intentional injuries).The opposite was true for those from lower income areas. As demonstrated by a closer look at academic trajectories from Kindergarten to Grade 3, the good news is that although low income can have a negative effect on outcomes for some children, this impact does not have to be permanent. The right policies and programs can help to improve children’s health and well-being.

Report: How are Manitoba’s Children Doing? - Marni Brownell, Joykrishna Sarkar, Mariette Chartier, Leonard MacWilliam, Rob Santos, Elaine Burland, Okechukwu Ekuma, Ina Koseva, Wendy Au, Wendy Guenette (released October 2012)

Giving Birth in ManitobaA healthy start in life has a lifelong impact on individuals and their families. This study used data covering the time of prenatal care through the newborn’s first year of life to examine the health and healthcare use of mothers and babies. Dr. Maureen Heaman and colleagues found that as the mothers’ social and economic circumstances declined, the health of the newborns also declined. For example, women living in poverty were not only less likely to have less healthy pregnancies and deliveries, their babies were also more likely to have serious health problems and to die within the first year of life. A first look at midwifery care was also included; although it has increased over time, it is not reaching enough women in target groups such as poor, teenage, socially isolated, and other at-risk mothers. Other measures studied include mothers’ age, caesarean births, preterm births, how far mothers travel to give birth, mothers’ mental health, and maternal diabetes.

Report: Perinatal Services and Outcomes in Manitoba - Maureen Heaman, Dawn Kingston, Michael E. Helewa, Marni Brownell, Shelley Derksen, Bogdan Bogdanovic, Kari-Lynne McGowan, Angela Bailly (released November 2012)


New Uses for Manitoba’s Provincial Lab DataBetter information about the health of Manitobans and the health services available to them depends on better (and bigger) data. One such data source, Manitoba’s public Cadham Provincial Laboratory was recently added to MCHP’s data repository. This lab tests for bacteria, viruses, and viral diseases, focusing on detecting and monitoring human diseases. Because these data can be linked to health administrative data in the Repository it is a valuable tool for public health and other health services researchers to use. For example, future studies can focus on specific demographics where the results could provide useful evidence for health officials to target programs and policies for at-risk Manitobans. Dr. Lisa Lix and her team used the process of acquiring and evaluating the quality of these data to develop a clearer system for managing new data at MCHP as well as new tools to describe quality, both of which can be adapted by other centres with similar data.

Report: A Systematic Investigation of Manitoba’s Provincial Laboratory Data - Lisa Lix, Mark Smith, Mahmoud Azimaee, Matthew Dahl, Patrick Nicol, Charles Burchill, Elaine Burland, Chun Yan Goh, Jennifer Schultz, Angela Bailly (released December 2012)

Continuity of Care: Best Option, But Not Always RealityIt is commonly believed that having a regular primary care provider (e.g. family physician) who knows the patient and builds a relationship over time is the best model for ensuring quality health care and ultimately better health outcomes. Such physicians should be in the best position to judge when a patient needs more specialized care and to make the necessary referral. Dr. Alan Katz and his team looked at Manitobans with chronic conditions and found that although most of their care (four out of every five visits) was provided by their main physician, many referrals to specialists were made by a different family physician. Quality of care measures for each chronic condition were also examined by comparing between patients with similar visit frequency and by the type of physician from whom they typically received their care.

Report: Understanding the Health System Use of Ambulatory Care Patients - Alan Katz, Patricia Martens, Dan Chateau, Bogdan Bogdanovic, Ina Koseva, Chelsey McDougall, Eileen Boriskewich (released March 2013)


DELIVERABLES IN PROGRESSSocial Housing in Manitoba (Spring 2013)Part I: Manitoba Social Housing DataGreg Finlayson, Mark Smith, Charles Burchill, Dave Towns, William Peeler, Ruth-Ann Soodeen, Heather Prior, Shamima Huq, Wendy Guenette

Part II: Social Housing and Health in Manitoba: A First LookMark Smith, Greg Finlayson, Patricia Martens, Jim Dunn, Heather Prior, Carole Taylor, Ruth-Ann Soodeen, Charles Burchill, Wendy Guenette, Aynslie Hinds

Who is in our Hospitals? (Fall 2013)Randy Fransoo, Patricia Martens, Heather Prior, Chelsey McDougall, Elaine Burland, Ina Koseva, the Need To Know team

Manitoba RHA Atlas 2013 (Fall 2013)Randy Fransoo, Patricia Martens, Charles Burchill, Heather Prior, Ina Koseva, Elisa Allegro, the Need To Know team

The Cost of Publicly Supported Housing for SeniorsGreg Finlayson, Malcolm Doupe, Greg Mason, Sazzadul Khan, Marina Yogendran, Jennifer Schultz, Elisa Allegro

Defining the Capabilities of the Newly Implemented Emergency Use Data Systems in WinnipegMalcolm Doupe, Greg Finlayson, Ruth-Ann Soodeen, Shelley Derksen, Joykrishna Sarkar, Matt Dahl, Dave Towns, Wendy Guenette, Carole Ouelette, Ricardo Lobato de Faria, Trevor Strome, Carolyn Snider

Physician Integrated Network (PIN) Long-term Change Analysis (PIN Phase 2)Alan Katz, Dan Chateau, Bogdan Bogdanovic, Carole Taylor, Kari-Lynne McGowan, Leanne Rajotte, John Dziadek

Evaluation of the InSight Mentoring ProgramChelsea Ruth, Marni Brownell, Jill Isbister, Leonard MacWilliam, Kari-Lynne McGowan, Eileen Boriskewich, Deepa Singal

Evaluation of the Manitoba Health Program IMPRxOVEDan Chateau, Murray Enns, Oke Ekuma, Chelsey McDougall, Elisa Allegro

The future of treatment and care of Manitobans living with kidney failureMariette Chartier, Allison Dart, Paul Komenda, Navdeep Tangri, Nathan Nickel, Charles Burchill, Randy Walld, Bogdan Bogdanovic, Say Hong, Kari-Lynne McGowan, Leanne Rajotte

CIC Identification of Factors and Supports that Contribute to the Educational Success of Students in Foster CareMarni Brownell, Mariette Chartier, Leonard MacWilliam, Wendy Au, Jennifer Schultz, Wendy Guenette

Public Reporting Template for LTC Quality IndicatorsMalcolm Doupe, Marni Brownell, Natalia Dik, Chelsey McDougall, Wendy Guenette, Shauna Zinnick

The Cost of Smoking: A Manitoba StudyPatricia Martens, Evelyn Forget, Lisa Lix, Donna Turner, Nathan Nickel, Heather Prior, Randy Walld, Ruth-Ann Soodeen, Leanne Rajotte, Pranay Das


RESEARCH PARTNERSHIPS & COLLABORATIONSThe world-renowned Repository at MCHP is available to all investigators who are interested in exploring the relationships between health domains and between health, social, educational, housing, justice and other determinants of health factors in Manitoba. As a result researchers at MCHP have been able to develop research collaborations with colleagues from a wide range of disciplines. These relationships increase access to and use of the Repository, broaden the scope of issues that can be investigated, particularly if it involves new databases being linked with existing Repository data.

List of Collaborators & Adjunct Research ScientistsThe designation of Adjunct Scientist at the Manitoba Centre for Health Policy was created to recognize the valuable contribution made to its research by external participants. Adjunct Scientists are involved in collaborative research with an MCHP Researcher, have an ongoing commitment to health services research, have previous research involvement with scholarly publications, and/or have clinical/policy expertise that is of assistance to MCHP Scientists in framing research questions, interpreting results of particular analyses and advising on the policy implications of the findings.

Judith Bartlett, MD, MSc, CCFP, Associate Professor, Department of Community Health Science, Faculty of Medicine, University of Manitoba

James Bolton, MD, B.Sc., FRCPC, Assistant Professor, Department of Psychiatry, Faculty of Medicine, Department of Psychology, Faculty of Arts, University of Manitoba

Shelley Buchan, MD, FRCP, Medical Officer of Health, Southern Regional Health Authority

Allison Dart, MD, MSc, FRCPC, Assistant Professor, Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba

Raisa Deber, PhD, Professor, Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto; Director, CIHR Team in Community Care and Health Human Resources

Carolyn De Coster, PhD, RN, MBA, Executive Director, Clinical & Zone Analytics, Data Integration, Measurement and Reporting, Alberta Health Services; Research Assistant Professor, Department of Community Health Sciences, Faculty of Medicine; University of Calgary

Brenda Elias, PhD, Assistant Professor, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba

Murray Enns, MD, FRCPC, Professor and Head, Department of Psychiatry, Faculty of Medicine, University of Manitoba; Medical Director, Adult Mental Health Program, Winnipeg Regional Health Authority

Evelyn Forget, PhD, Professor, Director, Graduate Program, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba

Allan Garland, MD, MA, Associate Professor, Department of Internal Medicine, Department of Community Health Sciences, Co-Head, Section of Critical Care, Faculty of Medicine, University of Manitoba

Maureen Heaman, RN, PhD, Professor, Faculty of Nursing, University of Manitoba; CIHR Chair in Gender and Health

Tim Hilderman, MD, FRCPC, Director, Community Medicine Residency Program; Assistant Professor, Community Health Sciences


Doug Jutte, MD, MPH, Assistant Adjunct Professor, UC-Berkeley-UCSF Joint Medical Program, Associate Director, Master’s Degree in Health & Medical Sciences, School of Public Health, University of California, Berkeley

Laurence Katz, MD, FRCPC, Associate Professor, Department of Psychiatry, Faculty of Medicine, University of Manitoba

Anita Kozyrskyj, PhD, Research Chair, Maternal-Child Health and the Environment, Associate Professor, Department of Pediatrics, Faculty of Medicine, University of Alberta

Meir Kryger, MD, FRCPC, Professor, Yale University School of Medicine

William Leslie, MD, FRCPC, Section of Nuclear Medicine, St. Boniface General Hospital; Professor, Department of Internal Medicine, Department of Radiology, Faculty of Medicine, University of Manitoba

Doug Manuel, MD, MSc, FRCPC, Senior Scientist, Ottawa Hospital Research Institute; PHAC/CIHR Chair in Applied Public Health Sciences; Senior Medical Advisor, Statistics Canada; Associate Professor, Department of Family Medicine, Department of Epidemiology and Community Medicine, University of Ottawa; Associate Scientist, C.T. Lamont Primary Care Research Centre, Élizabeth Bruyère Research Institute; Adjunct Scientist, Institute for Clinical Evaluative Sciences (ICES)

Colleen Metge, PhD Director, Research and Evaluation Unit, Winnipeg Regional Health Authority, Assistant Professor, Community Health Sciences

Michael Moffatt, MD, MSc, FRCPC, Executive Director, Research and Applied Learning, Winnipeg Regional Health Authority

John O’Neil, PhD, Professor and Dean, Faculty of Health Sciences, Simon Fraser University

Hude Quan, PhD, Professor, Department of Community Health Sciences, Faculty of Medicine, University of Calgary

Chelsea Ruth, MD, FRCPC, Assistant Professor of Paediatrics, Section of Neonatology, Faculty of Medicine, University of Manitoba; Assistant Medical Director Intermediate Care Nursery, Medical Director Manitoba Rh Program

Rob Santos, PhD, Associate Secretary to Healthy Child Committee of Cabinet, Government of Manitoba; Executive Director, Science and Policy, Health Child Manitoba Office; Assistant Professor, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba

Shahin Shooshtari, PhD, Director, Interdisciplinary Health Program, Assistant Professor, Department of Family Social Sciences, Faculty of Human Ecology, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba; Researcher, St. Amant Research Centre

F. Estelle. R. Simons, MD, FRCPC, FAAP, FACAAI, FAAAAI, Professor, Department of Pediatrics and Child Health, Department of Immunology, Faculty of Medicine, University of Manitoba

S. Leonard Syme, PhD, Professor Emeritus, Department of Epidemiology and Community Health/Human Development, School of Public Health, University of California – Berkeley

Laura Targownik, MD, Associate Professor, Department of Internal Medicine, Faculty of Medicine, University of Manitoba


FEATURED PROJECTSPATHS Equity for Children (Pathways To Health and Social Equity)The PATHS program of research aims at understanding what works to reduce inequity in children’s outcomes, and includes collaborations with external partners. Multiple interventions will be evaluated to determine their impact on the health and well-being of children in terms of inequities in socioeconomic status, geography and sex at different points during childhood.

PATHS comprises a series of 16 inter-related sub-projects, each designed assess the impact of a different intervention. Each sub-project has its own team and set of objectives, but all projects will assess whether the intervention positively changed outcomes and/or gradients (i.e., socioeconomic, geographic and/or gender), and whether the intervention reached those intended (i.e., universal or targeted). The final sub-project will be an integrative analysis to be completed at the end, which will look at the interventions holistically to see whether combinations of programs are more effective than individual interventions, and whether combinations are more effective simultaneously or sequentially.

The sub-projects are:

i. Baby Friendly Hospital Initiative (BFHI)

ii. Physician Integrated Network (PIN)

iii. In-School Teen Clinics

iv. Healthy Baby Program

v. Families First Home Visiting Program

vi. Social Housing

vii. Healthy Buddies

viii. Roots of Empathy (ROE)

ix. Full-Day Kindergarten

x. Qualitative analysis: understanding mechanisms of inequality

xi. Early Intervention for ADHD

xii. Early Psychosis Prevention and Intervention Program (EPPIS)

xiii. Community Schools Investigator’s (CSI) Summer Learning Enrichment Program

xiv. PAX Good Behavior Game

xv. Public Health Sensitive Conditions (PHSC)

xvi. Integrative Analysis

Currently, nine of the 16 sub-projects are underway and the remaining seven are to begin over the course of the next three years. The projects that have started are in the early-to-mid stages of analysis.

Several PATHS-related abstracts have been accepted at upcoming conferences in the 2013-2014 year.


A post-doctoral student from the United States, Dr. Nathan Nickel, joined MCHP for training in the use of the Repository and to assist with several projects at MCHP, including PATHS. As well, several graduate students from the Department of Community Health Sciences have been hired to assist with PATHS literature searches and systematic reviews – Jason Randall, Leah Crockett and Aynslie Hinds.

Critical Care Research GroupMCHP’s 2012 deliverable co-led by Dr. Allan Garland (Critical Care Medicine) and Dr. Randy Fransoo (MCHP), The Epidemiology and Outcomes of Critical Illness in Manitoba, provided a unique opportunity to link the clinical ICU database (which captures the majority of all ICU care in the province) with the administrative data already in MCHP’s Population Health Research Data Repository.

The power of this combination was evident in the report, and marked the start of a rich new research collaboration between a group of local ICU physician/researchers and MCHP research scientists, focusing on different aspects of critical care. The deliverable has led to two academic papers already published, one in press, and five more in development. It also spawned new research topics that have been funded by U of M, Manitoba Health Research Council, and Canadian Institutes for Health Research grants, and are ongoing at MCHP. These include work on mortality after ICU care, and the use of ICU care by Manitobans with chronic inflammatory diseases.

This group is also now embarking on a national study of sex differences in rates of ICU care and how these are affected by family and social supports, with colleagues from Manitoba, Ontario and BC; this work is funded by the “Technology Evaluation in the Elderly Network.”

CNODES (Canadian Network for Observational Drug Effectiveness Studies)CNODES is an assembly of the top pharmacoepidemiologists across Canada, working collaboratively to conduct post-marketing drug safety and effectiveness studies. CNODES is funded by the Drug Safety and Effectiveness Network (DSEN) which has been established at the Canadian Institutes of Health Research (CIHR) in partnership with Health Canada as part of the federal government’s Food and Consumer Safety Action Plan (FCSAP).

Even though prescription drugs undergo safety and effectiveness studies before they are approved, an estimated 10,000 Canadians die each year and 150,000 are hospitalized from adverse drug reactions. Research is being conducted in individual provinces, but the databases used are often not large enough to study rare and serious adverse reactions, drugs used for uncommon diseases, and newly introduced medications.

CNODES is using existing healthcare databases on over 27 million people across Canada and internationally to conduct expedited evaluations of the risks and benefits of certain medications and disseminate this information widely to clinicians, patients and decision makers.

The CNODES Manitoba site leads are Dr. Patricia Martens and Dr. Patricia Caetano, along with others who meet monthly and work on the projects: Dr. Alan Katz, Dr. Colette Raymond, Dr. Colleen Metge, Dr. Dan Chateau, Dr. Laura Targownik, Dr. Salah Mahmud, Shawn Bugden, Silvia Alessi-Severini, Matt Dahl, and Elaine Burland.

To date, there have been six CNODES evaluations; the first one - the Statins AKI project [High-Dose Statins and the Risk of Acute Kidney Injury] , co-led by Colin Dormuth (Canadian lead) and Dr. Colette Raymond (Manitoba site lead) - has been completed and results were published in the March 20, 2013 British Medical Journal.

The PPI project [Proton Pump Inhibitors and Community Acquired Pneumonia] (Co-led by Kristian Filion (Canadian lead) and Dr. Laura Targownik (Manitoba site lead) has also been completed. The manuscript was recently accepted, pending revisions, for publication in the Gut journal.


The other four active projects are at various stages of development:

• DKA project [Antipsychotic Agents and Risk of Hyperglycaemic Em

2012/13 mchp annual report - university of manitoba...annual report 2012/13 | page 5 dr. clyde...

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