Translational Research in Troubled Times: thinking about ‘implementation’ in health services under pressure

Carl May

Personal introduction Empirical research

Professional knowledge and practice Technological innovation

Theoretical development Policy relevance: translational gaps Future focus of my work

basic interests

basic science: sociology methods and materials: ethnography policy application: evaluation processes: integration

interaction (individualised knowledge)interaction processes, genetics, rheumatology, terminal care

chronicity(illness trajectories)back-pain, diabetes, medically unexplained symptoms

innovation(intervention trajectories)informatics, telemedicine, shared-decision-making tools, medical devices.

evidence(generalized knowledge)randomized trials, pragmatic evaluations, development.

research interests: fields

research interests: over time

understanding professional-patient interaction in terminal and chronic illness

interrogating policy and practice relating to the design and delivery of innovative health technologies

developing explanatory models for the evaluation of healthcare technologies and other complex interventions

seeking to promote minimally disruptive healthcare in the face of increasing treatment burdens

next five years

White Paper:reorganization of NHS and

refocusing of public spending• in service organization and delivery• relationships between universities,

NHS and local authoritiesresearch may be refocused,

research funding will change

next five years

understanding innovation policy changes and spending cuts will

force NHS and other providers to seek technological solutions to problems of organization and delivery

call for rapid answers to complex problems around new ways of thinking, acting, and organizing in healthcare systems under stress

example: telemedicine and telecare

longstanding programme of work, focused on:design and evaluationworkability in clinical practiceintegration within NHS providers

and across health/social care boundaries

work with Mair (Glasgow), Murray (UCL), Finch (Ncl)

next five years

understanding implementation NHS and other providers will need to

find ways to embed solutions to problems in organization and delivery

crossing translational gaps, supporting professionals in the face of dynamic as healthcare providers seek to maximize value of new technologies and complex healthcare interventions

example: delivering clinical trials

complex intervention trials in connecting community, primary care, and specialist services complex dynamics of inter-professional

co-operation contingency in knowledge and practice problem of process evaluation

work with McColl (Ncl), Shah (Mayo Clinic), Gunn (Melbourne), Mort (Lancaster)

next five years

understanding integration radical changes in the organization and

delivery of healthcare will have important implications for patients and carers as the boundaries between home and healthcare are shifted

Exploring the changes in the experience and management of illness for patients and carers as their responsibilities are redefined

example: changing burdens of healthcare

Reconfiguring ideas about healthcare, ‘future patients’ and ‘shared burdens’ Refocusing patient/carer expertise Redrawing boundaries between home

and healthcare Maximizing effectiveness, minimizing

disruption and treatment burdens Work with Montori (Mayo Clinic), Mair

(Glasgow), Rogers (Manchester)

transforming health

transdisciplinary research old disciplinary boundaries provide no

future security translational research

jumping the gap between fundamental and applied research

transformational research making the links between fundamental

and applied research, real-life healthcare, and professional knowledge and practice

the kind of work I want to do

great science objectives, collaborations,

imagination visible contribution

clarity, direction, quality acknowledged impact

evidence, analysis, value

thank you