Stroke is the third leading cause of death in BC and the leading cause of brain disability. Stroke is also estimated to be the most expensive disease in Canada that, until recently, was considered untreatable. My research team is evaluating a three-step stroke program in the Vancouver Island Health Region to improve prevention and treatment options. The first step will be developing a surveillance system to collect information on all strokes in the region and to find people who are at high risk. Next, the project team will work on providing new tools to help patients and their doctors plan ahead and implement life style changes that will reduce stroke risk. The third component will use Stroke Victoria’s computer system as a tool for quality improvement initiatives in stroke care. The team will evaluate every stage of the project to assess the effectiveness of this approach for saving lives, improving care and reducing the costs of health care delivery. Stroke is so debilitating, complex and costly that it is worth investing in innovative approaches to prevention. We believe relevant, rapid and rigorous epidemiology is key.
Archives: awards
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Patient-focused care over time: issues related to measurement, prevalence, and strategies for improvement among patient populations in B.C.
Patients often see multiple health professionals in a variety of places for the care of their health problems. Linking care from different providers over time is challenging, with the risk that some care may be missed, duplicated or ill-timed. Concern about this fragmentation of care is growing in Canada and worldwide. Continuity of care, which is accomplished when the connections between care are seamless, is thought to improve patient outcomes, patient satisfaction with their care and physician and health providers’ satisfaction as well. I am studying the impact of continuity of care on costs and quality of care. A common way to connect care over time is to have one central person, usually a primary care physician, responsible for providing the majority of services and linking a patient to specialists. I am examining a variety of data to measure the concentration of care in this type of sustained relationship. A growing trend is team care provided at a clinic, where patients see any one of the physicians working there. My study will compare outcomes for patients who use health care teams to those who primarily see one physician, and I will look at the way walk-in clinic care affects continuity and patient outcomes. I will also examine how continuity of care affects patient health over time for people with severe and persistent mental illness, individuals with workplace injuries, and patients with HIV/AIDS.
P-glycoprotein, ABC transporters and genomics in cancer research
My research focuses on genes that play a role in the development of cancer, with a particular interest in genes that help malignant cells survive by limiting the effects of anti-cancer drugs. Our research team was the first to discover a protein (P-glycoprotein) on the surface of cancer cells that resists multiple cancer drugs. The protein protects cancer cells by pumping out drugs before they inflict lethal damage. With recent advances in genome science, the team has learned that proteins similar in structure to this one are present in more than 50 genes in the human genome. What these genes do in normal cells or in malignant ones is not yet fully understood. This is one of the questions that our team of more than 40 clinicians and scientists in the Cancer Genomics Program are working to answer. By analyzing how these genes act in normal tissue, and in cancers that are or are not responsive to drug therapy, we hope to identify markers (changes in the molecular structure or function of cells) that will be useful in diagnosing specific cancers earlier. Our goal is more effective treatment and, better still, more effective preventive measures.