Implementing evidence-based innovations in Kingston and beyond: a profile of Dr. Elizabeth Eisenhauer

For Dr. Elizabeth Eisenhauer, retirement looks a little different than it does for most. She retired from herheadshot of Dr. Elizabeth Eisenhauer position as Department Head of Oncology in 2017 and before that, she was working at the Canadian Cancer Trials Group (CCTG) at Queen’s, which is the home base for the pan-Canadian research group. “After I retired, I was approached by [Kingston Health Sciences Centre President and CEO] Dr. David Pichora to see if I would be interested in coming back one day a week to develop an innovation portfolio for the hospital,” she says. After accepting this offer, Dr. Eisenhauer spent the first half of 2018 settling into her new role as Innovation Lead at KHSC, interviewing leaders at KHSC, Queen’s, SEAMO as well as many within our region and across the province about what innovation within a tertiary acute care hospital could include and the most important themes that KHSC should focus on, based on local strengths and expertise. “This culminated in the development of a set of five thematic innovation priorities presented in mid-2019. These are viewed as joint priorities of both KHSC and the Queen’s Faculty of Health Sciences because the two are so tightly connected,” she says. “These five themes were further reduced to three for development into workshops: one on digital health/artificial intelligence; one on minimally invasive interventions; and one on integrated care, specifically elimination of wait times for access to specialty consultation.”

By the time the COVID-19 pandemic hit, only one workshop (Digital Health, Machine Learning and AI) had taken place – and the other two were put on hold. Then, a proposal from Dr. Chris Simpson (then Vice-Dean in FHS and Medical Director for SEAMO) was made to move forward with implementing some of the ideas planned for presentation in the Elimination of Wait Times workshop. Dr. Eisenhauer says developing this initiative has been thanks to substantial collaboration between primary care physicians, hospital specialists, leaders in SEAMO, KHSC, patients and more. “Some of the work we’re doing is to co-develop strategies and implement projects in partnership with primary care. The wait times initiative has five streams of activity and each of those streams has a working group,” she says. The five streams are:

1.    Central referral and triage using digital tools
2.    Pathways for primary care management of common, non-urgent consults
3.    Direct specialist phone access for primary care
4.    Optimizing virtual care to increase capacity
5.    Embedding specialty clinics in primary care offices

Dr. Eisenhauer says, “Thankfully we have been able to recruit two great project managers to help with this work – Jessica Elgie from KHSC and Madelaine Meehan from Queen’s FHS. We’ve done a lot of development work and are now in the implementation phase. Embedded clinics and patient management pathways are being piloted and launched. Ocean eReferral integrated with an electronic waitlist management system (Novari) is being piloted in four specialties. Some of these efforts include enhancing eConsult use. What we’re trying to do is think of a whole system approach to implementing evidence-based innovation that, collectively, should have an impact on reducing wait times.” For a full list of the members of these working groups and a status update on each stream, please view the July 2021 newsletter on the KHSC Innovation portfolio website. Some of this work is also supported by a philanthropic donation made to the Faculty of Health Sciences.

Another area of the innovation portfolio with growing interest is that of digital health, data analytics and machine learning.  A key source of information to examine are administrative and patient data from the hospital, Dr. Eisenhauer says. “We’re starting to consider how to maximize the impact of the data we already collect on improving patient outcomes as well as efficiency and value in the hospital setting. We’ve started a webinar series looking at examples of how other groups are using these data as potential models for what might be achieved here.” 

Innovation is no stranger to Dr. Eisenhauer’s work, as she is the 2021 recipient of the Canada Gairdner Wightman Award. She says this award is largely acknowledging her CCTG accomplishments, where in a relatively short period of time, a collaborative Canadian network of researchers was established to work towards a common goal of evaluating promising new, anti-cancer therapies. “What I learned at CCTG applies to the work I’m doing now, because little can be accomplished by single individuals working alone in our health system, whether it’s testing new cancer treatments or developing new approaches to using data and developing innovative models of care. All of those require common goals, collaboration and the willingness to bend a bit to achieve more together.” 

For Dr. Eisenhauer, the work of being the Innovation Lead at KHSC feels sometimes like a ray of light during a period of pandemic darkness. “This work provides excitement that allows people to focus on looking ahead to a future where we have different relationships with primary care, we take risks to work together differently and we’re not feeling locked in to doing things the same way forever,” she says. Transformative change is possible if you engage the right people and excite them about the possibilities. “For me, innovation is about how we implement, adapt and evaluate evidence-based discoveries and approaches,” she says. “Research focuses on discovery and innovation is about making a difference by implementing and evaluating evidence-based discoveries and initiatives emerging from research. Some innovations are large and transformative that require a team effort to move into practice. Indeed, the wait times initiative and its team of volunteers and staff exemplifies that. But innovation can also include smaller, bite-sized changes and quality improvement initiatives that everyone should be considering to improve their work.” 

Dr. Eisenhauer’s work continues, and this is what she would like you to know about innovation: “A successful innovation portfolio must include taking leaps into more disruptive ways of thinking about health care delivery and health interventions, so by definition must include moving away from a culture of risk-aversion that wants nothing to ever change.”