In this episode, IFIC Chief Executive Dr Niamh Lennox-Chhugani is joined by Dr Robert Reid, Chief Scientist Emeritus at the Institute for Better Health in Toronto and Professor at the University of Toronto and McMaster University.
Robert is a global expert in population health, primary care, and learning health systems. In this conversation, he reflects on his journey from primary care physician into research and evaluation, and on what it takes to build learning health systems that genuinely improve health for patients and communities.
Drawing on his experience embedding research within health systems in Canada and beyond, Robert explores how evaluation can better support real-world decision-making. He discusses the importance of balancing the priorities of researchers, system leaders, and communities; how rapid mixed-method evaluations can generate useful evidence for policymakers; and why evaluation should be built into implementation from the beginning.
The conversation also looks at how learning health systems can expand beyond healthcare to address the wider determinants of health, working with partners across sectors such as education, urban design, and transportation. Throughout, Rob emphasises that evaluation is most powerful when it is used not just to judge success or failure, but to continuously improve care.
The discussion draws on Rob’s work with Sarah Greene in the article Gathering Speed and Countering Tensions in the Rapid Learning Health System, which explores why health systems still struggle to generate and use evidence quickly enough to improve care. The paper highlights the tensions that arise when researchers, health system leaders, and funders pursue different priorities, and argues that these tensions must be actively managed if learning health systems are to succeed.
Key insights from Robert Reid
On the purpose of evaluation
“It's not research and evaluation per se that's important — it's actually the practical applications of it to reach patients, all patients, and their communities.”
On whose priorities matter
“The whole purpose for the health system is to deliver health for patients and communities… those priorities should be our north star.”
On bringing stakeholders together
“When we bring people together, we can drive consensus in fairly efficient ways.”
On generating evidence quickly
“We have to generate evidence much quicker and be creative in the methods that we use.”
On mixed methods
“Mixing quantitative and qualitative evidence is absolutely essential.”
On evaluation that actually changes practice
“I view evaluation as essential for the improvement part of it… threading it through the implementation of any project.”
On learning health systems
“Learning health systems are really quality improvement on steroids.”
On looking beyond healthcare
“Health is a product of many things — the environment, work, transportation, family dynamics and social supports.”