Cost & Value in Healthcare

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Established in December 2016, the Research Exchange Group on Cost and Value in Healthcare brings together partners from community organizations, educators, practitioners, health system officials, government partners, students, academic researchers, and members of the public who share an interest in improving cost-efficiency and promoting better value in healthcare.

See Group Activities and Presentations

Group Conveners
  • Dr. Gerard Farrell—Associate Professor, Faculties of Medicine and Computer Science, Memorial University
  • Dr. Hai Van Nguyen—Associate Professor, School of Pharmacy, Memorial University


Goals & Objectives

The Research Exchange Group on Cost and Value in Healthcare aims to:

  • Inform health policy to reduce costs and increase value in healthcare
  • Review research in progress/existing research literature on cost and value in healthcare
  • Build research teams on issues identified by the group and looking for research funding to support their work
  • Network with peers
  • Exame best practices around the world
  • Look at collaborative research to examine challenges in healthcare
  • Identify programs that have been a good use of healthcare dollars
  • Ensure that any new health care initiatives include evaluative components to assess new programs

Research Themes

Ethics and Access will be considered sub-themes of each of the five topics below:

  1. Determining the appropriateness of services and care being delivered (e.g. prescribing, screening, testing, procedures)
  2. Identifying administrative, clinical and service delivery innovations
  3. Accelerating cost saving and cost-effective health technology solutions
  4. Patient/Citizen engagement (e.g. in addressing gap between spending, appropriateness and outcomes)
  5. Linking social determinants of health with specific health care policy and care delivery solutions

NLCAHR’s Research Exchange Group on Cost and Value in Healthcare welcomes anyone with an interest in cost and value in healthcare to join us. Please see our calendar of meetings for information about upcoming webinars or email for more details.

Group Activities & Presentations

October 20, 2022 | A New Social and Economic Well-Being Plan for Newfoundland and Labrador | Renee Ryan is the Director of Social and Economic Well-Being with the Department of Children, Seniors and Social Development in the Government of NL.  Renee spoke about the current work of the Provincial Government on the development a Social and Economic Well-Being Plan. The Provincial Government has developed a framework to guide discussions on how to best address social and economic well-being for all Newfoundlanders and Labradorians. This includes a lifecycle approach and six components of well-being. In November 2020 the Provincial Government launched Health Accord NL which produced a final report of calls to action on improving specific social, economic, and environmental conditions affecting our health. The Social and Economic Well-Being Plan has been informed by the work of the Health Accord NL and the extensive engagement process that was part of that work. Presentation on NL Social & Economic Well Being Plan R Ryan October 2022


March 3, 2023 10:30am - 12:00pm | Canada Health Measures Survey Presentation | Lisette Dufour RDH/HD, is the Oral Health Advisor at the Office of the Chief Dental Officer of Canada Health Promotion & Chronic Disease Prevention Branch (HPCDPB) /Public Health Agency of Canada. At this presentation, Lisette will:

  • provide a national landscape on dental expenditures and on oral health human resources across our country
  • provide some background on Canadian oral health surveillance
  • outline the drivers and the recommendations regarding oral health data required for the next decade
  • define the roles and responsibilities of each party involved in the Canadian oral health data collection in Cycle 7 of the CHMS
  • provide information about the household, clinical and bio-sample oral health measurements to be collected during cycle 7 of the CHMS
  • provide information on the newly created National Oral Health Assessment Tools for children and Seniors


September 20, 2021 | 2:00pm NST | The Department of Children, Seniors, and Social Development | Presented by: The Honourable John G. Abbott, Minister, and Ms. Susan Walsh, Deputy Minister LINK TO PRESENTATION HERE | The Department of CSSD works to foster social development and diversity, build inclusive communities, and ensure the delivery of critical services to protect children and vulnerable adults. CSSD develops policies, programs and partnerships to promote an inclusive, accessible and socially advanced province that values its children, youth, families, persons with disabilities, seniors and all individuals across the life span. This meeting of the Research Exchange Group on Cost and Value in Healthcare provided a valuable opportunity to meet with the Minister and Deputy Minister to learn more about the Department’s priorities and mandate, and to discuss the potential for policy-relevant research that might support decision making in these areas.


September 22, 2020 | Unintended Consequences: The Electronic Medical Record, Physician Mental Health and Burnout | Dr. Gerard Farrell |

October 20, 2020 | Virtual Healthcare in the Age of COVID-19: Physician and Patient Perspectives | Primary care providers, patients and caregivers got together to talk about their experiences either providing or receiving healthcare in a variety of virtual healthcare settings. | 

December 3, 2020 | The Cost of Pharmaceuticals: Cost-Benefit Analyses for New Medications, Implications of Long-Term Prescription Use, and Considerations for Canadian Drug Policy | Dr. Hai Van Nguyen |

December 15, 2020 | Therapeutic Cannabis: In the Absence of Evidence, What’s the Guidance? | The group discussed policy considerations for therapeutic cannabis use, safe supply, clinician and patient perspectives on cannabis use, and what will be needed to guide physician advice to patients who are experimenting with cannabinoids and other cannabis products to self-treat a variety of conditions and symptoms. | 

March 6, 2020 | Healthcare Cost Avoidance and Resource Reallocation/ Restructuring with Quality of Care NL | Dr. Krista Mahoney and Dr. Karen Dickson | Link to Presentation | 


November 25, 2019 | CIHI's National Health Expenditures Database | Laura Samson, Senior Analyst Eastern Canada, Canadian Institute for Health Information (CIHI) | on Link to Database  | 

January 28, 2019 | Breast Screening Recommendations of the Canadian Task Force on Preventive Healthcare | Dr. Anne Kearney | Link to Presentation | 

February 25, 2019 | Western Health on Western Health's Alternate Transportation Systems | David Buckle, Regional Director of Paramedicine | Presentation discussed a project that utilizes non-medical transport for patients. |

April 29, 2019 | The Gathering Place: Programs and Services to Support Vulnerable Communities | Joanne Thompson, Executive Director of the Gathering Place | Link to Presentation |

May 27, 2019 | Comprehensive Care Program for Thrombosis Patients in Newfoundland & Labrador | Dr. Stephanie Young and Dr. Rufaro Chitsike  | Link to Presentation | 


November 26, 2018 | Better Now: Six Big Ideas to Improve Health Care for All CanadiansDr. Danielle Martin | Link to Slides |

December 17, 2018 |  Quality of Care/Choosing Wisely NL | Dr. Brendan Barrett and Dr. Robert Wilson | The group was updated on the healthcare costs savings achieved through the Quality of Care/ Choosing Wisely initiative in Newfoundland & Labrador. | Link to Slides |

October 29, 2018 | How Social Innovation Can Address Youth Homelessness and School Disengagement in Newfoundland & Labrador | Sheldon Pollett and Kris Kelly of Choices for Youth | Link to Presentation |

January 29, 2018 |  Stella's Circle : Determinants of Health: A Community Lens | Lisa Browne, CEO, Stella's Circle | Link to Presentation |

February 26, 2018 | Why Complexity Matters: An assessment of the NL School Food Environment | Emily Doyle | Link to Presentation | Farm-to-Cafeteria Canada Website: A Pan-Canadian School Food Initiative |

March 26, 2018 | 1) The Children's Dental Health Plan: A Success Story to Build On | Michelle Zwicker | Link to Presentation | 2) Integrating Dental Services Into a Primary Healthcare Initiative for Low-Income Individuals in St. John’s | Jill Allison and Katrina Bartellas | Link to Presentation |

April 30, 2018 | Process Improvement with Lean: Eastern Health's Journey | Gerard Gibbons, Manager, Decision Support Eastern Health and Justin Swain, Manager, Eastern Health's Performance Office | 

May 28, 2018 | Drop-in Counselling Services in a Non-Profit Community-Based Agency: An Exemplar of Responsive, Effective, Accessible and Cost Efficient Mental Health Service Delivery| Dr. Catherine deBoer | Link to Presentation |


October 30, 2017 | It is Time to Re-Evaluate Population-Based Mammography Screening | Dr. Anne Kearney | Link to Presentation | Link to References | 

November 27 2017 | 1) Using Health Administrative Data to Evaluate Practice and Outcomes | 2) Surveillance, Data Capture and Quality, Burden on the System, Getting Quality Information to Assist with Informed Decision Making | Phil Murphy |  Link to Presentation | 

February 17, 2017 | Determining the Appropriateness of Services and Care Being Delivered (e.g. prescribing, screening, testing, procedures) | Dr. Robert Wilson | Discussion about the Choosing Wisely NL program and its approach to helping clinicians and patients engage in conversations about unnecessary tests, treatments and procedures | 

March 17, 2017 | Accelerating Cost Saving and Cost-effective Health Technology Solutions |

  • Dr. Gerard Farrell: “eHealth: What’s New?“
  • Elizabeth Wallack of the telegerontology research team presented, on behalf of Dr. Roger Butler: "Research findings and a recent cost-analysis from a tele-gerontology study that used online interventions for community-dwelling seniors with dementia."

April 21, 2017 | Identifying Administrative, Clinical, and Service Delivery Innovations | 

  • Dr. Daryl Pullman: “Toward a two-tiered publicly administered health care system: a 'fourth way' in the public vs. private debate.”
  • Dr. Hai Van Ngyuen: “Using bundled payment to promote quality and improve efficiency of health care: Evidence and implications for NL healthcare reform.”

May 19, 2017 | Identifying Administrative, Clinical, and Service Delivery Innovations | 

  • Dr. Kris Aubrey-Bassler: “Designing primary care to optimize efficiency and effectiveness.”
  • Dr. Kristin Harris Walsh and Dr. Olga Heath: “Enhancing Inter-professional Education in Pre- and Post-Licensure Health/Social Care Professional Education in Newfoundland and Labrador (NL)”