Fireside Chat: The ROI in Team- Developing a Return on Investment Framework for Team-Based Care

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Brief Description:

Governments in Canada have made a commitment to team-based and integrated care for the Canadian health system(s).[1] To ensure interprofessional care (IPC) and interprofessional education (IPE) are used appropriately in Canada, it is vital to know where, when and how the two approaches provide return on investment (ROI). Although some studies have shown improved health outcomes, cost savings and decreased treatment lengths,[2] there is still the need to categorize outcomes and the value of IPC and IPE in a way that can be interpreted and used in a coordinated fashion for decision making across the country.[3] 
Between 2009 and 2012, the Health Education Task Force of the F/P/T committee on health human resources, funded the development of an ROI framework to allow such a categorization.[4] The ROI framework is built on two existing frameworks: an evidence framework identifying the main inputs, processes, outputs and outcomes from IPC and IPE;[5] and an evaluation framework called the Payback Framework.[6]

While the evidence framework builds on a wealth of existing knowledge on IPC and IPE, the payback framework has successfully been used to support government funding decisions (ring fencing the UK Dept. Health R&D budget in 2009).[7] In this framework, ROI is specifically used to ensure the full range of impacts from IPC and IPE are captured, not just the simple economic measures related to IPC/IPE. 
This approach is now informing evaluations in Canada (Alberta Health Services; An economic evaluation of nursing specialties) and the USA (US Centre for Interprofessional Practice and Education). These examples are ones that can be leveraged across Canada to increase the power of future ROI analyses using the framework.


Eddy Nason
Director, Health and Innovation / Directeur, Santé et Innovation
Institute On Governance / Institut sur la gouvernance


[1]         Canada. First Ministers’ Meeting. 2004. A 10-Year Plan to Strengthen Health Care. Ottawa, ON: Health Canada; Government of Ontario. 2012. Ontario’s Action Plan for Health Care. Toronto, ON: Queens Printer for Ontario.

[2]         Grimes and Tholl. 2010. Toward Building a Better Business Case for Team-Based Health Care in Canada. London, ON: CP Net.
[3]        Health Council of Canada. 2009. Value for Money. Available at:; Health Council of Canada. 2009. Teams in Action: PHC Teams for Canadians. Available at:; Curran, V. 2007. Collaborative Care: Synthesis Series on Sharing Insights for the PHCTF. Available at:
[4]         Nason. 2013. The ROI in Team. Toronto, ON: Institute on Governance.
[5]         Grimes and Tholl. 2010.
[6]         Donavon and Hanney. 2011. The ‘Payback Framework’ explained. Research Evaluation, 20(3): 181–183.
[7]         Buxton et al. 2008. Medical Research: What’s it Worth? London, UK: Brunel University, Office of Health Economics and RAND Europe.



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Health Canadacihr logo1This initiative has been generously funded by grants from Health Canada and the Canadian Institutes of Health Research. The views expressed here do not necessarily reflect those of the funders.