It takes only a few minutes talking with Prof. Moriah Ellen to realize she navigates an intellectual landscape that is several steps ahead of most people’s assumptions about how health systems work. She speaks quickly but not hurriedly, layering insights with the steady confidence of someone who has spent many years observing ideas rise, fall, and occasionally – when the stars align – become actual policy.
“We know the research. We know what works. The question is, how do we get it done?” she says, as if sharing the distilled essence of her field. The truth, she insists, is that much of what could make healthcare more equitable, efficient, and humane isn't missing from the scientific record; it's simply not being utilized.
Ellen’s research home is Ben-Gurion University’s Department of Health Policy and Management, where she leads IS-PEC, the Israel Implementation Science and Policy Engagement Centre. These fields don’t promise the glamour of miracle drugs or cutting-edge machines; instead, they grapple with a more stubborn reality: a world in which knowledge rarely translates smoothly into action. “I don’t test whether something works,” she says. “I test how to make it work in real life, and real life is messy.”
Messiness, rather than discouraging her, energizes her. She revisits it repeatedly, as if it were both an academic challenge and a human puzzle worth solving. Her journey to this work was neither linear nor accidental. “I grew up in a home that was all about giving and caring,” she recalls. “I wanted to be a doctor, but I hated blood and veins.” Instead, she pursued an MBA in health services management, “ I figured I would manage the doctors,” she jokes, and entered the workforce as a project manager.
Very quickly, she realized something was missing. “I wasn’t being challenged enough academically,” she says. She shifted to a PhD at the University of Toronto, then returned to consulting, then to a postdoc at McMaster University, then back to consulting, and finally settled into academia for good. “I always fluctuated between the real world and academia,” she says. “Eventually, I realized I needed both: the depth of research and the impact of practice.”
That dual perspective shapes how she discusses evidence. She has no interest in knowledge as a stand-alone achievement. Evidence, for her, is raw material, not a finished product. “The research says we should do X, but we’re not doing X,” she says. “So why not? What gets in the way? How do we support policymakers, so evidence reaches them in a usable form? And after they approve something, how do we ensure it’s implemented on the ground?”
The progression she describes – evidence, policy, implementation – is simple enough in theory. In practice, each step is its own battlefield. Her example of nurse practitioners illustrates this complexity. “The evidence is unequivocal,” she says. “Nurse practitioners provide excellent care. They are efficient, they improve patient outcomes, and they’re not just ‘doctor substitutes.’ They have their own strengths.”
Policymakers can understand this, she notes; some even approve measures that expand their roles. “But then implementation hits,” she says. “And suddenly you’re dealing with organizational culture, professional anxieties, resource bottlenecks, ego, habit. Evidence doesn’t automatically survive contact with the real world.”
Ellen often describes implementation work as a kind of joint expedition with the people responsible for change. It is not top-down persuasion and certainly not the caricature some assume. “People sometimes say, ‘So you’re a marketer?” she says, amused. “Absolutely not. There’s a whole science and methodology behind this work. We’re not selling a product; we’re figuring out how to embed what’s been proven into a living system with all its complications.”
A new discipline, and what it takes to build one
Implementation science is well developed in Canada, the UK, Australia, and Brazil, but it is still emerging in Israel. “There are three of us in the country: me, one professor at Hebrew University, and one at Bar-Ilan,” Ellen explains. Instead of feeling isolated, through IS-PEC, she chose to create a community.
She established a national forum that meets with all three research groups and their students monthly. “It was somewhat lonely working alone," she admits. “So, we gather to collaborate, ask questions, and develop the field. That’s how disciplines grow.”
Her Canadian academic background, shaped by a collaborative culture, influences her. “Working alone doesn’t work in my world,” she says. “To create change, you need people across different disciplines, institutions, and levels of the system. There’s no other way.”
This ethos aligns with her warm view of Ben-Gurion University, which she describes as highly collegial. “People genuinely want to help. My department feels like a big family. Even if someone isn’t involved in a project, they’ll connect you with people who can assist. It’s such a collaborative environment."
Her collaborative spirit also informs her of barriers to applying evidence. The first barrier is often human. “People believe they know better than the research,” she notes. “You hear, ‘We already do that,’ or ‘Our situation is unique,’ or ‘I won’t practice cookbook medicine.'" She doesn’t dismiss local differences, far from it. “Every country has unique issues, but the core problem isn’t new. Similar issues have occurred elsewhere; we can learn from them and adapt accordingly."
What frustrates her is not the focus on local nuances but the refusal to consider outside perspectives. A second barrier is the mismatch in pace between policymakers and researchers. “Research progresses at one speed; policy at another,” she explains. “They don’t share the same incentives, timelines, or even language sometimes."
Beyond pace, ego, and habits, human emotion complicates things. “Implementation is messy,” she says. "It involves dealing with people and all their complexities. That’s what makes it challenging but also beautiful." Her pragmatic yet idealistic outlook extends to academia. When asked about her desired impact, she responds: "I wish the default was: What does the evidence say? Before designing a study, let’s see what’s been done so we avoid duplicating efforts."
During her PhD work on clinical practice guidelines, she realized people rarely use these evidence-based tools despite knowing their value. "Billions are invested in research," she reflects. "How do we ensure it impacts practice instead of collecting dust?"
This practical and ethical concern underpins all her work. It also explains her persistent focus on implementation challenges, not despair. She sees her work as navigating a dynamic space where ideas meet reality, a place where she feels at home.
In this space – challenging, chaotic, often frustrating – Ellen is a builder. “Our role is to make sure academic research is implemented,” she affirms. “Bridging the gap between knowing and doing." This could be her mantra, but in her voice, it’s more a promise: knowledge doesn’t have to be inert, systems can evolve, and even in a world flooded with information, there’s an urgent need for those who can turn evidence into action.
This article was written in collaboration with Ben-Gurion University of the Negev.