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Implementation of a Precision Oncology Program as an Exemplar of a Learning Health Care System in the VA

Traditional research methods, well suited for scientific discovery and drug development, fall short of providing health care systems with pragmatic information in 2 important ways: Current funding and institutions cannot support comparative effectiveness studies in sufficient numbers to answer the plethora of important clinical questions that confront health care providers (HCPs). The resultant knowledge gap manifests in treatment variability based on clinician impression rather than on direct evidence. A second equally important deficiency is the inability to make full use of the knowledge acquired in treating past patients to determine the best treatment option for the current patient.

Digitization of medical records, creation of health care system corporate data warehouses, and state-of-the-art analytical tools already allow for this revolutionary approach to patient care. Obstructing progress, however, is a lack of understanding by health care system managers and HCPs of the capability of the approach, and unfamiliarity with the requisite informatics by traditional medical researchers. Furthermore the regulatory approach is tilted against the reuse of medical record data for learning and toward strict adherence to patient confidentiality.

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Louis Fiore, MD, MPH; Ryan E. Ferguson, PhD, ScD, MPH; Mary Brophy, MD, MPH; Valmeek Kudesia, MD, MS; Colleen Shannon, MPH; Andy Zimolzak, MD, MMSc; Karen Pierce-Murray, RN; Sara Turek, MPH; and Philip Lavori, PhD

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Louis Fiore, MD, MPH; Ryan E. Ferguson, PhD, ScD, MPH; Mary Brophy, MD, MPH; Valmeek Kudesia, MD, MS; Colleen Shannon, MPH; Andy Zimolzak, MD, MMSc; Karen Pierce-Murray, RN; Sara Turek, MPH; and Philip Lavori, PhD

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Louis Fiore, MD, MPH; Ryan E. Ferguson, PhD, ScD, MPH; Mary Brophy, MD, MPH; Valmeek Kudesia, MD, MS; Colleen Shannon, MPH; Andy Zimolzak, MD, MMSc; Karen Pierce-Murray, RN; Sara Turek, MPH; and Philip Lavori, PhD

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Traditional research methods, well suited for scientific discovery and drug development, fall short of providing health care systems with pragmatic information in 2 important ways: Current funding and institutions cannot support comparative effectiveness studies in sufficient numbers to answer the plethora of important clinical questions that confront health care providers (HCPs). The resultant knowledge gap manifests in treatment variability based on clinician impression rather than on direct evidence. A second equally important deficiency is the inability to make full use of the knowledge acquired in treating past patients to determine the best treatment option for the current patient.

Digitization of medical records, creation of health care system corporate data warehouses, and state-of-the-art analytical tools already allow for this revolutionary approach to patient care. Obstructing progress, however, is a lack of understanding by health care system managers and HCPs of the capability of the approach, and unfamiliarity with the requisite informatics by traditional medical researchers. Furthermore the regulatory approach is tilted against the reuse of medical record data for learning and toward strict adherence to patient confidentiality.

Click here to continue reading.

Traditional research methods, well suited for scientific discovery and drug development, fall short of providing health care systems with pragmatic information in 2 important ways: Current funding and institutions cannot support comparative effectiveness studies in sufficient numbers to answer the plethora of important clinical questions that confront health care providers (HCPs). The resultant knowledge gap manifests in treatment variability based on clinician impression rather than on direct evidence. A second equally important deficiency is the inability to make full use of the knowledge acquired in treating past patients to determine the best treatment option for the current patient.

Digitization of medical records, creation of health care system corporate data warehouses, and state-of-the-art analytical tools already allow for this revolutionary approach to patient care. Obstructing progress, however, is a lack of understanding by health care system managers and HCPs of the capability of the approach, and unfamiliarity with the requisite informatics by traditional medical researchers. Furthermore the regulatory approach is tilted against the reuse of medical record data for learning and toward strict adherence to patient confidentiality.

Click here to continue reading.

References

Note: Page numbers differ between the print issue and digital edition.

References

Note: Page numbers differ between the print issue and digital edition.

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26S-30S
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Implementation of a Precision Oncology Program as an Exemplar of a Learning Health Care System in the VA
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Implementation of a Precision Oncology Program as an Exemplar of a Learning Health Care System in the VA
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