ASPO Abstracts
The role of learning health systems in advancing preventive oncology
Category: Electronic Health Records (EHRs), Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2018
Abstract Body:
Background: Translating cancer research results into improvements in real world cancer care is a persisting challenge. Many aspects affect the implementation and adoption of successful interventions in clinical practice, including patient, clinician, and system-level factors. Moreover, recent research has highlighted disparities in receipt of efficacious interventions, even when we have compelling evidence. We need to start asking why these gaps persist and explore the active role(s) we can take as researchers to ensure that our research has the intended impact of improving cancer prevention and control in community-based clinical practice. Methods: The National Academy of Medicine and others have proffered the continuous Learning Health System as a relatively new paradigm that aims to close the translation gap between research evidence and clinical practice. This model proposes that leveraging electronic health record data and informatics, utilizing novel clinical trial designs such as cluster randomized trials, and involving patients and other stakeholders will accelerate continuous improvement and innovation. In an ideal learning health system, evidence and best practices are seamlessly embedded in care delivery, and new knowledge is harvested from each patient’s care experience. Results: The learning health system model can catalyze rapid advances in cancer prevention and control, as demonstrated through specific use cases of research conducted by members of the Health Care Systems Research Network. Use cases will highlight the facilitators and barriers encountered in working with real-world care delivery systems. Facilitators include ability to harvest comprehensive data from robust and mature EHRs, and the use of patient portals to collect patient-reported outcomes. Barriers include aligning research with health system priorities, and the need to engage frontline clinicians in ways that seamlessly integrate a research study into routine clinical operations. Conclusion: Partnering with health system clinical and operational leaders to conduct pragmatic trials in cancer care can increase the uptake of results from observational research to inform care delivery. Additional training is needed to support cancer researchers working in delivery systems.
Keywords: learning health system, implementation, care delivery