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Bringing the Gold Out of the Mine

February 21, 2009
by Mark Hagland
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The announcement on Feb. 16 that the ANSI organization is working to facilitate the use of electronic health information to support clinical research activities nationally and internationally is of serious interest, and something that CIOs should be paying real attention to. When we published ourMarch 2008 cover on the linkage between academic research and the EMR, it was clear then that we were near to the first steps on a very long journey. The potential for benefiting both research and patient care by creating more flowing data connections between the two is huge; but at the present time, very few organizations--even and including the most innovative academic medical centers--are beyond the very initial steps of creating critical data linkages that will improve patient care and also improve the ability to conduct innovative clinical research. So the fact that 27 academic organizations have stepped forward with support (including financial) in this effort, is a very positive development indeed. Years from now, I'm sure we'll look back at the present period and say, on the one hand, gosh, it really took them a long time to create that research-patient care thruway, didn't it? But on the other hand, great that they all started getting things moving when they did. And for CIOs, these developments pose a happy challenge. Particularly if they're at an academic medical center, they need to start working with the clinical research leaders at their organization to begin to figure out ways to build the interconnections within their organization, while cooperating with this national initiative going forward. The good news for everyone is that, even if they're in non-teaching community hospitals, eventually, the benefits of these developments will accrue to their organizations in the form of accelerated research-driven improvements to patient care. In other words, we all have skin in this game. And there's reason for real optimism going forward in this area, even as we recognize that it will take a very long time to see the most practical results from the foundation that is starting now to be laid in linking clinical research and patient care improvements via data innovation and integration.



There is a lot of new money (relative to historical spending) in the stimulus package for comparative effectiveness research.

AHRQ, for example, is likely to need to double it's grant and contract management capacity, according to one, off-the-record official.  It's a great problem to have; it's still a big challenge.

That research, combined with adherence to data standards (some of which are hidden in certification requirements), the CTSA funding construct (aka translational medicine), and the growing dissatisfaction with current practices are all coming together nicely, toward the goals you described.

I strongly agree with your observation that it's going to be a long road. A great, important journey, and a long one that calls for Marathon Thinking (as opposed to sprint thinking), preparation and execution.  It's a kind of discipline to a routine that is particularly hard when organizations are running with skeletal staffs and budgets, and being offered additional new work whose pay-off starts in 2011.  That's just what I'm hearing.  I'm not complaining.  Again, it's a better challenge to have than not!

Tim Tolan,
My apologies for missing this comment at the time you made it. But your comment was extremely helpful, thank you!