BRIDG; I-SPY 2 Trial) and noted that the common denominators are that they are all standards-based, manage multidimensional data, and link care and research (i.e., they address the problem of data liquidity). These, and some of the other examples discussed during the workshop, remain isolated efforts, and Kean said that no one is tasked with or responsible for linking them into a national system.

Many of the hurdles to achieving data liquidity were highlighted throughout the workshop (e.g., appropriate sampling; high-quality, validated data; privacy; data ownership; intellectual property; IT infrastructure). If these challenges can be met, the opportunities for personalized cancer medicine and a rapid-learning health care system will abound. Kean suggested that data liquidity could also increase the “velocity of knowledge”—that is, moving from data to information to insights to knowledge to wisdom will happen much faster. This is apparent in other industries, for example, the financial industry.


Kean outlined the proposed coalition principles (Box 6-1), reiterating that they are open for further discussion. She emphasized that while the proposal calls for open technology frameworks, this does not in any way mean that the commercial IT sector will not play an important role.

Operational Strategy and Activities

As proposed, Kean said that the coalition could deliver rapid, seamless data exchange that would be facilitated by interoperability; driven by just-in-time standards; implemented in small-scale capabilities that are open at the interfaces; and developed incrementally and iteratively to address specific and immediate needs. At the same time, the coalition would be thinking about integrating and coordinating in a systematic way, so that over time these capabilities roll up into a national system.

Kean briefly listed a broad range of activities the coalition could undertake. The coalition could convene; advocate; mobilize participation; serve as an honest broker; select and apply standards and catalyze standards development where none exist; provide consulting and project management services via contracts to members; catalyze the building of capabilities that serve immediate needs via contracts to members or others; leverage successful

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