Health care has been called one of the most complex sectors of the U.S. economy. Driven largely by robust innovation in treatments and interventions, this complexity has created an increased need for evidence about what works best for whom in order to inform decisions that lead to safe, efficient, effective, and affordable care. As health care becomes more digital, clinical datasets are becoming larger and more numerous. By realizing the potential of knowledge generation that is more closely integrated with the practice of care, it should be possible not only to produce more usable evidence to inform decisions, but also to increase the efficiency and decrease the costs of doing clinical research.
Patient-Centered Clinical Research Network, or PCORnet, is a nation-wide patient-centered clinical research network intended to form a resource of clinical, administrative, and patient data that can be used to carry out observational and interventional research studies and enhance the use of clinical data to advance the learning health care system. The primary goal of the first phase of PCORnet will be to establish the data infrastructure necessary to do such research.
In April and June 2014 the Institute of Medicine's Roundtable on Value and Science-Driven Health Care convened two workshops aimed at accelerating progress toward real-time knowledge generation through the seamless integration of clinical practice and research, one of the fundamental concepts of a continuously learning health system, centered on the development of the PCORnet. The first workshop brought together health care system leaders, both administrative and clinical, and researchers to consider issues and strategic priorities for building a successful and durable clinical research network and facilitate progress toward a continuously learning health care system more broadly, including issues related to science, technology, ethics, business, regulatory oversight, sustainability, and governance. The second workshop focused on implementation approaches. Health system CEOs convened to consider strategic priorities and explore approaches to implementation. These workshops will inform the decisions of field leaders moving forward, including PCORI, the PCORnet steering committee, and PCORnet grantees. Integrating Research and Practice is the summary of the presentations and discussions of the workshops.
Table of Contents
|1 Introduction and Overview||1-10|
|2 Continuous Learning and Improvement in Health Care||11-30|
|3 Continuously Learning Health Care: The Value Proposition||31-44|
|4 Integrating Clinical Research and Practice: Examples||45-56|
|5 Creating the Conditions for Sustainability||57-70|
|6 Addressing Issues of Regulatory Oversight||71-84|
|7 Governance That Accelerates Progress and Sustainability||85-96|
|8 Fostering the Well-Prepared Stakeholder Culture||97-108|
|9 Multiuse Infrastructure for Continuous Learning||109-118|
|10 Continuous Learning as an Executive Agenda Priority||119-148|
|11 Recurring Workshop Themes||149-152|
|Appendix A: Workshop Agendas||155-166|
|Appendix B: Biographical Sketches of Workshop Speakers||167-194|
|Appendix C: Workshop Attendees||195-206|
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