AMIA: Clinical research and care need to be better aligned

Despite widespread adoption of electronic health record systems by providers, data-driven healthcare remains “overwhelmingly” unrealized.

That’s the conclusion of a new American Medical Informatics Association paper, published on Wednesday in JAMIA Open, which calls for better integrating clinical research and clinical care to fully leverage America’s existing healthcare information technology infrastructure.

“Increasingly, all health stakeholders have the opportunity—and obligation—to leverage health information technology systems, and the valuable data they contain, for the development and delivery of new interventions,” state the paper’s authors.

“However, despite the unprecedented volumes of clinical data generated each day across hospitals, physician offices, urgent care facilities and neighborhood walk-in clinics, the ability to leverage these data to increase our knowledge of health and disease and drive improvements in care remain overwhelmingly unrealized,” they contend.

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“Increasingly, clinical care activities generate the data foundations for biomedical and health services research,” said AMIA Board Chair Peter Embi, MD, the paper’s lead author and CEO of the Regenstrief Institute. “If we are to realize the promise of our national investment in health IT, we must reimagine how research relates to clinical practice—and vice versa—so that we can learn systematically from each healthcare encounter, facilitate biomedical discovery, and advance our collective understanding of health. This is core to evidence-generating medicine and the creation of learning health systems.”

AMIA’s paper, which provides more than a dozen public policy recommendations meant to facilitate the generation of evidence, is divided into three areas:

• Nodes—policies needed to facilitate evidence generation at the local level;
• Networks—policies needed to facilitate clinical research across organizations; and
• Sustainability—policies needed to maintain a national research ecosystem.

“We explore and suggest public policies needed to facilitate (evidence-generating medicine/evidence-based medicine) activities on a national scale, particularly those policies that can enable and improve clinical and health services research at the point-of-care, accelerate biomedical discovery, and facilitate translation of findings to improve the health of individuals and populations,” states the paper.

Based on the paper’s recommendations, AMIA is launching a new initiative in 2019 focused on advancing informatics-enabled improvements to the U.S. healthcare system. The group said a forthcoming report detailing the strategy will be released at a December conference in Washington.