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    ROCC Member Spotlight: Amy Abernethy, M.D., Ph.D.

    The Research on Care Community highlights Amy Abernethy, M.D/Ph.D. who serves as Director for the Center for Learning Healthcare at Duke University as well as the lead at the Duke Cancer Care Research Program. Amy’s work connects the Duke Cancer Institute and brings together practical solutions and facilitated learning for research investigations in an academic environment. As a Learning Health Systems Planning Awardee, Amy will lead Duke University in the development of The Duke University Learning Health System Training Program (LHSTP), which aims to support systematic change in the provision of graduate medical education to better meet the needs of an LHS, and preparing future physicians to be practitioners of “evidence-based medicine version 2.0.” In the initial pilot, LHSTP will implement a novel educational program to train high-level users of the LHS.

    What does the Duke Learning Health System Training Program (LHSTP) seek to accomplish?

    The LHSTP will build clinician skills in practice-assessment and the acquisition and analysis of practice-based data.  The goal is to teach clinicians (starting with residents and fellows) how to blend research-derived evidence published in the medical literature with data generated within day-to-day clinical practice in order to improve future practice. 

    How will the LHSTP enhance the capacity for research at Duke?

    The LHSTP will increase clinician understanding of data, data quality, and the value of complete data for their own personal learning.  Better understanding of data leads to higher quality institutional data resource that can be used for research and clinical care.  In fact, our own research shows that real-time use of clinical data (e.g. through reporting and electronic triage methods) increases the meaning of the information to clinicians and patients; as a result, more meaningful data is more likely to be corrected or collected correctly in the first place, thereby leading to improved data quality and more complete datasets (i.e., reduced missing data).  Second, it will increase clinician understanding of the kinds of hypotheses that can be generated and/or addressed using health system data.  Third, it will reinforce clinician understanding of the interrelationship between clinical care, conducting research to answer clinically relevant questions, implementing research findings into day-to-day practice, and identifying subsequent questions to answer – all critical elements of a learning health system.

    What is the potential impact of a learning health system for the research community at large? 

    The research community needs clinicians who understand and value data.  Clinical practice has historically been a qualitative, story-driven profession – and it should still be.  That being said, stories can be transformed into discrete, analyzable data.  And this process is easier and more reliable when clinicians understand the link.  The LHSTP intends to teach clinicians the tools of EBM 2.0, but its underlying purpose is to expose clinicians to the importance and value of high-quality data.  This is important for research – and for clinical care.  In aggregate, this has enormous potential for the research community at large.  Just like traditional EBM catapulted the role of the clinical trial and systematic review to the forefront, EBM 2.0 intends to accelerate understanding of analyzable data and the critical relationship between data, research and improving clinical practice further catapulting the importance of research in the minds of practicing clinicians.

    What are the anticipated challenges to successfully implementing the LHSTP and the process change that is required? How will your team plan to overcome these challenges?

    One of the challenges that we face is the ability to engage house staff from programs throughout the health system.  We have a strong cohort of internal medicine residents and internal medicine subspecialty fellows, aligned with Dr. Mary Klotman’s (Chair of Medicine) endorsement of the program throughout her Department.  We are looking to expand the LHSTP to include trainees from pediatrics, surgery, radiology and anesthesiology, among others, in upcoming cohorts.  To overcome this challenge, we have been actively working with program directors from these disciplines to identify and recruit applicants from these programs for the Fall 2014 cohort.