The Research on Care Community highlights Ted Wun, M.D. who serves as a professor and associate dean for research, chief for the Division of Hematology-Oncology and director for the Clinical Research Center at UC Davis. In this month’s Member Spotlight, Dr. Wun shares how the UC Davis CTSC facilitates knowledge transfer and engagement with researchers, clinicians, and health systems. Learn more about the UC Davis CTSC initiatives or download Dr. Wun’s ROCC star profile.
Please describe the approaches at the UC Davis CTSC that facilitate knowledge transfer and engagement of researchers, clinicians, and health systems
The CTSC Bioinformatics Program has helped researchers and clinicians build disease team registries through the electronic health record. These registries accumulate real-time data on various populations and are used to track quality metrics and answer research questions. Examples include transfusion, diabetes, and sepsis registries. Another example is using EHR derived data to track the implementation of a project to increase appropriate venous thromboembolism prophylaxis across the UC system. The other tactic we've used is pilot funding for outcomes/implementation projects. We just awarded 3. This is a good way to create new teams and stimulate research.
What suggestions do you have for researchers interested in engaging/collaborating with clinicians and colleagues across disciplines?
Find clinicians engaged "on the ground" and engage as many interested parties as you are able. However, one also needs to identify a few champions that keep things moving forward. An example is a recent sickle cell care improvement project at our hospital. M.D. from hospital medicine, adult and pediatric hematology, and emergency medicine; R.N. from the wards, E.D., and outpatient clinics; Hospital Lean and EHR teams; and perhaps most importantly patients directly affected by the initiative. Identify an important AND very feasible project that has a relatively near-time deliverable. This results in a win that keeps the enthusiasm going.
Based on your experience with the UC Davis CTSC, what are the biggest opportunities for clinical and translational science? Biggest barriers?
There are so many it is hard to pick a few. On the one end is translating the incredible amount of new knowledge about basic pathophysiology into therapeutic interventions. On the other end is dissemination and implementation science to make sure that therapeutic gains are actually used appropriately. The recent emphasis by NIH and PCORI to conduct large pragmatic trials also is a great opportunity to answer important questions.
The biggest barrier is, of course, having adequate resources (workforce, time, money) to answer these questions. This will force us to be smarter and more efficient in the design and conduct of our research. We probably should also be better at picking the questions that have the potential to have the most impact.
What processes/policies are critical to ensuring that knowledge generated from research has the greatest opportunity to impact health care?
Clinical research needs to be designed in such a way as to ensure maximal generalizability for the affected population. Dissemination and implementation strategies should be considerations in design. Policymakers must not be hesitant to denigrate those therapies that have been clearly proven to be inferior and/or harmful.