Kilbourne Amy M, Jones Patricia L, Atkins David
Health Services Research and Development, Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, DC, USA.
Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA.
J Clin Transl Sci. 2020 Mar 17;4(3):195-200. doi: 10.1017/cts.2020.25.
Translation of research to practice is challenging. In addition to the scientific challenges, there are additional hurdles in navigating the rapidly changing US health care system. There is a need for innovative health interventions that can be adopted in "real-world" settings. Barriers to translation involve misaligned timing of research funding and health system decision-making, lack of research questions aligned with health system and community priorities, and limited incentives in academia for health system and community-based research. We describe new programs from the US Department of Veterans Affairs Health Services Research and Development (HSR&D) and the National Center for Advancing Translational Sciences (NCATS) Clinical and Translational Science Award (CTSA) Programs that are building capacity for Learning Health System research. These programs help to incentivize adopting and adapting Learning Health System principles to ensure that, primarily in implementation science within academic/veterans affairs health systems, there is alignment of the research with the health system and community needs. Both HSR&D and NCATS CTSA Program encourage researchers to develop problem-focused research innovations in partnership with health systems and communities to ultimately facilitate design treatments that are feasible in "real-world" practice.
将研究成果转化为实际应用具有挑战性。除了科学方面的挑战外,在美国快速变化的医疗保健系统中导航还存在其他障碍。需要有能够在“现实世界”环境中采用的创新性健康干预措施。转化过程中的障碍包括研究资金与卫生系统决策时间不一致、缺乏与卫生系统和社区优先事项相一致的研究问题,以及学术界对卫生系统和基于社区的研究激励不足。我们介绍了美国退伍军人事务部卫生服务研究与发展局(HSR&D)以及美国国立转化医学推进中心(NCATS)临床与转化科学奖(CTSA)项目中的新项目,这些项目正在建设学习型卫生系统研究的能力。这些项目有助于激励采用和调整学习型卫生系统原则,以确保主要在学术/退伍军人事务卫生系统内的实施科学中,研究与卫生系统及社区需求保持一致。HSR&D和NCATS CTSA项目都鼓励研究人员与卫生系统和社区合作,开发以问题为导向的研究创新,最终促进设计出在“现实世界”实践中可行的治疗方法。