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Edward C. Chao, DO, says collaboration is the answer and offers three simple steps.
Can our patients’ and our own challenges and pain points spark a search for solutions?
One May evening nearly 3 years ago, hearing a mid-year grant update on a wearable sensor led me to think about many of our patients’ struggles with self-testing blood glucose (SMBG). That serendipitously led to a collaborative investigation on needle-free glucose monitoring with Joseph Wang, PhD, and his team of nanoengineers at the University of California San Diego (UCSD) where I currently teach and do research.
Healthcare professionals face gaps every day - between what we aspire to, and where we currently stand. A case in point: the divide between research and practice. Discoveries can take decades to reach patients, as tests or treatments. Translational research aims to catalyze discoveries from the bench to the bedside and bedside to community.1
The NIH’s National Center for Advancing Translational Sciences Program supports an innovative national network of centers that promote translational research2; UCSD’s Clinical and Translational Research Institute is 1 of among more than 50.3
How can we harness the best of research and practice, so that each informs and improves the other?
1. We must reach out and regularly engage with our colleagues across disciplines.
Steve Jobs purposely designed the new Pixar and Apple headquarters to be circular to promote spontaneous encounters among employees.
Opportunities for cross-disciplinary interactions and bouncing ideas off one another are virtually limitless and many are already within reach. These can be local-the grant update I attended was UCSD’s Academy of Clinician Scholars’ biannual meeting. There are also grand rounds, CME courses, and regular workshops. On a larger scale, there are annual professional society meetings-the American Diabetes Association’s Scientific Sessions, or the annual meeting of the American Association of Clinical Endocrinologists. Simply seek out a colleague from the academic world if you’re in private practice, or vice versa. One of my mentors is an anesthesiologist, and we’ve had some immensely interesting conversations that have generated ideas we have put to use.
2. Keep patients at the core.
We speak often of patient-centered care, but what about in research? The Patient-Centered Outcomes Research Institute (PCORI) involves patients, caregivers, and other individuals who historically have not been at the table when studies were designed.4
“In my community, folks are looking for answers, and PCORI lets them be a part of finding those answers,” Neely Williams, a pastor and a PCORI patient co-investigator said. “PCORI engages patients in meaningful, respectful ways that allow them to feel like not a subject but a part of the solution to the problem they're facing ...They gain more ownership. People who would never ask their doctor a question say, ‘I’m going to ask my doctor about this.’”
Elizabeth D. Cox, MD, PhD, a pediatric health services researcher at the University of Wisconsin-Madison, applauded this concept. “Working with stakeholders helped our project focus on research that solves the problems that matter most to patients and families,” Cox said. “The stakeholders helped revise our study procedures to better recruit and retain diverse participants...Another project engaged children with type 1 diabetes and their parents to tailor diabetes self-management resources to the unique needs of each child and family.”
3. Heed Howard Jones’ advice!
The great singer had it right: “Always asking questions. We’re always asking questions.” Why do some patients not implement our clinical recommendations? What limits some individuals from adhering with regular SMBG? What’s something in my clinic that bothers me, that’s inefficient, or can be improved? We must continually ask questions, and doggedly pursue ways to bring improved therapeutic agents and devices to market, but also enhanced ways to help patients access these advances.
I urge you to take action, by learning more! Connect with a colleague from “across the aisle,” whatever that potential divide may be. Discuss clinical trials with your patients. Share your experiences here, and let’s all recommit to closing those gaps a bit more, each day.
1. Woolf SH. The Meaning of Translational Research and Why It Matters. JAMA. 2008;299:211–213.
2. US Department of Health and Human Services, National Institutes of Health. National Center for Advancing Translational Sciences. https://ncats.nih.gov/index.php. Accessed April 28, 2018.
3. Altman Clinical and Translational Research Institute, University of California San Diego. https://actri.ucsd.edu/Pages/default.aspx. Accessed April 28, 2018.
4. Patient-Centered Outcomes Research Institute. www.pcori.org. Accessed April 28, 2018.