In this episode of the NIH Collaboratory Grand Rounds podcast, Dr. Lesley Curtis speaks with Dr. Robert Califf, Head of Strategy and Policy at Verily Life Sciences and Google Health about whether the COVID-19 crisis can lead to reformation of the current healthcare delivery system. This discussion follows Dr. Califf’s keynote presentation of a Grand Rounds Series titled Advances at the Intersection of Digital Health, Electronic Health Records, and Pragmatic Clinical Trials.
Click on the recording below to listen to the podcast.
The Healthcare Worker Exposure Response & Outcomes (HERO) Registry invites both clinical and nonclinical healthcare workers to share their life experiences in order to understand the perspectives and problems faced by those on the COVID-19 pandemic frontlines. HERO Registry participants could have the opportunity to participate in future research studies to improve the understanding of COVID-19 and beyond, generating evidence to help healthcare workers stay safe and healthy.
The HERO Registry is open to all healthcare workers, including nurses, therapists, physicians, emergency responders, food service workers, environmental service workers, interpreters, transporters — anyone who works in a setting where people receive health care.
An article on the Healthcare Innovation website last week highlighted the launch of the NIH Collaboratory’s special Grand Rounds series on electronic health records (EHRs). The article discusses a presentation by Dr. Robert Califf, head of strategy and policy for Verily Life Sciences and Google Health, who envisioned how the healthcare system can learn from innovations being implementing during the COVID-19 emergency. Dr. Califf gave the opening keynote address for the EHR workshop series.
The article mentions the new Healthcare Worker Exposure Response and Outcomes (HERO) registry, funded by the Patient-Centered Outcomes Research Institute (PCORI), and the RECOVERY Trial, a national platform trial in the United Kingdom. Both of these COVID-19 studies were recently featured on NIH Collaboratory Grand Rounds.
Recording June 30, Available July 7, 2020: Podcast: Summary Expert Panel Discussion (Patrick J. Heagerty, PhD; Keith Marsolo, PhD; Wendy Weber, ND, PhD, MPH; Moderator: Lesley H. Curtis, PhD)
The NIH Collaboratory Coordinating Center is using its popular Grand Rounds platform to share late-breaking research and promote resources in support of clinical researchers affected by the COVID-19 public health emergency.
In this week’s COVID-19 Grand Rounds session, Dr. Derek Angus of the University of Pittsburgh will present “Optimizing Learning While Doing: The REMAP-CAP Adaptive Platform Trial.” The REMAP-CAP trial is an adaptive platform trial of treatments for community-acquired pneumonia. The trial team recently implemented a COVID-19 pandemic appendix to the core protocol. The Grand Rounds session will be held on Friday, May 15, at 1:00 pm eastern. Join the online meeting.
In case you missed the May 1 keynote address by Robert M. Califf, MD, MACC, you can now listen to the recorded webinar and Q&A. Dr. Califf, head of strategy and policy for Verily Life Sciences and Google Health, kicked off the Collaboratory’s Grand Rounds workshop series, Advances at the Intersection of Digital Health, Electronic Health Records, and Pragmatic Clinical Trials.
His presentation outlined several opportunities to drive change and rebuild clinical research in the aftermath of COVID-19, including:
Evaluate what has and has not worked in the changes that have been made in response to the crisis
Allocate a significant part of recovery funding to transition issues in evidence generation, especially at the interface of medicine and public health
Do everything possible to fix the “purposefulness issue”:
Create methods for deciding the most important questions
Reward behavior that gets important questions answered quickly
Develop inclusive networks driven by people with the health problems of interest; increase incentives for clinicians and investigators that lead to reliable and faster evidence generation (balance financial focus with purpose); and automate mapping of EHR data beyond individual systems
“The effective use of digital information such as electronic health records, telehealth, applications, and patient-reported outcomes should free up effort to fix the human components that are holding us back.” – Dr. Robert Califf
Recording June 30, Available July 7, 2020: Podcast: Summary Expert Panel Discussion (Patrick J. Heagerty, PhD; Keith Marsolo, PhD; Wendy Weber, ND, PhD, MPH; Moderator: Lesley H. Curtis, PhD)
Clinicians and researchers at Seattle’s Harborview Medical Center documented their experiences in the early weeks of the COVID-19 outbreak in King County, Washington. Their report offers lessons from clinical and research personnel, patients, and peer interventionists during the evolving pandemic response in an early US COVID-19 epicenter.
The article, published online in Psychiatry, presents a case series of experiences of frontline clinical and research teams in incorporating COVID-19 prevention strategies in the context of an ongoing comparative effectiveness trial of multidisciplinary, peer-integrated care coordination for patients with severe injury. The report also describes key themes from qualitative data collected during daily team meetings for the Trauma Survivors Outcomes and Support (TSOS) study, a pragmatic clinical trial also underway at Harborview. TSOS, an NIH Collaboratory Trial, is a stepped-wedge, cluster randomized pragmatic trial testing the delivery of screening and intervention strategies for patients with posttraumatic stress disorder and comorbid conditions at 24 level I trauma centers in the United States.
The case series offers evidence that primary and secondary prevention strategies can be integrated into ongoing clinical and research interventions during pandemic response. Procedures can also be developed to support team members who are adapting to rapidly changing individual, organizational, and societal demands.
This work was supported in part by the Patient-Centered Outcomes Research Institute (PCORI). TSOS is supported within the NIH Collaboratory by a cooperative agreement from the National Institute of Mental Health and by the NIH Common Fund through a cooperative agreement from the Office of Strategic Coordination within the Office of the NIH Director.
For more news and resources related to the COVID-19 public health emergency, see the COVID-19 Resources page.
Robert Califf, MD, MACC Head of Strategy and Policy Verily Life Sciences and Google Health
Topic
Advances at the Intersection of Digital Health, Electronic Health Records, and Pragmatic Clinical Trials: Keynote-Can the COVID-19 Crisis Lead to Reformation of the Evidence Generation Ecosystem?
Keywords
Electronic health records; Digital health; Mobile health; Coronavirus; COVID-19; Ecosystem; Clinical trials; Evidence generation
Key Points
The HERO Registry and RECOVERY Trial are good examples of a rapid clinical research response to the urgent COVID-19 health crisis.
Among the essential steps to move the evidence generation system in the right direction:
Evaluate what has and has not worked in the changes made in response to the crisis
Allocate a significant part of recovery funding to transition issues in evidence generation, especially at the interface of medicine and public health
Increase purposefulness by creating methods for deciding the most important questions and rewarding behavior that gets those questions answered quickly
Discussion Themes
The COVID-19 pandemic has shone a spotlight on disparities in our current healthcare delivery system. How can we avoid leaving the most vulnerable of society behind?
Telemedicine can be a framework for the integration of research and clinical care. But the digital element must be integrated with the human element. The routine and effective use of digital information should free up effort to fix the human components that are holding us back.
We’ve been trying to modernize clinical trial design for decades (factorial/sequential/adaptive designs for example). While some positive movement in the past month has been made, the research enterprise remains largely conservative when it comes to design modernization. How do we make more rapid progress?
The NIH Collaboratory will use its ePCT Grand Rounds platform on Friday, May 1, to launch a special workshop series on electronic health records (EHRs). The webinar series, Advances at the Intersection of Digital Health, Electronic Health Records and Pragmatic Clinical Trials, will highlight advances in digital health, new approaches and evolving standards for EHRs, and implications for researchers conducting pragmatic trials.
Recording June 30, Available July 7, 2020: Podcast: Summary Expert Panel Discussion (Patrick J. Heagerty, PhD; Keith Marsolo, PhD; Wendy Weber, ND, PhD, MPH; Moderator: Lesley H. Curtis, PhD)
The NIA IMPACT Collaboratory has announced 2 new funding opportunities to support embedded pragmatic clinical trials (ePCTs) of nonpharmacological interventions within healthcare systems to improve the care of people living with Alzheimer disease and related dementias and their care partners. Applications that address dementia care for people of all backgrounds and that promote health equity are a high priority.
Career Development Awards: The NIA IMPACT Collaboratory funds 2 to 3 career development awards annually. These awards support the development of early-stage investigators who seek careers conducting ePCTs. Optional informational webinars on April 29 and May 20 will provide prospective applicants with an overview of application details. The webinars will be recorded and posted online. Read the full funding opportunity description.
Pilot Studies: The NIA IMPACT Collaboratory funds several 1-year pilot studies annually to support the generation of preliminary data necessary to design and conduct a full-scale ePCTs. In response to the COVID-19 public health emergency, this cycle of awards will prioritize applications that propose pilot ePCTs of telemedicine, telehealth, and remote technologies interventions. An optional informational webinar on May 6 will provide prospective applicants with an overview of application details. Read the full funding opportunity description.
The NIA IMPACT Collaboratory is supported by a grant from the National Institute on Aging.
