By Dr. Patrick Parfrey
Research within the Faculty of Medicine at Memorial University of Newfoundland is about to enter a new era.
For decades, researchers at our facility followed traditional routes to answer their research question with the hope of finding a sometimes elusive answer that could affect change. Conventionally at the end of the project, with luck, a good research paper was published in a high-impact journal. And for a substantial amount of time these findings didn’t move in the direction of change the researchers had hoped.
The Translational & Personalized Medicine Initiative (TPMI) is a program that will support the broader goals of health system reform through the creation of a sustainable health system by reducing inappropriate utilization, increasing efficiencies, improving cost effectiveness, and improving patient outcomes.
The TPMI itself is made up of two major programs, the Quality of Care Program and the Translational Genomics Program.
The Quality of Care Program will focus on identifying and addressing inappropriate utilization of health care resources using sophisticated analytical techniques through linkage of administrative, clinical and research databases.
The areas identified for improvement will require an electronic intervention, an evaluation of this intervention, and a health policy system that can sustain improvements in utilization. This program will merge health information with health analytics so that interventions to improve utilization can be identified and tested and health policy can be developed to sustain change.
The Translational Genomics Program’s goal is improved population health through the application of genomic discoveries. While genomics research has accelerated to explain the genetic basis of multiple diseases, the translation of these discoveries has been slow, particularly in transfer “from the bench to the clinic,” but also in the transfer from the clinic to the community.
Translational research is coupled with the concept of personalized medicine in which all known patient risk factors, including genetics, are integrated at the point of care to stratify patients at different risks of adverse outcomes.
There is an applied research deficit in demonstrating the diagnostic utility of genomics testing, the clinical and cost-effectiveness of genomics testing, the clinical and cost-effectiveness of genomics based interventions, the social and economic benefits to the country and the ethical, environment and legal barriers associated with the application of genomics discovers.
Population-based genomics interventions are rare in this province which has multiple advantages in pursuing this agenda: a founder population associated with multiple genomic discoveries; a “captive” population isolated by geography; an interdisciplinary approach to multiple diseases determined by inheritance; a universal health care system with a functional collaboration between the health delivery system, decision makers in the Department of Health and Community Services and the Regional Health Authorities of this province.
The Center for Health Informatics and Analytics (CHIA) in collaboration with IBM will include a next generation health informatics and data analytics hardware and software platform, which will facilitate the rapid interrogation and integration of complex source data from multiple partner organizations.
Clinical data including Electronic Medical Record, Radiology, PACS, OPIS, Pharmacy, Laboratory, Financial and Administrative data from NL Centre for Health Information and the Regional Health Athorities under the appropriate protocols will be integrated with clinical research data including, molecular, epidemiological data, psycho-social data and health risk data.
The integration of this data will be managed by the partners and governed under provincial privacy and ethics legislations. This convergent data opportunity will facilitate transformational change in health system utilization, costs and health outcomes.
Our mandate as we move forward is to develop personalized medicine for the population of this province, providing the right care to the right patient at the right time.
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