Health care delivery organizations are critical partners in NIH research. A number of NIH Institutes support research involving collaborative activities between health care delivery organizations such as health maintenance organizations (HMOs). Examples include the National Cancer Institute’s (NCI's) HMO Cancer Research Network (CRN), a network of 14 healthcare systems nationwide, the National Human Genome Research Institute’s (NHGRI’s) eMERGE Network, which consists of 5 institutions with large DNA biorepositories coupled to electronic medical records, and the National Heart, Lung, and Blood Institute’s (NHLBI's) Cardiovascular Research Network, a network of 15 U.S. member health plans of the national HMO Research Network (HMORN). These collaborative programs have established valuable paradigms for the operation of distributed health networks that preserve patient privacy and protect proprietary information while developing valuable research resources for the nation’s health.
The intent of this initiative is to build on these investments and to take advantage of new opportunities. Currently health care delivery is changing rapidly as many health care delivery organizations are forging new partnerships, and working to improve care through the strengthening of electronic health records; this period of change is creating an opportunity for transformation in the methods of clinical research. Through Common Fund support, the NIH intends to test the proposition that enhanced cooperative activities between the NIH and health care delivery organizations can transform methods of clinical research and contribute to solutions of some of the current pressing challenges in clinical research.
One major challenge is the cost-effective implementation of pragmatic clinical trials to test health care interventions in real world settings. Greater use of health care delivery settings is critical for such studies, both to leverage the resources of heath care delivery organizations, especially the growing capabilities of electronic health information systems, and to strengthen the translation of research results to ‘real world’ health practice. A major goal of the HMO Collaboratory is to strengthen the national capacity to implement important pragmatic research studies in real world health care delivery settings.
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