Translating Knowledge into Practice
In 2001, the Institute of Medicine report Crossing the Quality Chasm(1) found that it takes 17 years to translate scientific evidence into clinical practice and that today’s patients only receive evidence-based care 50 percent of the time. One promise of the Electronic Health Record (EHR) was to close that gap by making it easier to incorporate best evidence into practice guidelines through improved collaboration and communication between the research setting and real-world clinical practice (2).
The Agency for Healthcare Research and Quality (AHRQ)(3) is furthering this agenda through a series of evidence generation projects. CHOICE (Clinical and Health Outcomes Initiative in Comparative Effectiveness)(4)is the first coordinated national effort to establish a series of pragmatic clinical comparative effectiveness studies. Specifically, this funding is focused on large projects in comparative effectiveness aimed at generating new knowledge to help inform decision making in priority areas of clinical care. PROSPECT (Prospective Outcome Systems using Patient-specific Electronic data to Compare Tests and therapies)(5)is focused on advancing the quality, depth and scale of the electronic data collection infrastructure as a basis for comparative effectiveness research. It is designed to fund up to five awards for the creation or enhancement of national patient registries, with a primary focus on the 14 priority conditions (6). DEcIDE (Developing Evidence to Inform Decisions about Effectiveness)(7) is a multi-center research system that conducts studies on the outcomes, effectiveness, safety, and usefulness of medical treatments and services. It focuses on distributed data network models that use clinically rich data from electronic health records.
Although it will take years for these projects to bear fruit, other models aimed at translating knowledge into practice are being proposed now (8).
1.  Committee on Quality Health Care in America, IOM. Crossing the quality chasm: a new health system for the 21st century. Washington DC: National Academy Press, 2001. Accessed February 24, 2010
2. Stewart WF, Shah NR, Selna MJ, Paulus RA, Walker JM. Bridging The Inferential Gap:The Electronic Health Record and Clinical Evidence. Health Affairs 26, no. 2 (2007): w181–w191 Accessed February 24, 2010
3.  Accessed February 27, 2010
4.  Accessed February 27, 2010
5.  Accessed February 27, 2010
6.  Accessed February 27, 2010
7.  Accessed February 27, 2010
8.  Taplin SH, Rollason D, Camp A, diDonato K, Maggenheimer E. Imagining and Electronic Medical Record for Turning Cancer Screening Knowledge into Practice. Am J Prev Med 2010;38(1)89-97. Accessed February 24, 2010
Submitted by Paula Scariati