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Fiore LD, Brophy MT, Turek S, Kudesia V, Ramnath N, Shannon C, Ferguson R, Pyarajan S, Fiore MA, Hornberger J, Lavori P. The VA Point-of-Care Precision Oncology Program: Balancing Access with Rapid Learning in Molecular Cancer Medicine. BIOMARKERS IN CANCER 2016; 8:9-16. [PMID: 26949343 PMCID: PMC4772906 DOI: 10.4137/bic.s37548] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 12/15/2015] [Accepted: 12/22/2015] [Indexed: 01/26/2023]
Abstract
The Department of Veterans Affairs (VA) recognized the need to balance patient-centered care with responsible creation of generalizable knowledge on the effectiveness of molecular medicine tools. Embracing the principles of the rapid learning health-care system, a new clinical program called the Precision Oncology Program (POP) was created in New England. The POP integrates generalized knowledge about molecular medicine in cancer with a database of observations from previously treated veterans. The program assures access to modern genomic oncology practice in the veterans affairs (VA), removes disparities of access across the VA network of clinical centers, disseminates the products of learning that are generalizable to non-VA settings, and systematically presents opportunities for patients to participate in clinical trials of targeted therapeutics.
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Affiliation(s)
- Louis D Fiore
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Veterans Affairs Boston Healthcare System, Department of Veterans Affairs Office of Research and Development-Cooperative Studies Program, Washington DC, USA
| | - Mary T Brophy
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Veterans Affairs Boston Healthcare System, Department of Veterans Affairs Office of Research and Development-Cooperative Studies Program, Washington DC, USA
| | - Sara Turek
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Veterans Affairs Boston Healthcare System, Department of Veterans Affairs Office of Research and Development-Cooperative Studies Program, Washington DC, USA
| | - Valmeek Kudesia
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Veterans Affairs Boston Healthcare System, Department of Veterans Affairs Office of Research and Development-Cooperative Studies Program, Washington DC, USA
| | - Nithya Ramnath
- VA Ann Arbor Healthcare System, the University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
| | - Colleen Shannon
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Veterans Affairs Boston Healthcare System, Department of Veterans Affairs Office of Research and Development-Cooperative Studies Program, Washington DC, USA
| | - Ryan Ferguson
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Veterans Affairs Boston Healthcare System, Department of Veterans Affairs Office of Research and Development-Cooperative Studies Program, Washington DC, USA
| | - Saiju Pyarajan
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Veterans Affairs Boston Healthcare System, Department of Veterans Affairs Office of Research and Development-Cooperative Studies Program, Washington DC, USA
| | - Melissa A Fiore
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Veterans Affairs Boston Healthcare System, Department of Veterans Affairs Office of Research and Development-Cooperative Studies Program, Washington DC, USA
| | - John Hornberger
- Cedar Associates, Menlo Park, CA, USA.; Department of Health Research and Policy, Stanford University, Stanford, CA, USA.; Department of Medicine, Stanford University, Stanford, CA, USA
| | - Philip Lavori
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA.; Department of Statistics, Stanford University, Stanford, CA, USA
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