BOSTON--“We’re in first place, but the wrong first place,” Leonard D’Avolio, PhD, director of the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), said of the U.S. global ranking in healthcare costs at the Medical Informatics World Conference on April 8. As the U.S. ranks only 37th in care, D’Avolio is on a mission to move the dial on healthcare delivery through a learning healthcare system.
At MAVERIC, D’Avolio is involved in cutting-edge science to amass large amounts of data to improve care. MAVERIC is an interdisciplinary research and development organization working to create a learning healthcare system within the Department of Veterans Affairs (VA) through the application of research resources and methodologies to important clinical problems, he said.
The goal: build one of the world's largest medical databases by safely collecting data stored anonymously for research on diseases like diabetes and cancer, and service-related illnesses, such as post-traumatic stress disorder.
MAVERIC’s ultimate large-scale initiative is obtaining blood samples and health information from one million veteran volunteers. After collecting the blood, the DNA data is surveyed, linked to EMR data and made accessible to researchers, D’Avolio explained.
The organization encompasses four competencies: epidemiology, core laboratory, clinical trails and biomedical informatics. The core laboratory stores more than 500,000 samples for VA researchers. The Epidemiology Research and Information Center promotes VA-based population research, including genomic analyses, for VA providers’ use to improve quality of care.
“The challenge is to facilitate personalized medicine. It does not happen without deep knowledge of biology and large sample sizes,” he said.
The data also is used in clinical trials through its Cooperative Studies Program Coordinating Center (CSP), he said. Through collaborative efforts with federal, university, international and vendor partners, CSP accomplishments have included key research findings across a range of diseases and have helped to provide definitive evidence for clinical practice within the VA and the country at large, he said.
“Pharma is not turning out enough drugs to stay sustainable,” he explained, noting that many drugs in clinical trials fail, costing companies millions of dollars.
The answer is moving toward “real world” systems. In other words, a clinical trial is entered into an EHR. “You turn every situation where you don’t know what works best into a clinical trial.”
D’Avolio said veterans have been receptive to participating. “We tell veterans that the machine will choose your care, and ask ‘are you cool with that?’ 90 percent say yes,” he said.
The MAVERIC director also stressed the importance of partnering with nontraditional researchers.
“All stakeholders have skin in the game,” he said.