South Carolina goal: Use technology effectively
Training, data collection will be enhanced
The NIH roadmap calls for research collaborations that would harness technologies into a virtual research enterprise, which is one of the first areas in which the collaboration called Health Sciences South Carolina is focusing.
Also, the roadmap envisions the training of thousands of practitioners so they might conduct research in their own community offices, which would greatly expand the available pool of research participants. Here is a brief look at the ways the South Carolina effort might serve as a model for the NIH research roadmap:
- Harnessing technologies: Information technology (IT) companies were among the first to see the potential of the South Carolina collaboration, says Raymond S. Greenberg, MD, PhD, president of Medical University of South Carolina.
If the four institutions integrate their databases, which now are recorded on different operating systems, there’s potential for having a huge patient database available to investigators who seek to recruit patients with specific diagnoses, Greenberg says.
"We’re in the process of selecting our vendor," Greenberg says. "It would be nice if everybody was on the same template."
Once the infrastructure is in place, the collaboration could bring research training and clinical trials protocols to satellite and rural facilities, says Harris Pastides, PhD, vice president for research and health sciences at the University of South Carolina at Columbia.
"The protocol would be identical, but the beauty of having developed the infrastructure is you could have a satellite microcomputer with the right software and communication vehicles available for staff in Orangeburg Community Health Center, for example," he says. "They could recruit patients and monitor blood pressure, input the information in the microcomputer and transmit it to Columbia or wherever the hub is."
Improving health disparities
- Moving research to small communities: Due to the agricultural-textile state’s large rural population, there are entrenched health disparities that have contributed to the state’s last or near bottom rating on various conditions, including prevalence of heart disease, breast cancer, colon and prostate cancer, and trauma injury.
"Researchers at Palmetto Health are finding that there’s evidence African American women have a higher mortality rate, and we’re not sure why that is," says Judy C. Smith, coordinator for Health Sciences South Carolina.
"When we have the opportunity to work in three large geographic areas with the same breast cancer data, we’ll be able to explore and help solve that problem," she says. "Sharing common problems with the whole geographic base can help open eyes for researchers to new possibilities."
Health clinics and practitioners in these rural and poor areas have lacked the resources necessary to improve these health disparities, and that’s something that is being addressed by Health Sciences South Carolina.
The collaboration might start with expanding research to the satellite facilities of the participating institutions, and if that works then it will expand research projects to the truly rural areas of the state, Pastides says.
"We could have a sponsor who wants a hypertension trial with African American males or females in certain age groups," he says. "And it might take longer to recruit in Charleston, but between three and four community health centers we could do it more quickly."
Bringing clinical trials to areas serving rural and poor populations will bring these areas access to cutting-edge treatments and technology, says Jim Raymond, MD, senior vice president for medical education and research at Palmetto Health.
"There’s good evidence in the literature that individuals who participate in clinical research have an overall better quality of life and health outcomes," he adds.
Work force recruiting
- Enhance clinical research work force training:
Palmetto Health has developed, starting this year, a clinical research institute that will be a training ground for clinical researchers, Raymond reports.
The health care organization has created an 18-month intensive curriculum with seven faculty members, he says.
The training institute is designed for physicians and other doctorate-level researchers, although there is separate training available for research coordinators, Raymond says.
"We’ve gotten different departments to agree to give us 20% of these individuals’ time for the training," he adds. "The curriculum includes human subjects protection, research methodology, statistics, history, and everyone will have a project to complete, including the submission of a grant."
Eventually, this program could be made into a degree program and expanded to provide training to health care providers who will be working with Health Sciences South Carolina, but who are not employees of Palmetto Health, Raymond says.