The VA Point-of-Care Precision Oncology Program: Balancing Access with Rapid Learning in Molecular Cancer Medicine

Author:

Fiore Louis D.1,Brophy Mary T.1,Turek Sara1,Kudesia Valmeek1,Ramnath Nithya2,Shannon Colleen1,Ferguson Ryan1,Pyarajan Saiju1,Fiore Melissa A.1,Hornberger John34,Lavori Philip56

Affiliation:

1. 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.

2. VA Ann Arbor Healthcare System, the University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA.

3. Cedar Associates, Menlo Park, CA, USA.

4. Department of Medicine, Stanford University, Stanford, CA, USA.

5. Department of Biomedical Data Science, Stanford University, Stanford, CA, USA.

6. Department of Statistics, Stanford University, Stanford, CA, USA.

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 healthcare 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.

Publisher

SAGE Publications

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