Abstract
Background/Aims Cancer Screening Effectiveness And Research in Community-based Healthcare (SEARCH) involves 8 Cancer Research Network (CRN) sites and includes two comparative effectiveness research (CER) proof-of-principle studies anchored in colorectal and cervical cancer screening. This portion of the project was designed to:
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understand how cancer screening guidelines are developed, implemented and disseminated at each site;
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identify the appropriate clinical leads within each health plan to further engage in bidirectional discussions about future comparative effectiveness cancer screening research and to help disseminate SEARCH findings across the CRN sites; and
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identify opportunities for researchers and clinical leaders to collaborate on informing each other and/or conducting comparative effectiveness research together.
Methods We conducted 18 semi-structured interviews with clinical leaders across 8 health plans (GHC, Geisinger, Marshfield, Fallon, Harvard Pilgrim, Kaiser: Northwest, Hawaii, Northern California) and with one State-wide quality improvement group.
Results There is considerable site variability in guideline development, implementation and dissemination processes. Much work goes into reviewing evidence and developing clinical guidelines; parallel work and evidence reviews happen across. Many different vehicles are used for guideline dissemination; opportunities exist to study how to most effectively disseminate guidelines to patients and providers to yield optimal screening. Clinical leaders provided critical information around principles and required elements for conducting CER. Opportunities, barriers and principles around conducting CER will be presented.
Discussion There are a number of areas that can be immediately leveraged: to further facilitate learning health care systems, and for researchers and delivery systems to improve the cancer screening guideline development, dissemination and implementation. We see important opportunities for helping the research network and its member sites develop and use guidelines more efficiently to improve care and enhance the research we conduct. Research teams must work with key leaders to identify high priority CER studies and to hard-wire the conduct of CER trials into standard clinical work-flow.
