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OVERALL INTEGRATED APPROACH AND GOVERNANCE Introduction to the Delaware Valley Institute for Clinical and Translational Science. The Delaware Valley Institute of Clinical and Translational Sciences (DVICTS) was created in 2008 as a key strategic extension of longstanding collaborations between 4 of the largest institutions offering health care services and health care-related education and research in the state of Delaware and elsewhere in the Delaware Valley:
We have created DVICTS to formalize the partnership among these 4 distinct and complementary organizations. In doing so, we are building a critical mass of intellectual and physical resources to evaluate and implement critical clinical and translational research concepts that can help us address the urgent healthcare needs of our region. DVICTS operates under the authority of the Delaware Health Science Alliance (DHSA), cooperative educational and research collaboration. The 4 DVICTS partners also have important affiliations with many institutions in our region with whom we will interact in the context of the CTSA. These institutions include Cheyney University and Lincoln University, both in Pennsylvania, and Delaware State University (all members of the Historically Black Colleges and Universities), 33 hospitals, more than 130 research and clinical centers, and 14 schools and colleges. Collectively DVICTS encompasses approximately $400M of annual sponsored research funding, with $113M/yr of NIH funding, substantial regional clinical trials activity, with a comprehensive track record of training clinical translational researchers and developing new intellectual property. DVICTS integrates pediatric, adult, and geriatric clinical and scientific programs, and aims to create novel, interdisciplinary, inter-professional, team-based educational programs spanning the entire health care training spectrum. DVICTS will develop innovative collaborations between experts in community-based medical practice, health economics, population sciences, information technology, public health and policy, and material and biomedical sciences to improve health care technology and to enhance access to and quality of health services for diverse communities within Delaware and the greater Delaware Valley. As DVICTS will work across several state lines, the lessons learned from this CTSA will also be of drect value to the broader community of CTSAs and enhance the interactions between the national collaborative centers. There are three general categories of translational research, which we define as follows:
Objectives of DVICTS Clinical and Translational Science Award (CTSA): DVICTS has identified three core objectives to enhance clinical and translational research. Moreover, we propose comprehensive and specific, yet innovative, ways to achieve them. These goals are attainable because of the complementary strengths of the four DVICTS partner institutions and their common historic focus on education and patient care. Objective 1: Train the next generation of healthcare-related professionals in translational research. We will develop educational programs aimed at drawing medical professionals, basic life scientists, and informaticists toward clinical and translational science. To this end, we will create novel, interdisciplinary, team-based educational programs spanning the healthcare training spectrum. Training in translational methodology will be integrated into curricula starting with pre-baccalaureate education and running through the professional schools and beyond, into residency and postdoctoral training. Integrating UD's and TJU's commitment to academic research and learning with the missions of the three DVICTS teaching hospitals, we will train and educate medical and life science professionals as well as community leaders about the conduct of translational research. We will integrate expertise within the UD Colleges of Arts & Science, Health Science, Agriculture & Natural Resources, Business & Economics, Education & Public Policy, and Engineering, At TJU, we will draw on resources of Jefferson Medical College and notably, the new School of Population Health. Objective 2: Develop new methodologies to translate research discoveries into clinical trials, clinical practice and ultimately into community health settings. As noted, DVICTS will emphasize T3 translational research (the study of how to best move evidence-based guidelines from T1 and T2 research into health practice, through delivery and dissemination research) and population-based medicine, taking advantage of the formal ties between the four primary institutions and the State of Delaware. Delaware's Health Information Network, DHIN, a one-of-a-kind statewide health information network and the Nemours electronic medical record (EMR, a robust clinical care system for inpatient and outpatient pediatric care that also includes physician order entry, automated pharmacy dispensing, bar code medication administration checking, and computer-generated alerts and reminders) provide the infrastructure necessary to disseminate health care discoveries to the community across the entire state, also gives researchers a novel tool for measuring success of new approaches to translate research discoveries into clinical practice. To further enhance T3 efforts, we will augment the existing infrastructure with automated, targeted translational research communications systems, and will provide individuals with access to Personal Health Records, such as Google Health Record. The extensive hospital networks of the partner institutions, including the cancer and cardiovascular networks serving Delaware and parts of southeastern Pennsylvania, New Jersey and Maryland will provide additional opportunities for health care delivery and investigations of it. These networks will ensure access to the diverse population in this 4-state region. This is complemented by over 140 years of community outreach experience in the UD College of Agriculture and Natural Resources and college of Earth, Ocean and Environment through continuous funding of land grants and 33 years of sea grants. Objective 3: Implement and assess programs aimed at improving specific health outcomes of the community in Delaware. Within DVICTS, we will develop innovative collaborations between experts in community-based medical practice, health economics and policy, population sciences, public health and policy, and material and biomedical sciences to improve health care technology and to enhance access to critical health services for the diverse communities within the state of Delaware. By including all residents within a defined community that mirrors national demographics, we will have a test-bed to identify successful translational methods and technologies that can then be applied to the benefit of other communities in the Delaware Valley. In Delaware, we will test and evaluate the effects of our interventions. Through the CTSA consortium, these discoveries can also be transferred to communities throughout the nation. Key Resources for T3 Research by DVICTS: The Delaware Valley, including the entire state of Delaware and surrounding parts of Pennsylvania, New Jersey, and Maryland, has continuing public health problems and health care disparities in such areas as hypertension, obesity, diabetes, and cancer screening that mirror those in the United States as a whole. At the same time, Delaware offers a matchless laboratory for developing, implementing and evaluating new approaches to health care in this country for the following reasons: 1) Its small size and population permit studies involving the whole state; 2) demographically, Delaware is similar to the US in terms of ethnic and racial composition and the urban-to-rural population distribution; and 3) Delaware has a unique, successful, state-wide Regional Health Information Organization (RHIO), the Delaware Health Information Network (DHIN). DVICTS will use and enhance the data resource opportunity that DHIN presents. Moreover, the Delaware Valley in general and DVICTS partners in particular, have population health science, epidemiology, biostatistics and informatics resources and expertise that can be creatively harnessed for research and implementation in this virtual laboratory, making it ideally suited for a CTSA that emphasizes T3 research, i.e. research into how the dissemination of translational research results impacts community practice and public health. Thus, placing this virtual laboratory at the center of our CTSA offers a powerful public health research resource. While T3 research plays a greater role in this proposal than in most other CTSA applications, we will also show that the critical mass created by forming the DVICTS partnership is letting us bring together key human and physical resources needed for innovative inter-institutional, cross-disciplinary T1 and T2 research as well. Many such new and planned collaborations are now possible because the Delaware DVICTS partners have NCRR-NIH grant funding earmarked for institutions in smaller states, including IDeA Networks of Biomedical Research Excellence (INBRE) and Centers for Biomedical Research Excellence (COBRE) grants spanning fields including biomechanical and tissue engineering, proteomics and bioinformatics along with core instrumentation to conduct this research. At the same time, Thomas Jefferson University brings to this translational research partnership proven expertise in biomedical research and mentored clinical translational education. Using this special combination of resources to understand and address the regional healthcare challenges for this CTSA effort will result in specific measurable outcomes. |