Future Directions for Translational Informatics - Translational Informatics: Realizing the Promise of Knowledge-Driven Healthcare - page 166

10.3.3 New Model

10.3.3.1 Enabling a Virtuous Cycle Between Research and Practice

to Create a Learning Health System

As previously mentioned, the IOM has recognized the need for a “learning health-
care system” that will systematically improve based on evidence gleaned in the
course of healthcare delivery [ 8 ]. What the above noted challenge make clear is that
in order to achieve such a vision, a fundamental paradigm shift in the relationship
between research and practice is needed. Rather than the current unidirectional rela-
tionship between research and practice, the new paradigm recognizes the essential
connection between practice and research. The end result is the cyclical generation,
application, and refi nement of high-quality evidence (via Evidence Based Medicine)
with the insertion of Evidence Generating Medicine (EGM) as the missing concept
needed to create such a virtuous evidence cycle (Fig. 10.2 ).
As defi ned in our recent publication on the topic, EGM involves: “the systematic
consideration and incorporation of evidence generating activities into the organiza-
tion and practice of healthcare to advance biomedical discovery and improve the
health of individuals and populations” [ 25 ].

Fig. 10.2 The “Evidence Cycle” that emerges with a paradigm shift from a uni-directional model
of the research-practice relationship to one that is a “virtuous cycle” of evidence, including both
the generation of evidence through practice-enabled research (i.e. via Evidence Generating
Medicine) and the application of research-derived evidence to practice (i.e. Evidence Based
Medicine)