Granite Geek: Medical research is great, sure, but how can you get it out to actual patients?

By DAVID BROOKS

Monitor staff

Published: 09-02-2024 9:00 AM

Moving results from the research world into the real world can be a real challenge but I think the challenge is hardest when the research concerns people’s health.

It’s one thing to show that a medicine or treatment or practice helps patients in a lab setting, where everything is nice and controlled. It’s something else to roll it out to the world’s hospitals and doctors and nurses and dentists and urgent-care clinics and home health agencies and ambulance paramedics and, who knows, maybe even veterinarians, and still have it help us despite patient preferences, industry habits and (worst of all) health insurance constraints.

Maneuvering through that maze is the goal of an interesting new online master’s degree program at Dartmouth’s Geisel School of Medicine, involving something called implementation science. The 9- or 18-month program is designed, the school says, “to identify and address gaps in moving evidence-based clinical practices into routine use in the real world.”

It is the medical school’s first online-only degree program, and only the second at Dartmouth.

I had never heard of implementation science until I saw the school’s announcement. The formal field is pretty new, although the idea of translating research into practice dates back forever. The field is established enough to have its own scientific journal and a few research hubs, including the year-old Dartmouth Center of Implementation Science or DCIS. 

“Implementation scientists identify programs and policies that work, and collaborate with stakeholders to get people to actually use or follow them,” is how Jeremiah Brown, PhD, a professor of epidemiology at Geisel and founding director of DCIS, described it in a statement from the school.

The program has a target of 50 students annually, including international enrollment. I’m sure that luring overseas grad students as well as older folks looking to change or boost careers. It’s a big reason the degree is totally online, since even Dartmouth has to be concerned about America’s looming shortage of graduating high-school seniors.

News of this degree came on the heels of a sort-of-related announcement from the Geisel School of Medicine about a $2.1 million grant to study what it calls the first-ever trial of ways to involve patients and the public in research studies.

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That announcement sounded weird at first since health research studies are already done with patients and the public – I mean, who else are you going to use? This approach, called PPI for “patient and public involvement” because everybody loves initialisms, is designed to go a lot further. It wants to get folks other than the research team participating not just as subjects of studies but as part of the design and implementation team, as well as helping to communicate results and even figure out how to use them. 

That last bit is what implementation science is all about, too: figuring out how to turn academic results into life-changing actions.

It’s encouraging to see the medical research field realize that they haven’t always done a great job of making sure their discoveries actually help people.  Bridging the town-and-gown gap is always beneficial.

Here I’d like to add a note of caution. We need to be careful not to fall into the trap of dismissing the importance of academia’s “ivory tower.”

There’s a reason why people trying to understand the world, for clear back as far as written records exist, often separate their work from day-to-day existence. This seems to be a necessary part of distilling problems down to solvable form. If we don’t maintain places for such separation to occur, if we think that the only true wisdom comes from everyday life and “common sense” (a meaningless phrase but a potent one), we will be shooting ourselves in the foot.

Speaking of which, I hope the implementation scientists can design better ways to implement treatment of plantar fasciitis, the inflammation of tissue on the bottom of the foot. I’m tired of hopping around like Chester on Gunsmoke when I get up in the morning. 

David Brooks can be reached at dbrooks@cmonitor.com.