Booz Allen Hamilton

Discovery Vs. Delivery: Bridging The Great Health Care Divide

April 13, 2015

By Gretchen Thompson and Caitlin Edgar

When Alexander Fleming discovered penicillin—accidentally, so the legend goes—in 1928, one of the greatest breakthroughs in the history of medicine landed without so much as a thud.

Few were excited by the news. It took two more years before the first recorded cure of anything using penicillin was on the books, and 10 years after that before a method for mass production was developed. Even then, drug production was low. We simply couldn’t connect the dots fast enough.

Penicillin wouldn’t be available to the American public until 1945, a full 17 years after Fleming’s fortunate discovery inside a moldy petri dish. The eventual public rollout was hailed as a modern miracle, though not a prayer that was answered quickly. Many died from otherwise treatable infections due to the gap between discovery and delivery.

What did we learn from that ordeal? Hard to say. More than a half-century later, not so much has changed.

Today, we continue to face discrepancies between the medical and health science we know, the care that we provide, and the policies that we make. Despite miracle advancements in our ability to instantly network researchers from around the world, to share data globally from the comforts of our homes, and to connect doctors with patients on other continents, we have as many unanswered questions as ever.

Are vaccines safe? Have we really discovered a cure for Ebola? Has nature evolved to a point where the antibiotics ushered in by Fleming and others will no longer save lives in the future?

Questions are plenty but answers are few.

Since 2001—in response to an Institute of Medicine (IOM) report released that year detailing the growing challenges in coordinating biomedical and clinical research with health care delivery and health policy—research institutions, medical facilities, and policy makers have endeavored to narrow the gap. With studies showing that it could still take 17 years for research to reach clinical practice and health policy (no faster than the penicillin lifecycle from 50 years earlier) the IOM announced that the “nation’s healthcare delivery system has fallen far short in its ability to translate knowledge into practice and to apply new technology safely and appropriately.”

The news led to investments in translation and implementation science, which seek to apply evidence-based practice to real-life settings and identify the factors that interrupt its uptake. But even with these investments, change comes slowly. The National Institutes of Health have identified a variety of challenges for translation and implementation science, including the limited external validity of randomized-controlled trials, the diversity of primary care practice, and the burden of chronic disease in the U.S.

But perhaps most concerning is the lack of successful, ongoing collaboration between the research, medical professional, and patient communities. No one’s talking. And that’s where Booz Allen is making a difference.

To address the myriad challenges, we increasingly see policymakers, clinical providers, and researchers approach the Clinical-Research Continuum as a holistic framework for understanding the progression from scientific research to clinical practice and population health. Where there are gaps, Booz Allen builds bridges, linking partners across functions.

We deliver expertise in research design and execution, research portfolio management, training and dissemination tools, clinical operations, performance metrics, and advanced analytics to support our clients in executing research, dissemination, practice, policy, and impact evaluation. Our approach includes bringing the most advanced communications specialists and SMEs to augment our clinical research and data science teams so that findings and reports are effectively disseminated and recommendations subsequently implemented.

Together with our clients, we seek to execute the highest quality research, provide cutting-edge clinical care, and craft meaningful policy to continuously improve individual and population health. No more relying on luck and miracles.