Showcase MHS Excellence! Fix CRADAs that Block MHS Participation in National Benchmarking Registries
How do the MHS and individual military treatment facilities stack up when it comes to survival of extra-low birthweight premature infants? Maximizing growth of children with pediatric kidney disease? Developmental and school outcomes of premature infants? Prevention of rejection in pediatric renal transplant recipients? The answer: much better than the national average.
Pediatricians and neonatologists caring for infants and children in the MHS know this since they compare their local experience to data from large networks of hospitals and health systems. The registries formed from these large networks, originally formed to answer research questions and identify best practices, increasingly serve as the origin of national benchmarks for hospitals and clinics for quality of care, adherence to clinical practice guidelines, and patient outcomes. Notable pediatric registries serving in this capacity include the Vermont-Oxford Network and the North American Pediatric Renal Collaborative Studies. A quick review of their websites shows that quality benchmarks are as much - if not more - about setting quality standards as about generating research.
So what's the problem? The problem is that no one outside each individual MTF knows how MHS pediatric and neonatal care measure up in terms of quality and excellence. Restrictive CRADAs, (Cooperative Research and Development Agreements), prevent MTFs from participating in these quality benchmarking networks run by non-governmental organizations. CRADAs are designed to protect the government and private interest's intellectual property and were originally meant to speed the commercialization of technology. However, CRADAs, in their boiler-plate form with legal language about technology and patents, have been an insurmountable sticking point when MTFs have wanted to participate in these national data sharing registries.
Let’s find a way to showcase MHS excellence and stimulate quality improvement by allowing our MTFs to participate in these registries. There is a way to safeguard personal health information, protect the government’s interest, and form collaborations with national medical registries. Get the lawyers, health care administrators, and research experts together to draft a common-sense CRADA for medical registry participation. Let’s start with the Vermont-Oxford Neonatal Network and the North American Pediatric Renal Collaborative Studies at one MTF, and then scale participation up to other MTFs of all three services and to similar registries in surgery, internal medicine, ophthalmology, orthopedics, and other specialties.
This is an easy-to-implement, inexpensive, and cost-effective way to highlight MHS excellence as part of a strategic communications plan. The innovation lies in its simplicity: remove one regulatory stumbling block and allow the peer-networks to showcase and drive quality across the board in more metrics and in more disciplines than a policy-maker could mandate by fiat - or you, as a reviewer, can imagine.