Researchers from all over the globe gathered this week at the annual Defense Department Military Health System Research Symposium (MHSRS). Known as the top military medical conference in the world, it is an academic-based venue for professionals to talk, learn and share with each other. The focus of this year’s event was how military medical experts use cutting-edge research to improve care for the warfighter.
Dr. Richard Stoltz, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) acting director, spoke at this year’s MHSRS. Along with colleagues, Stoltz introduced the knowledge translation process developed at DCoE. He focused his discussion on how using a systematic approach and best practices can impact military psychological health challenges.
Why Knowledge Translation?
Once experts capture medical research data, they may use a knowledge transition process to distill the information into regular clinical practice.
For example, groundbreaking research in medicine needs to undergo lengthy processes, from publication to being accepted by medical associations, before health care providers are regularly using this innovation to better treat patients.
On average, it takes more than a decade for providers to adopt new research. Public health organizations, such as the Centers for Disease Control and Prevention and Agency for Healthcare Research and Quality, see the value in speeding this process up. These agencies invested time and developed their own evidence-based knowledge translation processes.
Stoltz believes the Military Health System (MHS) will benefit from embracing knowledge translation best practices and procedures.
“The leaders at these agencies believe that not having a translation process is like leaving for a road trip without a map or GPS,” said Stoltz. “If we develop a clearer map, we will get to our destination more efficiently."
Navy Capt. Mike Colston, former DCoE director, explained the importance of translating research findings to improve medical practices during his May report to Congress.
“This capability provides a standardized process to use psychological health and traumatic brain injury (TBI) research to develop evidence-based practices and consistent standards of health care,” said Colston. “We are optimistic that this process may also herald advancements in MHS practices beyond psychological health and TBI.”
DCoE Process Model Feedback
During his briefing, Stoltz outlined a DCoE standardized, adaptable knowledge translation process model.
He also offered a practical example of the DCoE process with details from a beta test using the popular Virtual Hope Box mobile app. The purpose of the app, a National Center for Telehealth and Technology (T2) product, is to help people coping with stress and negative emotions.
During the test, T2 included knowledge translation best practices into a behavioral health provider workshop at Fort Carson, Colorado, in October 2016. The success of the initial test inspired additional tests.
Dr. Robert Ciulla, T2 mobile health program lead, and his team executed the beta test. Ciulla believes that although they succeeded in improving providers’ understanding of mobile health tech, proactive teamwork is critical to successful implementation.
“A key piece [of knowledge translation] is promoting behavioral change,” Ciulla said. “We’re asking providers to make fundamental changes to the way they approach their clinical practice.”
Dr. Kathy McGraw, Deployment Health Clinical Center (DHCC) deputy director, supports using knowledge translation to reduce the gap between research and evidence-based practices. A standard process would reduce the time it takes the military to translate research findings into clinical practice, according to McGraw.
McGraw is also part of the Defense Department and Department of Veteran Affairs Practice-Based Implementation Network. This network is a cadre focused on bridging the gap between mental health research and clinical practice in the military and veteran communities.
“Using standardized processes would save time and better inform us [health care providers] on how to invest our resources,” she said.
There are 9.4 million service members, veterans and family members who rely on the MHS for care. The thoughtful discussions during the symposium reflect how important a knowledge translation process is – especially for warfighters.
“Systematic processes that move research from bench to field within the same system can greatly benefit the MHS,” Stoltz said. “Otherwise, good work and important contributions may get stuck on the sidelines.”